New Mexico Medicaid 2026: Turquoise Care and How to Apply

Updated Nov 13, 20269 official sources

Quick Answer: New Mexico Medicaid is run by the New Mexico Health Care Authority (HCA), and most members get care through Turquoise Care, the managed care program that replaced Centennial Care on July 1, 2024.

Full answer and how we checked it

Adults 19 to 64 qualify under 133% of poverty ($1,769 a month for one person), children and pregnant women qualify much higher, and you choose from 4 health plans. Apply at YES.NM.GOV (opens in a new tab) or call 1-800-283-4465. Starting January 1, 2027, many adults 19 to 64 will need 80 hours of work or activity (or $580 in monthly income) and will renew every 6 months.

This guide is for: New Mexicans who need health coverage for themselves or their kids, Turquoise Care members trying to pick or switch a health plan, and adults 19 to 64 who got an HCA letter about the 2027 work and activity rules.

Data note: Grantsights checked HCA's Medicaid Changes page (opens in a new tab), Turquoise Care overview and member FAQ (opens in a new tab), Turquoise Care health plans page (opens in a new tab), the HCA 100 application (opens in a new tab) (revised November 26, 2025) and the Medical Assistance Programs eligibility pamphlet (opens in a new tab) (updated July 2026), plus Public Law 119-21 and federal rules. All were read on November 13, 2026. HCA's Turquoise Care FAQ was written before the July 2024 launch and still describes the 2024 open enrollment, so use it for background only.

In this guide

New Mexico Medicaid at a Glance (November 2026)
Who Qualifies for New Mexico Medicaid in 2026
Turquoise Care: The 4 Health Plans
How to Apply for New Mexico Medicaid, Step by Step
Work and Activity Rules and 6-Month Renewals in 2027
Back Coverage: 3 Months Now, Less in 2027
What HCA Doesn't Tell You
Common Mistakes and Red Flags
Fair Hearings: 90 Days to Ask
Other Help for New Mexico Families
FAQ: New Mexico Medicaid
Sources

New Mexico Medicaid pays your doctors, hospitals and pharmacies. HCA pays providers rather than sending members money, it isn't a grant, and a New Mexico application is free. Every income line by household size is in our New Mexico Medicaid income limits guide.

New Mexico Medicaid at a Glance (November 2026)

New Mexico sorts Medicaid into numbered categories, and the ones most people land in are 100 (adults), 200 (parents), 300 and 301 (pregnancy) and the 400s (children). According to HCA's July 2026 pamphlet and the other HCA data Grantsights checked on November 13, 2026:

Item	New Mexico's rule
Agency and program	New Mexico Health Care Authority; Medicaid through Turquoise Care managed care since July 1, 2024
Expansion status	Expanded: category 100 covers adults 19 to 64 under 133% of poverty, with or without children, no resource test
Adults 19 to 64	$1,769 a month for one person at 133%; $1,836 at 138% with the 5% disregard (July 2026 pamphlet)
Parents and caretakers	Category 200 fixed standard: $765 a month for a family of three; parents above it are checked for category 100
Children	Medicaid and CHIP up to 300% of poverty under age 6 and 240% for ages 6 to 18
Pregnancy	Category 301 up to 250% of poverty, counting the unborn child
Seniors and disability	SSI-related Medicaid, institutional care and waivers, Medicare Savings Programs, Working Disabled Individuals
Income numbers	Every household size is in our New Mexico Medicaid income limits guide
How to apply	YES.NM.GOV; 1-800-283-4465; local Income Support Division office; mail to Bernalillo; fax 1-855-804-8960
Decision time	45 days; up to 90 days when a disability determination is needed (HCA 100)
Work rule	Starts January 1, 2027 for many adults 19 to 64

Sources: HCA eligibility pamphlet (July 2026), HCA 100 application (November 26, 2025), Turquoise Care pages, checked November 13, 2026.

Grantsights analysis of HCA's July 2026 chart shows how much higher New Mexico sets children's lines than adults': for a family of three, a child under 6 stays covered up to $6,830 a month, more than twice the $3,142 adult line at 138%. A parent who's over the adult limit should still apply for the kids.

