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Do You Qualify for a Subsidy?

The Coverage Connector will help connect you with the right type of insurance plan, as well as see:

  • If you qualify for a lower insurance premium
  • What type of insurance plan you may qualify for (such as Medicare, Medicaid or an individual or family plan)
  • What website you should visit for enrollment information (New Mexico Health Exchange or this website)

All fields required.

Please enter the number of members in your immediate family.

If you have more than 10 family members, please call 505-923-5678 for help determining if you qualify.

Please enter a valid dollar amount.

Please enter your current age.

Please select whether your employer offers insurance.

Please select a group you best identify with.

What is this for?

This interactive tool will help you answer two very important questions as you begin your search for the right health insurance:

1. Do I qualify for a lower premium through a government subsidy?

2. Where should I shop for an insurance plan? Your options include:

  • Commercial insurance provider (like Presbyterian)
  • Medicaid (for low-income families)
  • Medicare (for individuals age 65+)
  • New Mexico health exchange (for those who qualify for a subsidy)

Under the Affordable Care Act (ACA), households who make below a certain income level can get a premium tax credit through a government subsidy. If you qualify for a subsidy, you must enroll for your health plan on the New Mexico Health Exchange to receive this discount. You are still able to purchase a plan administered by Presbyterian, even if you purchase it on the New Mexico Health Exchange, and enjoy the great benefits of a free gym membership, video visits and more.

Family Size

Let us know how many people are in your immediate family. Immediate family includes your legally married spouse, plus any children under the age of 18 (considered "dependents").

If you have more than 10 family members, you will need to call to get help determining if you qualify for a subsidy.

Phone: 505-923-5678
or 1-800-356-2219
TTY: 1-877-298-7407
Hours: Daily 8:00 a.m. - 8:00 p.m.

We have free interpreter services to answer any questions you may have about our health or drug plan. To get an interpreter, just call us at 1-800-797-5343.

Annual Family Adjusted Gross Income Help

This is your total income, before taxes and deductions are applied. If you are married and filing jointly, this number is your combined earned income. If you are married but filing separately, use the amount from the spouse with the highest annual gross income.

Use your most recent tax return to find this information; the table below will help identify where on your tax return you can find this information. For instance, if you file with Form 1040, enter the amount from line 37.

Form 1040 Line 37
Form 1040A Line 21
Form 1040-EZ Line 4

Your Current Age Help

We are asking for your age to see if you qualify for Medicare (available for those citizens 65+). Please use your current age for accurate results.

Employer-Based Insurance Help

In general, employees who are offered insurance through work are not eligible for government subsidies to help lower the cost of their healthcare premiums. However, that is only true if their employer-offered plan meets certain federally mandated requirements.

If your income is 100%-400% times the federal poverty level AND you pay more than 9.5% of your household income for your employer-offered plan premiums, you would be eligible for government subsidies.

For instance, if the federal poverty level is $15,000 per year, and your household income is $38,000 per year (which is between 100% and 400% of $15,000), you would qualify for a subsidy if your cost for an employer-offered plan was more than $3,610 per year (which is 9.5% of $38,000).

If you think you might be eligible for a subsidy even if your employer offers insurance, visit the New Mexico Health Insurance Exchange to find out for sure.

Native American Help

There are special provisions for Native Americans. For example, all Native Americans (regardless of tribal membership status) with incomes up to 400% of the federal poverty level can get premium tax credits and limits on the amount of out-of-pocket expenses they would need to pay.

Tribal Members with a household income of less than 300% of the federal poverty level will pay no out-of-pocket expenses if they get insurance through the Exchange.

All plans offered through the Exchange help you get coverage for services not offered through an Indian health provider. Things like emergency care, certain doctor visits, diagnostic tests and more.