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If you have a preexisting condition, New Mexico state insurance companies are allowed to exclude your condition for 12 months. It is also allowed to exclude your preexisting condition from coverage by adding an elimination rider to the policy. If you are switching your health insurance company in New Mexico and maintained your previous coverage with no coverage lapses, your old coverage can be used as credit for a preexisting condition. This means that the preexisting condition, even though it existed under the old policy, must still be covered under the new policy. Please make sure you understand where you stand with the insurance company on preexisting conditions during the first 10–day free review period after receiving the policy, if not before.
New Mexico requires all health insurance plans to provide coverage for several medical services including: Alcoholism, Autism, Birthing Centers/Midwives, Cervical cancer/HPV Screening, Cleft Palate, Dental Anesthesia, Diabetes Self Management, Diabetic Supplies, Early Intervention Services, Emergency Services, Home Health Care, Hospice Care, HPV Vaccine, Mammogram, Maternity, Maternity Stay, Mental Health General, Mental Health Parity Law, Orthotics/Prosthetics, PKU/Formula, Prostate Cancer Screening and Well-Child Care. This required coverage also adds to your costs.
New Mexico individual health insurance companies are required to offer coverage to newborns, adopted children and pregnant women. Newborns and adopted children are automatically included under a parent’s individual insurance policy for the first 31 days as long as the policy already allows coverage for dependents. The insurer might require that the parent enroll the baby or adopted child within the 31 days from birth in order to continue coverage after 31 days. Handicapped dependents are allowed coverage under a parent's individual health plan with no age restrictions. The child must not be able to support him/herself because of a mental handicap or physical disability and must rely on parents for support. Proof of disability will be required by the insurance company.
Remember that premiums are driven by the cost of medical care in the geographic area in which you live. Generally if you purchase a policy that costs less in monthly premium, you will usually end up paying a greater share of the medical expenses when you are sick or hurt.
Applying for health insurance requires filling out an application which includes questions about your past health conditions and treatments, in most cases. The insurance company uses this information to determine whether to approve you for coverage. Do not try to hide information about your health condition, as it can be reason to retroactively terminate your coverage, leaving you responsible for all of your expenses from that time forward, less any premiums paid. If you have exhausted COBRA coverage, loose COBRA coverage because your former employer went out of business and are considered federally eligible, insurance companies are usually required to offer you a choice of two different plans regardless of your health condition. These can be more expensive as can be any conversion policy available to you within 30 days after you terminate employment.
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