New Mexico Medicaid Long-Term Care Eligibility for 2025

New Mexico Long-Term Care

New Mexico’s Medicaid program, known as Centennial Care, offers critical long-term care support for seniors who cannot afford the care they need to remain safe and healthy. Medicaid covers various services, including nursing home care, assisted living, and in-home services, under three primary categories of long-term care:

Institutional / Nursing Home Medicaid: An entitlement program providing care in nursing facilities for those meeting financial and medical criteria.
Medicaid Waivers / Home and Community-Based Services (HCBS): Non-entitlement programs with enrollment caps that help delay or prevent nursing home placement by offering care at home or in the community.
Regular Medicaid (Aged, Blind, or Disabled): An entitlement-based program offering personal care assistance, adult day care, and other support services for seniors.

Eligibility for 2025

To qualify for Medicaid long-term care in New Mexico, applicants must meet the following criteria:

Residency and Citizenship: Must be a New Mexico resident and a U.S. citizen or have proper immigration status.
Age/Disability: Applicants must be aged 65 or older, blind, or disabled and require care for at least 30 consecutive days.
Income Limitations: Income must not exceed $2,901/month for a single applicant in 2025. A Qualified Income Trust (QIT) must be established if income exceeds this limit.
Asset Limitations: Countable assets must not exceed $2,000 if single. Transfers of assets below fair market value within the five-year look-back period may result in a penalty.

Generally, if everything is submitted on time and there are no issues, the New Mexico Medicaid application process takes between 60-90 days. Applications requiring a Qualified Income Trust may experience delays. Senior Planning can assist with creating a Qualified Income Trust to ensure eligibility and a smoother application process.

Exempt Assets for 2025

$2,000 or less in countable assets for individuals. Exceeding this limit at the beginning of the month results in ineligibility for that month.
One home: Exempt if equity is below $730,000 and the applicant intends to return or if a spouse, child under 21, or disabled dependent resides there. Proceeds from a home sale become countable assets.
One automobile: No equity limit specified.
Irrevocable funeral trusts: No limit specified.
Life insurance policies: Face value must be $1,500 or less.

Understanding which assets are exempt can be complicated. Senior Planning offers free consultations to help applicants and their families navigate these rules and protect assets where possible. Contact us today for guidance on exempt asset planning.

Spousal Rules for 2025

Community Spouse Asset Allowance: The community spouse may retain half of the couple’s countable assets, up to $157,920. If their share is below $31,584, additional assets can be retained from the institutionalized spouse.

Community Spouse Income Protection: The community spouse may retain part of the institutionalized spouse’s income if their own income is less than $2,555/month. Depending on living expenses, they may retain up to $3,948/month.

Senior Planning can help families understand spousal rules and ensure the non-applicant spouse retains the maximum allowable resources. Contact us for assistance with community spouse asset and income planning.

Specific New Mexico Medicaid Programs

New Mexico Centennial Care Community Benefit: Provides home and community-based services, including assisted living, adult day health care, home modifications, and personal care assistance. Participants can self-direct care or work with provider agencies.
Program of All-Inclusive Care for the Elderly (PACE): Integrates Medicaid and Medicare benefits into one program with additional services like dental and vision care.

For those exploring Medicaid programs, Senior Planning offers assistance with applications and guidance on choosing the right program for your needs. Contact us for a free consultation to learn more about your options.

How to Apply for New Mexico Medicaid

Applications for New Mexico Medicaid can be completed online at Yes New Mexico, by phone at 1-855-637-6574, or by submitting a paper application. Assistance is available from the New Mexico Human Services Department (HSD) Income Support Division (ISD) at 1-800-283-4465, or visit your local ISD office.

Applying for Medicaid can be a complex and time-consuming process. Errors in documentation or missteps can lead to delays or denial. Senior Planning specializes in simplifying this process, ensuring applications are accurate and complete. Call us for help today.