Healthcare Assistance for Single Mothers in New Mexico: Medicaid, CHIP & More [2025]

Last updated: September 2025

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Quick Help Box

• Apply online for Medicaid/CHIP at Yes New Mexico or call the application line at 1-855-637-6574. For case questions, call the Consolidated Customer Service Center at 1-800-283-4465 (Mon–Fri 7:00 a.m.–6:30 p.m. MT). (hca.nm.gov)
• Pregnant right now? Ask your clinic or hospital for “Presumptive Eligibility” so coverage can start the same day while your full application is processed (temporary coverage lasts through the end of the next month, up to 60 days). (hca.nm.gov, casetext.com)
• Kids under 6 keep continuous Medicaid coverage without annual renewal through their 6th birthday (approved 1/1/2024). (hca.nm.gov)
• Not eligible for Medicaid? Shop plans at BeWellnm (the NM Marketplace) with extra state help. Open Enrollment is Nov 1–Jan 15; many losing Medicaid get their first month’s premium paid automatically. Free help: 1-833-862-3935 (TTY 711). (bewellnm.com, hca.nm.gov)
• Need mental health help now? Call the New Mexico Crisis & Access Line 1-855-NMCRISIS (1-855-662-7474) 24/7, or dial/text 988. (nmcrisisline.com)
• Native American families may use IHS/Tribal clinics and can choose Fee-for-Service or a Turquoise Care plan. Albuquerque IHS main line: 505-248-4000. (hca.nm.gov, ihs.gov)
• Hospital/clinic bills and no coverage? Ask about financial assistance:
  UNM Health Financial Assistance 505-272-2521; Presbyterian Patient Financial Services 1-800-251-9292. (unmhealth.org, phs.org)

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Quick Reference Cheat Sheet (2025)

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How to Apply (fastest path first)

1. Apply online (fastest): Create an account and submit at Yes New Mexico. Upload pay stubs, ID, and pregnancy verification if you have it. You’ll get messages in your portal about any missing items. (hca.nm.gov)
2. Apply by phone: Call 1-855-637-6574 to complete the application. Keep your case number handy for follow‑up. (hca.nm.gov)
3. In person: Use the HSD/ISD Field Office locator to find your county office and lobby hours; most offices are open Mon–Fri 8:00 a.m.–4:30 p.m. (some have reduced hours). (hsd.state.nm.us)
4. If you’re pregnant and at a clinic or hospital: Ask staff to screen you for “Presumptive Eligibility” (PE). If eligible, your temporary Medicaid starts the same day and runs through the end of the next month while your full application is processed. (casetext.com)

Real‑world example

Maria, an Albuquerque mom with a preschooler, applied online on a Tuesday evening. Her OB clinic submitted Presumptive Eligibility the next morning, so prenatal visits and labs were covered that week. She uploaded pay stubs in the portal and selected a Turquoise Care plan when approved.

What to do if this doesn’t work:

• Call the CCSC at 1-800-283-4465 to check your case or to report that you submitted documents.
• If you need care immediately and are pregnant or your child is sick, ask the clinic about PE or charity care while the application is pending. UNM Health’s Financial Assistance team is at 505-272-2521. (hca.nm.gov, unmhealth.org)

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Who Qualifies in 2025 (Medicaid & CHIP)

New Mexico uses the 2025 Federal Poverty Guidelines and category-specific rules. Below are official monthly income thresholds from the New Mexico Health Care Authority’s MAD‑222 chart (effective 4/1/2025–3/31/2026). (hca.nm.gov)

• “Other Adults” (expansion, ages 19–64): up to 138% FPL.
• Parent/Caretaker: under the state “Fixed Standard” (see table).
• Pregnant Individuals: Category 300 (Fixed Standard) and Category 301 (up to 250% FPL), both with 12‑month postpartum coverage.
• Children 0–5: Medicaid up to 240% FPL; CHIP up to 300% FPL.
• Children 6–18: Medicaid up to 190% FPL; CHIP up to 240% FPL.
• Family Planning Only: up to 250% FPL (services limited to family planning). (hca.nm.gov)

