The federal Medicare program, for anyone age 65 or older, is a convenient and cost-effective form of health care sponsored by the US government. The base plan, which is sometimes referred to as either Original or Traditional Medicare, consists of two parts: Part A, and Part B. Together, these two parts can cover the majority of your medical needs, whether they occur inside or outside of a hospital. But there are some unfortunate coverage gaps which, if you aren’t careful, could end up costing you a lot of money. We’ll talk about those later in this article.

New Mexico Medicare Plans

But first, let’s discuss the base expenses you can expect when you enroll in Medicare in New Mexico. For some seniors, Part A might actually be free, but that largely depends on your history of employment. For those with a lengthy employment history, about 10 years or more (40 quarters can also qualify you), you will not have to pay anything for access to Part A benefits. Anything less than that, though, and you will be required to pay fees.

Medicare Part A (Hospital Coverage)

  • Inpatient care in hospitals
  • Skilled nursing facility care
  • Hospice care
  • Home health care
Medicare Part B (Medical Insurance)

  • Services from doctors and health providers
  • Outpatient care
  • Home health care
  • Durable medical equipment
  • Some preventive services
Medicare Part C (Medicare Advantage)

  • Includes all benefits and services covered under Part A and Part B
  • Usually includes Medicare prescription drug coverage (Part D) as part of the plan
  • Offered by Medicare-approved private insurance companies
  • May include extra benefits and services for an extra cost
Medicare Part D (Drug Coverage)

  • Helps cover the cost of prescription drugs
  • Run by Medicare-approved private insurance companies
  • May help lower your prescription drug costs and help protect against higher costs in the future

Different Types of Medicare Plans in New Mexico

In total, there are about 329,994 New Mexico residents who are currently receiving Medicare Benefits. 58% of them, however, are either sticking with Traditional Medicare alone, or have an alternative form of extra coverage through some employer benefit. The remaining 42% who want to protect their savings from disastrous gaps in Medicare coverage are split into two groups: those who have replaced their Original Medicare with a Medicare Advantage policy ( 30%, or 98,998 people) and those who have supplemented their Medicare benefits with a Medigap insurance policy (12%, or 39,945 individuals).

Should New Mexico Residents Worry About Supplemental Coverage?

For practical reasons, every retired senior citizen should give supplemental coverage some serious thought. Granted, there is no law saying that you have to purchase additional insurance; however, looking at the table below will give you an idea of some staggering costs you might be responsible for should you choose to avoid protecting yourself with extra coverage.

Medicare Part A Costs in 2022 Medicare Part B Costs in 2022
  • Part A is premium-free for most
  • Part A deductible is $1,556 per benefit period
  • Inpatient hospital stay days 61-90 is $389
  • The standard Part B premium is $170.10
  • The annual deductible for Part B is $233
  • Medicare pays 80%, you pay 20% out-of-pocket

The older you get, the more likely a medical emergency might be lurking around the corner. It’s never too early to secure some additional protection in the event that one of these emergencies strikes you without warning. Below, we’ll go into more detail about the top supplemental coverage plans available right now.

New Mexico Medicare Supplement Plans

Medicare supplement plans, often referred to as “Medigap” policies, are a form of private supplemental insurance offered in addition to Traditional Medicare benefits. There are a grand total of ten plans: A, B, C, D, F, G, K, L, M, and N. We’ve included a chart below which explains what benefits each plan offers. The good thing about Medigap is that each company in each state offers identical plans – so your plan K in New Mexico won’t offer more or less than plan K in Texas. Basically, you only have to worry about finding a reputable insurance company and an affordable price on your policy.

New Mexico Medicare Advantage Plans

You may have also heard these types of plans referred to as Medicare Part C. The tricky thing about Advantage plans is that they can be a bit confusing if you aren’t familiar with how they work. For all intents and purposes, purchasing a Medicare Advantage policy effectively replaces the Medicare benefits you are currently getting from the government. But the coverage you get from your Advantage policy is required by law to be identical, if not better. You may even have access to additional benefits, like dental, for a modest additional fee.

Keep in mind, though, that in areas where Medicare Advantage is competitively priced with other supplements, this is mostly in part due to their restricted provider networks. What does this mean for you? Well, if you are particularly attached to your current doctor, it could mean severing that relationship in favor of a physician in the approved Advantage network.

by Lindsay Malzone, Lindsay Malzone is the Medicare expert for Medigap.com. She's been contributing to many well-known publications as an industry expert since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.
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