Coverage Types
NOTE: Glossary words are highlighted. Click on any glossary word to see its definition.
Medicaid offers health care benefits to eligible individuals and families based on a number of categories. The category type for which an individual or family is eligible is based on income and living circumstances. The premiums and co-payments also depend on the type of category. Please read the brief description next to each category name and select the one that is most appropriate to your individual circumstances for more information.
Medicaid Categories
Click on a highlighted category listed below for more information:
New Mexico Works and Related Categories:
Medical Assistance for Women and Children (MAWC):
- Category 030 covers pregnant women who meet Aid to Families with Dependent Children (AFDC) guidelines
- Category 031 covers newborn babies born to mothers eligible for Medicaid, or to mothers that were eligible for Medicaid at the time of the birth.
- Category 032 covers children who are under age 19 and are in families with incomes under 185% of federal poverty guidelines
- Category 035 covers pregnant women and/or women ages 18-50 who are in need of family planning services related to birth control and pregnancy prevention who live in families with incomes under 185% of federal poverty guidelines
Foster Care and Adoption Subsidy/Chafee Medicaid:
Supplemental Security Income (SSI):
- Categories 001, 003, and 004 provide healthcare benefits for eligible aged, blind, or disabled individuals
- Category 034 provides Medicaid coverage for individuals who are ineligible for SSI due to income from a stepparent
Medicaid Extension:
- Medicaid Extension, categories 001, 003, and 004, provides for continuous Medicaid coverage for individuals who lose eligiblity for SSI and Medicaid due to Social Security cost-of-living increases and other reasons
Institutional Care Medicaid:
Home and Community-Based Waivers:
- Categories 090, 091, 092, 093, 094, 095, and 096 provide Medicaid coverage for individuals who are blind, disabled, elderly, medically fragile, developmentally disabled, have AIDS, or have a brain injury and who require institutional-level care, but are able to receive services in a home-based setting
Qualified Medicare Beneficiaries:
Specified Low-Income Medicare Beneficiaries (SLIMBs)/Qualified Individuals 1 (QI1s):
Qualified Disabled Working Individuals (QDs):
Working Disabled Individuals (WDIs):
- Category 043 provides Medicaid benefits to qualified disabled working individuals who do not otherwise qualify for Medicaid because of earnings
Medical Assistance for Refugees:
- Category 049 provides Medicaid benefits to low-income refugees
Breast or Cervical Cancer:
- Category 052 provides screening and treatment for qualifying women under 65 years of age
Emergency Medical Services for Undocumented Aliens:
- Category 085 provides coverage for emergency services for undocumented aliens who meet eligibility criteria for Medicaid services except for their alien status
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