2025 Monthly Income Guide (selected thresholds)

Source: MAD‑222 2025–2026. (5% income disregard applies to certain groups as noted in the chart.) (hca.nm.gov)

What to do if this doesn’t work:

• If your income is just over the limit, you may still qualify for PE during pregnancy, and children may be eligible at higher levels (see table).
• If you’re over Medicaid/CHIP income, use BeWellnm for subsidized private plans; state programs can reduce both premiums and out‑of‑pocket costs. (hca.nm.gov)

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Pregnancy & Postpartum Coverage (12‑Month Postpartum Rule)

Most pregnant applicants in NM qualify either under the Fixed Standard (Category 300) or up to 250% FPL (Category 301), and both provide full Medicaid benefits. New Mexico provides 12 months of postpartum coverage after the pregnancy ends (for any outcome). If your income changes, you keep coverage through the end of the 12‑month postpartum period. (hca.nm.gov, casetext.com)

• Start same‑day coverage via Presumptive Eligibility (PE) at a clinic or hospital while your regular application is processed. PE lasts through the end of the next month, up to 60 days. (casetext.com)
• Medicaid also pays for FDA‑approved over‑the‑counter contraception like Opill, plus pregnancy tests and emergency contraception at $0 at the pharmacy counter (show your Medicaid card). (hca.nm.gov)

Timeline: Pregnancy & Postpartum (what to expect)

What to do if this doesn’t work:

• If your PE window ends and your full case isn’t decided, call 1-800-283-4465 and your clinic’s eligibility worker.
• If you’re over income for Medicaid, book a no‑cost appointment with a BeWellnm assister (1-833-862-3935) to enroll in a subsidized plan mid‑year due to life event (birth). (hca.nm.gov, bewellnm.com)

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Children’s Coverage (Medicaid & CHIP)

• Babies born to a mom on NM Medicaid get 13 months of full Medicaid automatically as “Newborn Medicaid.” (hca.nm.gov)
• Children 0–5 qualify up to 240% FPL for Medicaid and up to 300% FPL for CHIP; ages 6–18 qualify up to 190% FPL for Medicaid and up to 240% FPL for CHIP. CHIP has no copayments in NM under Categories 420/421. (hca.nm.gov)
• Continuous coverage: Children from birth to age 6 keep coverage without annual renewals (approved 1/1/2024). (hca.nm.gov)
• EPSDT (“Keeping Kids Healthy”) means Medicaid covers all medically necessary services for kids—checkups, vaccines, therapies, dental/vision, and more. (hca.nm.gov)

What to do if this doesn’t work:

• If your child lost coverage due to paperwork, call 1-800-283-4465 and ask about reinstatement if you submit missing documents.
• Make sure your address is current and watch for mail from HCA; kids under 6 should not be re‑determined annually under the continuous coverage policy. (hca.nm.gov)

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Your Medicaid Plan Choices (Turquoise Care)

As of July 1, 2024, most NM Medicaid members enroll in one of four plans. You can change plans during open choice windows or with “good cause” if needed (provider not in network, etc.). (hca.nm.gov)

Plan contacts, member services, and ride (NEMT) numbers

Tips:

• Use your plan’s app or portal to pick a PCP and request rides 48 hours ahead.
• Native American members can opt out of managed care and use Fee‑for‑Service with IHS/Tribal clinics if preferred. (hca.nm.gov)

What to do if this doesn’t work:

• If no ride is available or denied, call your plan back and ask for the transportation vendor’s “Ride Assist” desk, then file a grievance if needed (keep the trip reference number). Plan complaint contacts are listed on the HCA plan page. (hca.nm.gov)

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If You’re Over the Medicaid Limit: Affordable Marketplace Coverage (BeWellnm)

New Mexico adds state-funded savings on top of federal tax credits.