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Who Qualifies for New Mexico Medicaid in 2026

HCA's July 2026 pamphlet lists more than 40 eligibility categories, but most families fit one of these:

Category (HCA pamphlet, July 2026)	Who it covers	Income rule
100, Other Adults	Ages 19 to 64, no Medicare, not pregnant	Under 133% of poverty; no resource test
200, Parent/Caretaker	Parents or close relatives caring for a child	Fixed standard: $451 for 1, $765 for 3
300 and 301, Pregnancy	Pregnant women (self-attested)	300 at the fixed standard; 301 up to 250%
400 and 402, Children under 6	Medicaid; private insurance allowed	Up to 240% of poverty
401 and 403, Children 6 to 18	Medicaid; private insurance allowed	Up to 190% of poverty
420 and 421, CHIP	Uninsured children only	240% to 300% under 6; 190% to 240% for ages 6 to 18

Source: HCA Medical Assistance Programs eligibility pamphlet (opens in a new tab), updated July 2026, checked November 13, 2026.

Newborns. Category 031 covers a baby born to a mother on New Mexico Medicaid (including Emergency Medical Services for Non-Citizens) for 12 months starting with the birth month, as long as the baby lives in New Mexico.

Seniors and people with disabilities. SSI recipients get Medicaid through categories 001, 003 and 004, with the 2026 SSI rate of $994 for an individual and $1,491 for a couple, and resource limits of $2,000 and $3,000. Institutional care, home and community-based waivers, Medicare Savings Programs and the Working Disabled Individuals category have their own lines in our New Mexico Medicaid income limits guide.

Immigrants, October 1, 2026. HCA says only lawful permanent residents (who may need to meet a waiting period), Cuban and Haitian entrants, COFA citizens, lawfully residing children under 21 and lawfully residing pregnant people keep Medicaid. New Mexico created a state-funded program for members enrolled as of September 30, 2026 who lost Medicaid on October 1, including trafficking victims and humanitarian parolees. BeWell New Mexico, the state's insurance marketplace, mails them enrollment letters; questions go to BeWell at (833) 862-3935.

Turquoise Care: The 4 Health Plans

Turquoise Care started on July 1, 2024. Two Centennial Care plans continued (Blue Cross and Blue Shield of New Mexico and Presbyterian), two new ones joined (Molina and UnitedHealthcare), and Western Sky Community Care members were moved to other plans, according to HCA's Turquoise Care FAQ.

Turquoise Care plan	Member services (HCA health plans page)
Blue Cross and Blue Shield of New Mexico	(866) 689-1523
Molina Healthcare of New Mexico	(844) 862-4543
Presbyterian Health Plan	(505) 923-5200 or (888) 977-2333
UnitedHealthcare Community Plan	1-877-236-0826

Source: HCA Turquoise Care health plans page (opens in a new tab), checked November 13, 2026.

How choosing works. You can pick a plan on your application or later on YES.NM.GOV; if you don't, HCA assigns one. Per the HCA 100 application, you can switch to a different plan within 3 months of enrollment. Your plan mails your Medicaid card within 20 days of approval, and your doctor can look up your coverage before the card arrives.

Special rules:

Native Americans can choose a plan or stay in fee-for-service Medicaid, which is automatic if you don't choose. Native American members who need long-term care, or who have Medicare, must choose a plan.
Children in state custody are enrolled with Presbyterian.
Medicare members in a Medicare Advantage plan are encouraged to pick the same company's Medicaid plan.
Not in managed care: QMB, SLIMB and QI-only members, family planning-only members, PACE enrollees, ICF-IID residents and Emergency Medical Services for Non-Citizens.

What's covered. HCA's FAQ says services covered under Centennial Care continued, chiropractic care was added, and each plan offers its own value-added services such as extra dental and vision, extra transportation or culturally responsive treatment. All Turquoise Care members are also enrolled in Turquoise Rewards for completing healthy activities (1-877-806-8964).

How to Apply for New Mexico Medicaid, Step by Step

HCA gives you 5 ways to apply, and one HCA 100 application screens for Medicaid, SNAP, cash assistance and LIHEAP.

