Turquoise Care is the New Mexico Medicaid Managed Care program that began on July 1, 2024. Most Medicaid members are enrolled in managed care, and there are four health plans to choose from. Managed Care Organizations (MCOs) are health plans that provide health care services to Medicaid members.
Medicaid’s mission is to provide no-cost or low-cost health insurance coverage to financially eligible citizens. Even if you didn’t qualify before getting pregnant, you may qualify for pregnancy coverage now.
Confused about Medicaid?
Many people don’t realize that as a pregnant person in New Mexico, you can qualify for Medicaid coverage at 250% of the fixed standard when you are not pregnant. This means that many people qualify, even if you already have insurance!
You only need to know if you qualify, and then complete an application online. We have provided links to assist you in this process.
To determine if you are eligible, just add up the gross pay of your household’s paychecks (the amount before taxes, insurance and everything else is taken out), and come up with the total for an average month.
If it totals less than the numbers below*, the pregnant person can qualify for Medicaid.
In determining the household size of a pregnant person, they are counted as self plus the number of children expected to deliver this pregnancy.
- Up to $4407 for a pregnant woman and unborn baby (family of 2)
- Up to $5553 for a pregnant woman and unborn baby plus one (family of 3)
- Up to $6698 for a pregnant woman and unborn baby plus two (family of 4)
- Up to $7844 for a pregnant woman and unborn baby plus three (family of 5)
- +$1146 for each additional household member
*These numbers are good through the end of March 2026.
Start the application process immediately if you think you may qualify for Medicaid. See below. It can take 45 days for coverage to be set up, and while you wait, your appointments may or may not be covered by Medicaid.
Find out for sure if you can get Medicaid, and apply today
You can find out for sure whether you qualify for any Medicaid program in New Mexico several ways. Choose the option that’s easiest for you:
Before you start an application, gather these:
- Social security numbers of the family members to enroll
- Employment and income information — paystubs, tax return, W2 forms
- Policy numbers, if you currently have health insurance (this doesn’t affect your eligibility)
- The first date of your last menstrual period
- They may ask for a “proof of pregnancy” letter from your current provider
If you qualify for Medicaid, you will be asked to select a Managed Care Organization (MCO) to administer your care. Dar a Luz accepts all MCOs.
Each MCO has the same coverage for most things: certified nurse-midwife fees related to maternity, lab work, ultrasounds, hospital admission, doctor visits, specialist visits, other medical care, behavioral health, long-term care, prescriptions, emergencies, vision, dental, certain kinds of rehabilitation, and x-rays. However, not all providers accept all MCOs. Call your favorite providers and find out if your choice will matter to them. What else makes the MCOs different? They may have different value-added services, such as free car seats, cribs, and mileage reimbursement for trips to provider offices. Visit their websites to find out what else they offer.
If you have other health insurance, you must report that to Medicaid, as well as to all your providers. Having other insurance does not affect your eligibility for Medicaid, and Medicaid will not cover your care until it is billed to all other insurance first.
Pregnancy Medicaid is usually back-dated to the beginning of your pregnancy. So if you’ve been told that you are eligible, your prenatal care at Dar a Luz will likely be covered no matter when you start seeing us.
Whatever you decide to do, please keep us informed. Tell us about all of your insurance policies. Tell us whenever anything changes. After your baby is born, add him or her to your Medicaid coverage within 30 days.