• Enrollment window: Nov 1–Jan 15 (coverage starts as early as Jan 1 if you enroll by plan deadlines). Losing Medicaid triggers a Special Enrollment Period and the first month’s premium may be paid for you automatically if you qualify. Free enrollment help statewide: 1-833-862-3935 (TTY 711). (bewellnm.com, hca.nm.gov)
• Programs include New Mexico Premium Assistance (lowers premiums), Turquoise Plans (extra-low deductibles/copays), and Clear Cost Plans (standardized costs so you can compare more easily). (hca.nm.gov)

What to do if this doesn’t work:

• If you can’t afford the marketplace plan even after subsidies, check hospital financial assistance and community health centers (below), and ask about the New Mexico Medical Insurance Pool for temporary coverage. (unmhealth.org, nmhealthcenters.org, nmmip.org)

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Low‑Cost Care if You’re Uninsured (or waiting for a decision)

• Community Health Centers (FQHCs) provide primary care, dental, and behavioral health on a sliding fee scale across the state: use the NM Primary Care Association’s “Find a Clinic” tool. (nmhealthcenters.org)
• Hospital Financial Assistance:
  • UNM Health (covers UNM Hospital/UNM Medical Group; UNM Care/Out‑of‑County Care for eligible residents). Help line 505-272-2521. (unmhealth.org)
  • Presbyterian Healthcare Services Financial Assistance. Call 1-800-251-9292 for help or to apply. (phs.org)
• New Mexico Medical Insurance Pool (NMMIP): a state high‑risk pool that offers coverage if you’re denied other insurance or stuck between enrollments. Customer service 1-866-306-1882; Executive Office 1-505-424-7105. (nmmip.org)
• Family Planning: Title X clinics provide low/no‑cost birth control and related care (teens can get services without a parent’s permission; citizenship not required). Nurse line 833‑SWNURSE (833‑796‑8773) and clinic locator available from NMDOH. (nmhealth.org)
• WIC: Nutrition for pregnant/postpartum women, infants, and kids under 5 with income up to 185% FPL. Statewide line 1‑866‑867‑3124. (fns.usda.gov, nmhealth.org)

What to do if this doesn’t work:

• Use the 24/7 NM Crisis & Access Line 1-855-662-7474 for mental health support and referrals. For primary care, call a community health center and ask for same‑day “sick visit” slots; many centers hold urgent appointments for established and new patients. (nmcrisisline.com)

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Documents You’ll Need (Application Checklist)

• Photo ID (if you have one) and proof of NM residency (lease, utility bill, or letter).
• Social Security numbers (if available) for applicants; immigration documents for non‑citizens applying.
• Income for the last 30 days (pay stubs, employer letter, unemployment).
• Pregnancy verification (clinic note/lab report) if pregnant.
• Childcare costs and health insurance info (if any).
• For self‑employed: recent invoices or a profit‑and‑loss statement.
• Bank/asset info generally not required for MAGI Medicaid, but may be needed if applying for disability‑based categories.

Where to send: Upload in your YesNM account, bring to a field office, or call 1-800-283-4465 to ask the best way to submit. (hca.nm.gov)

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Common Mistakes to Avoid

• Waiting to apply because you “make too much.” NM children’s thresholds are higher than many expect, and pregnancy coverage goes up to 250% FPL. Apply and let the state check. (hca.nm.gov)
• Not asking for Presumptive Eligibility when pregnant. This is the fastest way to get visits covered immediately. (casetext.com)
• Skipping your plan choice. If you don’t pick a Turquoise Care plan, one is assigned—your current doctor might not be in that network. (hca.nm.gov)
• Missing mail. Keep your address/phone updated with HCA to avoid lost notices, especially at the end of the postpartum year. (casetext.com)
• Paying out of pocket at a hospital before asking about financial assistance or charity programs. Many systems can reduce or forgive bills based on income. (unmhealth.org, phs.org)

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Transportation, Dental, Behavioral Health—What’s Covered?