Step 1: Choose a route

Route	Details from HCA
Online	YES.NM.GOV (opens in a new tab), which also has a chat option
Phone	1-800-283-4465
In person	Your local Income Support Division (ISD) office
Mail	Central ASPEN Scanning Area (CASA), PO Box 830, Bernalillo, NM 87004
Fax	1-855-804-8960

Source: HCA 100 application, revised November 26, 2025, checked November 13, 2026.

Step 2: List unpaid medical bills

The HCA 100 asks whether anyone had medical care in the last 3 months that hasn't been paid. Fill that chart in. It's how back coverage gets considered.

Step 3: Wait up to 45 days

Per the HCA 100, most Medicaid applications must be processed within 45 calendar days, and HCA has up to 90 days when the Disability Determination Unit must decide disability. If approved, coverage starts on the first day of the month you applied.

Step 4: Pick or confirm your plan

Check whether your doctors, hospital and pharmacy work with the plan you're assigned, and switch within 3 months if they don't.

For example, one applicant in Las Cruces, a 38-year-old restaurant cook living alone who earns $1,750 a month, is under the $1,769 category 100 line. If she applies in February 2027, HCA would look at January for work or activity hours, and her pay clears the $580 test (an illustration built from HCA's 2026 figures, not a real case).

Work and Activity Rules and 6-Month Renewals in 2027

New Mexico starts on January 1, 2027, per the HCA timeline, matching the deadline in the Federal Register rule (opens in a new tab). According to HCA's Medicaid Changes page:

Who: many adults 19 to 64 enrolled in Medicaid, unless exempt.
What: 80 hours a month of work, community service, a qualifying work program, school or career training at least half time, or other approved activity, combined if needed. Monthly income of $580 or more also counts, and seasonal workers can average $580 a month over the preceding 6 months.
New applicants: may need 80 hours in the month before they apply.
Current members: report activity at renewal and may be asked for proof of 80 hours in any month since the last renewal.
If HCA can't confirm it: you get a 30-day compliance notice to finish activities or show an exemption. Coverage may end if you don't.
Letters: HCA began mailing affected members on September 1, 2026, and in January 2027 it mails letters to members with March 2027 renewals.

Exempt groups, per the HCA Medicaid Changes page: former foster youth under 26; American Indians and Alaska Natives; parents or caregivers of a child 13 or younger; caregivers of a person with a disability; veterans with a 100% disability rating; people who are medically frail or have special medical needs; people required to meet TANF or SNAP work rules; people in drug or alcohol treatment; and people who are pregnant or receiving postpartum care. HCA says to report an exemption at renewal.

No hours needed until your next renewal if you're on Medicare, covered under another Medicaid category, released from jail or prison in the last 3 months, getting inpatient or nursing facility care, traveling for needed medical care, or living in a county with a federal disaster declaration or high unemployment.

Renewals every 6 months. HCA says many members will renew every 6 months instead of every 12, starting in 2027. That follows section 71107 of Public Law 119-21 (opens in a new tab).

Cost sharing. HCA lists "cost sharing for some adults" among the coming changes without giving amounts. The federal law allows it for expansion adults above poverty starting October 1, 2028, capped at $35 a service.

Back Coverage: 3 Months Now, Less in 2027

HCA's application says you may be eligible for up to 3 prior months of Medicaid, on top of coverage from the first of the month you applied. HCA's Medicaid Changes page says that beginning in January 2027, back coverage drops to 2 months for most applicants, including people 65 and older and people with disabilities, and to 1 month for most adults 19 to 64. Section 71112 of the federal law applies the shorter limits to applications made on or after January 1, 2027.

The practical point: a New Mexican with unpaid medical bills from September through December 2026 should apply in 2026.

Reporting changes. HCA asks members to report pregnancy, disability status, income and contact changes right away on YES.NM.GOV, through its chat, or at 1-800-283-4465.

