New Mexico

What is New Mexico Medicaid Long-Term Care?

Medicaid is a health care program designed for low-income individuals across all age groups. However, in this context, we are focusing on the long-term care Medicaid eligibility for elderly New Mexico residents (aged 65 and over). Besides nursing home care, New Mexico Medicaid also provides services and support to help elderly individuals remain at home or in assisted living settings. The three categories of Medicaid long-term care programs for which New Mexico seniors may qualify are as follows:

What is Institutional / Nursing Home Medicaid?

This program is an entitlement; anyone who qualifies will receive assistance. It is only applicable in nursing home facilities.

What are Medicaid Waivers / Home and Community Based Services (HCBS)?

This is not an entitlement; the number of participants is limited, and waiting lists may exist. Services are aimed at delaying or preventing the need for nursing home care and may be provided at home, adult day care, or in assisted living facilities.

What is Regular Medicaid / Aged Blind and Disabled?

This is an entitlement program; those who qualify will receive assistance. Long-term care benefits, such as personal care assistance or adult day care, may be available.

New Mexico Medicaid is referred to as Centennial Care. While this program is jointly funded by the state and federal governments, the state administers the program under federally-set guidelines. The New Mexico Health Care Authority is the body that oversees the administration of the program.

What Are the Income and Asset Limits for Medicaid Eligibility?

The financial criteria for the three Medicaid long-term care programs differ. Eligibility can also be influenced by factors such as marital status, and New Mexico offers several pathways to Medicaid eligibility. The financial requirements are reviewed and updated annually.

What Are the Criteria for a Single Nursing Home Applicant in 2025?

For 2025, a single Medicaid Nursing Home applicant must meet the following criteria:

• Income: Under $2,901 per month
• Assets: Under $2,000
• Medical Need: Requires a Nursing Home Level of Care

What is the 2025 New Mexico Medicaid Long-Term Care Eligibility for Seniors?

Below is a summary of the Medicaid eligibility limits for 2025, broken down by program type:

*Note: The income limits for Nursing Home Medicaid require that most of the applicant’s income, except for a Personal Needs Allowance of $97/month, be directed toward the cost of the nursing home.

†Some beneficiaries may be unable to keep income up to this level depending on their living situation.

‡Those qualifying for SSI are automatically eligible for Regular Medicaid, including long-term services.

What Does Medicaid Consider as Countable Income?

Almost all forms of income that an applicant receives are counted towards Medicaid’s income limit. This includes wages, alimony, pensions, Social Security Income (SSI and SSDI), IRA withdrawals, and dividends. In New Mexico, certain payments, such as VA Aid & Attendance, are excluded from being counted.

How Does Medicaid Treat the Income of Married Couples?

When only one spouse applies for Nursing Home Medicaid or a Medicaid Waiver, only the income of the applicant is counted. The non-applicant spouse may be entitled to a Minimum Monthly Maintenance Needs Allowance (MMMNA) to prevent financial hardship.

The MMMNA in New Mexico is $2,643.75/month (as of 7/1/25 – 6/30/26). This allows the non-applicant spouse to receive additional income if needed.

What Are Countable and Non-Countable Assets?

Countable assets include cash, stocks, bonds, bank accounts, and real estate (other than the home). Non-countable assets include personal belongings, household items, one vehicle, burial accounts, and generally the primary home (with some conditions).

How Does Medicaid Treat the Assets of Married Couples?

For married couples, all assets are considered jointly owned. However, a Community Spouse Resource Allowance (CSRA) allows the non-applicant spouse to retain a larger portion of the couple’s assets when applying for Nursing Home Medicaid or a Medicaid Waiver.

In 2025, the non-applicant spouse can keep 50% of the couple’s joint assets, up to $157,920.

What is Medicaid’s Look-Back Rule?

New Mexico enforces a 60-month Look-Back Period, meaning that Medicaid will examine any gifts or asset sales that occurred within the 5 years prior to the application date. Violating this rule can result in a penalty period of Medicaid ineligibility.

What Are the Home Exemption Rules for Medicaid?

For a home to be exempt from Medicaid’s asset limits, the applicant or their spouse must live in it. If neither resides in the home, the applicant must show an intent to return. Additionally, there is a home equity interest limit of $730,000 (2025).

However, the home is subject to Medicaid’s Estate Recovery Program, which may seek reimbursement from the estate following the applicant’s death.

What Are the Medical or Functional Need Requirements?

An applicant must meet the medical need for long-term care. For Nursing Home Medicaid and Medicaid Waivers, a Nursing Home Level of Care is required. In contrast, Regular Medicaid for the Aged, Blind, and Disabled only requires assistance with Activities of Daily Living (ADLs).

How Can Seniors Qualify for Medicaid If They Exceed the Financial Limits?

What is a Qualified Income Trust (QIT)?

A QIT allows applicants whose income exceeds the limit to still become eligible by diverting “excess” income into a trust.

What is an Asset Spend Down?

Seniors with assets exceeding Medicaid’s limit can “spend down” by converting excess assets into non-countable assets, such as home improvements or paying off debts.

What is Medicaid Planning?

Medicaid Planning involves working with professionals to develop strategies that can help individuals qualify for Medicaid, including protecting assets from Medicaid’s Estate Recovery Program.

What Specific Programs Are Available for New Mexico Seniors?

Centennial Care Community Benefit

This program offers home and community-based services like assisted living, adult day health care, and personal care assistance.

Program of All-Inclusive Care for the Elderly (PACE)

PACE combines Medicaid long-term care benefits with additional services such as dental and eye care.

How Can You Apply for New Mexico Medicaid?

Seniors can apply online through the Yes New Mexico portal, by phone at 1-855-637-6574, or by submitting a completed application (HSD-100-Application for Assistance). The application can be sent via fax, mail, or dropped off at a local office. If you are uncertain about your eligibility, Medicaid planning may be beneficial to ensure the best chance of acceptance.