• Non‑Emergency Medical Transportation (NEMT): All Turquoise Care plans offer rides to appointments and pharmacies. Book 48 hours ahead; numbers differ by plan (see plan table above). (phs.org, bcbsnm.com)
• Dental: Children get comprehensive dental through EPSDT; adults have covered dental through the Medicaid plan network (amounts and services vary by plan; ask Member Services). Fee‑for‑Service members can use the HCA dental directories. (hca.nm.gov)
• Behavioral Health: Covered by all plans; 24/7 crisis help at 1‑855‑NMCRISIS (662‑7474) and via 988. Plans also offer nurse lines and tele‑behavioral options. (nmcrisisline.com)

What to do if this doesn’t work:

• If you’re told a benefit isn’t covered, ask for the exact policy citation and how to file a plan appeal. The HCA plan page links to each plan’s grievances/appeals process. (hca.nm.gov)

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Local & Community Resources (statewide highlights)

• Community Health Centers: use the statewide finder to locate medical/dental/behavioral health on a sliding fee. (nmhealthcenters.org)
• Indian Health Service (IHS): Albuquerque Indian Health Center 505‑248‑4000; many pueblos and tribal clinics offer primary care, women’s health, and pharmacy. (ihs.gov)
• Children’s Medical Services (NMDOH): Care coordination, specialty clinics, and possible payment help for kids with special health needs. Toll‑free 1‑877‑890‑4692. (nmhealth.org)
• NM Crisis & Access Line: 1‑855‑662‑7474 (24/7), Warmline 1‑855‑4NM‑7100 (peer support). (nmcrisisline.com)

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Tables You Can Use Today

Table A — Where to apply and get help

Table B — 2025 Family Income Examples (monthly)

Source: MAD‑222 2025–26. (hca.nm.gov)

Table C — Pregnancy & Postpartum Pathways

Table D — Turquoise Care plan quick contacts

Table E — Low‑Cost Care if uninsured

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Diverse Communities: Getting the Right Door the First Time

• LGBTQ+ single mothers: All Medicaid plans must offer inclusive, nondiscriminatory care. If you need a provider who affirms your identity, ask your plan’s Member Services to filter by “LGBTQ+ friendly” in the directory. If you encounter bias, file a grievance with your plan and notify HCA. (hca.nm.gov)
• Single mothers with disabilities or disabled children: Children’s Medical Services (NMDOH) coordinates specialty clinics and may help with certain costs for eligible conditions. Call 1‑877‑890‑4692. EPSDT covers medically necessary therapies/equipment for kids on Medicaid. (nmhealth.org, hca.nm.gov)
• Veteran single mothers: You can enroll in Medicaid/CHIP and still use VA benefits. If you lose Medicaid, BeWellnm has extra state assistance to reduce premiums. (hca.nm.gov)
• Immigrant/refugee single moms: Many immigrants qualify for full‑scope Medicaid when lawfully present; emergency services (EMSNC) may pay for labor/delivery regardless of status—ask hospital financial counselors (UNM contact 505‑272‑2521). (unmhealth.org)
• Tribal citizens: You may use IHS/Tribal/Urban Indian facilities and can opt into or out of Turquoise Care managed care. For local IHS care in Albuquerque, call 505‑248‑4000. (hca.nm.gov, ihs.gov)
• Rural moms with limited access: All plans cover telehealth; NEMT can connect you to distant appointments (book 48 hours ahead). Community health centers operate in nearly every county; use the clinic finder. (nmhealthcenters.org)
• Single fathers raising children: The same rules and income thresholds apply; children’s and family planning benefits are neutral to gender and sexual orientation. (hca.nm.gov)
• Language access: HCA provides interpretation and translated materials; plans also offer interpreters at no cost. If language was a barrier in your appointment, report it to your plan and HCA. (hca.nm.gov)

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Frequently Asked Questions (New Mexico‑specific)

