Medicare and New Mexico Medicaid: Turquoise Care and the Medicare Savings Programs

Some New Mexicans qualify for both Medicare and Medicaid — often called being “dual eligible.” When that happens, Medicare pays first, and New Mexico Medicaid may help with costs Medicare leaves behind, like premiums, deductibles and coinsurance, plus services Medicare does not cover at all, such as long-term care at home or in a nursing facility.

How Medicaid works for seniors in New Mexico

New Mexico Medicaid is administered by the New Mexico Health Care Authority (HCA), the agency that took over from the Human Services Department in 2024. Its managed-care program is Turquoise Care, which replaced Centennial Care on July 1, 2024. Most members, including seniors and people with disabilities, get their Medicaid benefits through one of four health plans — Blue Cross and Blue Shield of New Mexico, Presbyterian Health Plan, Molina Healthcare of New Mexico and UnitedHealthcare Community Plan — which coordinate Medicaid services, including long-term services and supports, while Medicare continues to pay first for medical care. Eligibility is determined by HCA, not by an insurance agency; you apply through the state’s YesNM portal or an HCA income-support office.

Programs that can lower your costs

• Medicare Savings Programs (MSPs) — QMB, SLMB and QI — pay the Part B premium ($202.90 in 2026) and, for QMB, Medicare’s deductibles, copays and coinsurance as well. New Mexico eliminated the resource (asset) test for all three programs effective January 1, 2021, so only your income counts, and the income limits change each year. You apply through HCA, and you do not have to be on full Medicaid to qualify.
• Extra Help (Low-Income Subsidy) lowers what you pay for Part D premiums, deductibles and copays. If you qualify for an MSP or Medicaid you get Extra Help automatically; otherwise apply through Social Security.
• Dual Special Needs Plans (D-SNPs) are Medicare Advantage plans designed for people with both Medicare and Medicaid; they coordinate the two programs, usually at $0 plan premium, and often add extras while keeping your Medicaid benefits intact. In New Mexico several of the Turquoise Care plans’ parent companies also sell D-SNPs, so the two sides can be aligned; Presbyterian’s Dual Plus is the one Advantage plan it is keeping for 2027.

Free, unbiased state counseling on all of this is available from New Mexico SHIP — the State Health Insurance Assistance Program, run by the Aging and Long-Term Services Department’s Aging and Disability Resource Center — at 800-432-2080. When you are ready to talk through the Medicare side, we are here at (702) 706-6564.

How we help

We help you understand whether a D-SNP is available and a good fit where you live, how a Medicare Savings Program and Extra Help could reduce your costs, and how to keep your Turquoise Care benefits working alongside Medicare. Eligibility decisions rest with HCA and CMS; our job is to make the Medicare side clear.

ECOS Medicare Solutions is a private insurance agency and is not connected with or endorsed by Turquoise Care, the New Mexico Health Care Authority, or the federal Medicare program.