What HCA Doesn't Tell You

HCA's pages are clear about the 2027 changes, but Grantsights analysis of them found 6 gaps:

Some Turquoise Care pages are frozen in 2024. The FAQ still talks about yellow envelopes and an April to May 2024 open enrollment. The health plans page and HCA 100 are the current references.
The application calls it 3 plans and lists 4. The HCA 100's plan section says "three" managed care organizations, then lists Blue Cross, Presbyterian, Molina and UnitedHealthcare. There are 4.
Proof for "any month" is vague. HCA says you may be asked for 80 hours in any month since your last renewal, without saying how many months. Keep records for every month to be safe.
Cost sharing has no numbers yet. HCA lists it as a coming change, but no amounts or start date appear on its page; the federal law sets October 1, 2028 at the earliest.
High-unemployment counties aren't listed. HCA names the exception but doesn't publish which counties qualify. Ask at renewal if your county's unemployment is high.
Immigrant coverage moved to BeWell. People who lost Medicaid on October 1, 2026 enroll in the state-funded program through BeWell, not through YES.NM.GOV.

Common Mistakes and Red Flags

A common mistake in New Mexico is a parent assuming the kids won't qualify because the parent didn't. Children's lines run up to 300% of poverty under age 6, more than double the adult line.

Other ways New Mexicans miss or lose coverage:

Not answering the 30-day compliance notice. It's the last step before coverage ends under the 2027 rule.
Missing the 6-month renewal. Members used to yearly renewals can underestimate how quickly the next one comes.
Leaving the unpaid-bills chart blank on the HCA 100, which can cost months of back coverage.
Letting the 3-month plan switch window pass without checking whether your doctors are in network.
Outdated contact information. HCA mails renewal forms and notices; update your address on YES.NM.GOV.

Red flags: anyone charging to apply for Medicaid or Turquoise Care, asking for your YES.NM.GOV password, or texting a link that isn't on hca.nm.gov or yes.nm.gov. Avoid them: applying through YES.NM.GOV, 1-800-283-4465 or an ISD office is free.

Fair Hearings: 90 Days to Ask

New Mexico gives you 90 days from the date of a notice to request a fair hearing, according to the rights section of the HCA 100 application revised November 26, 2025.

How to ask: in person, by phone at 1-800-432-6217 or (505) 827-8164, or in writing to the HCA Office of Fair Hearings, PO Box 2348, Santa Fe, NM 87504.
Your rights: you can look at your case file and the records HCA used before the hearing, have a household member, friend or relative represent you, and bring a lawyer.
Plan decisions: if your Turquoise Care plan denies a service, start with that plan's grievance and appeal process; each plan's member services number is on the HCA health plans page.

Before filing with the Santa Fe office, read the reason HCA printed on the notice. A wrong household size, an old pay stub, or a child tested in the wrong age band is often the whole problem.

Other Help for New Mexico Families

The same HCA 100 application covers 4 programs, so many Medicaid households also get food or energy help:

Food: our New Mexico SNAP benefits guide explains applying and benefit amounts, and our New Mexico food stamps guide has the income limits.
Heating and cooling: see our New Mexico LIHEAP guide; HCA says crisis shut-off cases are handled within 48 hours.
New Mexico families with a baby on the way or kids under 5: see the WIC income limits guide.
Other states: the national Medicaid income limits guide compares New Mexico with Arizona, Colorado and Texas.

New Mexicans checking for other programs can use Grantsights' free eligibility checker, which points to official agencies. Only HCA can approve New Mexico Medicaid.

FAQ: New Mexico Medicaid

How do I apply for Medicaid in New Mexico?

At YES.NM.GOV, by calling 1-800-283-4465, at an ISD office, or by mail or fax.

What is Turquoise Care?

New Mexico's Medicaid managed care program since July 1, 2024, replacing Centennial Care, with 4 health plans.

What is the income limit for New Mexico Medicaid in 2026?

$1,769 a month for one adult at 133% of poverty; children and pregnant women qualify far higher.

When do New Mexico Medicaid work requirements start?

January 1, 2027, for many adults 19 to 64.

How do I change my Turquoise Care plan?

On YES.NM.GOV or at 1-800-283-4465, within 3 months of enrollment.

How long do I have to request a fair hearing in New Mexico?

90 days from the notice date.

Does New Mexico Medicaid pay past medical bills?

Up to 3 months back today; 1 or 2 months starting January 2027.

Sources

Last updated November 13, 2026. Published by Grantsights from public sources. See our editorial policy, how we build and check guides, corrections and how we make money.