• How fast can I get coverage if I’m pregnant?
  PE can start same day through a certified clinic/hospital and lasts through the end of the next month while your full case is processed. (casetext.com)
• Do babies get automatic coverage?
  Yes. Babies born to a mom on NM Medicaid get 13 months of full coverage as “Newborn Medicaid.” (hca.nm.gov)
• My toddler keeps getting renewal mail—should I worry?
  Children from birth to age six have continuous coverage and should not need annual renewal during that period. Keep your address updated. (hca.nm.gov)
• Are there CHIP copays in New Mexico?
  No. NM CHIP categories (420/421) list “No co‑payments.” (hca.nm.gov)
• Can I get rides to appointments?
  Yes. Each Turquoise Care plan provides NEMT rides—call your plan’s transportation number at least 48 hours ahead. (phs.org, bcbsnm.com)
• I just lost Medicaid—what now?
  You can enroll in BeWellnm with a Special Enrollment Period. If you qualify for federal tax credits, New Mexico may cover your first month’s premium automatically. Call 1‑833‑862‑3935. (hca.nm.gov)
• Where can I get free birth control or Plan B if I’m on Medicaid?
  NM Medicaid covers OTC contraception like Opill, pregnancy tests, and emergency contraception at $0 at the pharmacy counter. Title X clinics also offer low/no‑cost family planning statewide. (hca.nm.gov, nmhealth.org)
• I don’t have papers. Can I still get help?
  Emergency Medical Services for Non‑Citizens (EMSNC) can cover emergencies including labor/delivery. Hospitals can help you apply before discharge. (unmhealth.org)
• I’m Native American. Do I have to join a plan?
  No. Native American members can choose Fee‑for‑Service and use IHS/Tribal/Urban Indian clinics, or enroll in a Turquoise Care plan. (hca.nm.gov)
• Where can I talk to someone about stress or postpartum depression tonight?
  Call 1‑855‑NMCRISIS (662‑7474) or dial/text 988—free and confidential 24/7. (nmcrisisline.com)

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What to Expect After You Apply (reality check)

• You may be asked for extra documents (like a clearer pay stub). Upload quickly in your YesNM account or bring them to a field office.
• If your provider says they’re out‑of‑network, call your plan to switch PCPs or, if necessary, ask about changing plans during the next choice window. (hca.nm.gov)
• If you haven’t heard anything after a few weeks, call 1‑800‑283‑4465 with your case number to check status. (hca.nm.gov)

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About This Guide

Compiled by the ASingleMother.org Editorial Team
This guide uses official sources from New Mexico Health Care Authority, NM Department of Health, CMS/USDA, and established nonprofits. This guide is produced based on our Editorial Standards using only official sources, regularly updated and monitored, but not affiliated with any government agency and not a substitute for official agency guidance. Individual eligibility outcomes cannot be guaranteed.
Last verified September 2025, next review April 2026.
Please note that despite our careful verification process, errors may still occur—email info@asinglemother.org with corrections and we respond within 72 hours.

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Disclaimer

This guide is for general information. Program rules, income limits, premiums, provider networks, and contacts can change at any time. Always verify details directly with the agency or plan before you apply or make care decisions. We link to official sites and update promptly when changes are confirmed. For security, do not email or text personal case details to third parties; use official portals or phone lines listed here. If you believe your personal data has been exposed online, contact the HCA Customer Service Center at 1‑800‑283‑4465 and your health plan immediately. (hca.nm.gov)

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Sources (selected)

• New Mexico Health Care Authority (HCA): MAD‑222 2025–26 Women, Children & Family Medicaid Categories; 2025 Poverty Guidelines; Turquoise Care Overview & Plans; Apply for Benefits; EPSDT/Keeping Kids Healthy; Contact HCA; Marketplace Affordability Program. (hca.nm.gov)
• BeWellnm: 2025 Enrollment is Open. (bewellnm.com)
• NMDOH: Title X Family Planning Program; WIC info line & program. (nmhealth.org)
• Crisis Support: New Mexico Crisis & Access Line. (nmcrisisline.com)
• Plan contacts: BCBSNM Turquoise Care Contact; Molina NM Medicaid Contact; Presbyterian Turquoise Care; UnitedHealthcare Community Plan NM. (bcbsnm.com, molinahealthcare.com, phs.org, uhc.com)
• Financial assistance & alternatives: UNM Health Financial Assistance; Presbyterian Financial Assistance; NMMIP contacts. (unmhealth.org, phs.org, nmmip.org)
• Regulations & policy updates: [NMAC Presumptive Eligibility 8.291.400.13 & Postpartum 8.291.400.14 (12‑month)] (via HCA/NM Register). (casetext.com)

If you find an error or a broken link, please email us and we’ll fix it quickly.

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