New Mexico Health Insurance

New Mexico has fewer health insurance regulations than most states. Still, it's important to familiarize yourself with them, so you're more confident and wise in your purchase.

This guide:

  • Describes New Mexico health insurance policy regulations

  • Lists rules New Mexico health insurance companies must follow

Health insurance policies are regulated by each state's own health insurance laws. New Mexico health insurance companies and policyholders alike must abide by established insurance laws.

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New Mexico health insurance policy provisions

Some of the most important New Mexico health insurance laws are the ones that influence the health insurance policy itself.

For instance, New Mexico health insurance policies must contain a provision called the guaranteed renewability provision. This clause ensures your right to renew your New Mexico health insurance policy at the end of its term, provided you have kept up with paying your premiums.

Additionally, in New Mexico, insurance policies can contain a provision that excludes pre-existing conditions from coverage, but not for more than 6 months. Medical conditions that you have been diagnosed with 6 months before the effective date of your health insurance policy are considered to be "pre-existing conditions".

New pre-existing condition exclusion periods cannot be added if you are switching New Mexico health insurance plans and have had no breaks in your coverage. In these cases, your old policy's exclusion period credits your new policy's required exclusion period, meaning that if you have met the exclusion period in your old policy, you do not have to wait for medical coveragein your new policy.

Regulating New Mexico health insurance companies

Unless you have violated a policy regulation, no New Mexico health insurance company can refuse to renew your health insurance policy.

However, when you are applying for a New Mexico health insurance policy, any insurer is free to refuse you coverage. In fact, New Mexico insurance companies are permitted to deny health insurance coverage on the basis of your health.

Although the original premium of an individual New Mexico health insurance policy may vary due to your health status, age, gender, habits, and geographic location, your renewal premium can only increase because of your age and not because of declining health.

Temporary New Mexico health insurance

If you are seeking temporary health insurance because you are anticipating a break in health insurance coverage, conversion policies are a good choice. These New Mexico health insurance policies are available to individuals who have recently left (or are about to leave) a fully insured group policy.

Though the price of conversion plans are likely to be higher and the coverage less than your former New Mexico group health insurance policy, conversion policies are intended only to offer adequate insurance in times when you have breaks in between your coverage.

More NM health insurance help

If you want more help getting a good health insurance policy, take our free health insurance internet course.

Also see the guide to New Mexico small business health insurance.


To find out more about NM health insurance laws and regulations, visit the official website of the New Mexico Insurance Division.