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According to the Genworth Cost of Care Survey for 2021, seniors in New Mexico can expect to pay an average of $4,605 per month for in-home care and $4,652 per month for home health care. In-home care typically includes homemaker services and helps with bathing, grooming and other activities of daily living. Home health services are provided by nurses, physical therapists and other licensed professionals.
For the cost of home care, New Mexico is one of the most affordable states in the region. Colorado is the most expensive, as the monthly cost of care averages $6,387 for both in-home care and home health care. In Arizona, seniors can expect to pay $5,339 per month for in-home care and $5,434 for home health care. Utah’s costs are a bit higher than Arizona’s at $5,625 per month for in-home care and $5,720 per month for home health services. Only Texas has lower home care costs than New Mexico, with both types of care averaging $4,576 per month. New Mexico’s average costs are also lower than the national average of $4,957 per month for in-home care and $5,148 per month for home health care.
|Home Care||Home Health Care|
In New Mexico, home care costs much less than nursing home care, but it’s more expensive than assisted living and adult day health care. Nursing home care costs an average of $7,604 per month, while assisted living has average costs of $4,498 per month. With average costs of $1,993 per month, adult day health care is the least expensive option for seniors.
In New Mexico, Medicaid covers home care under the Aged, Blind and Disabled program. This includes personal care assistance, help with activities of daily living and home health services provided by licensed professionals. New Mexico also offers the Community Benefit waiver, which helps seniors stay in their communities.
Community Benefit Waiver
New Mexico’s Medicaid program, known as Centennial Care, offers the Community Benefit waiver to give eligible enrollees access to services that can help them maintain their independence. The waiver covers personal care assistance, home modifications, employment supports and other services for participants who require a nursing facility level of care. Participants receive their services through one of the state’s approved managed care organizations (MCOs), such as Presbyterian Health Plan or Blue Cross Community Centennial.
Application instructions and eligibility depend on a senior’s current Medicaid and MCO enrollment status.
For more information about the Community Benefit waiver, call (800) 432-2080.
Medicaid has income and asset limits for its Aged, Blind and Disabled programs. As of 2022, the income limit is $10,092 per year for single individuals and $15,132 per year for married couples. The asset limit is based on an applicant’s countable resources, which are assets that can be sold for cash. Some assets are exempt, such as prepaid funeral expenses, one vehicle and an applicant’s primary residence. Single individuals have an asset limit of $2,000, while married couples have an asset limit of $3,000.
|Income Limits*||Asset Limits|
You must also meet the following requirements to qualify for Medicaid:
To apply for Medicaid online, create an account on the New Mexico Health Insurance Exchange website. If you’re interested in other benefits, such as the Supplemental Nutrition Assistance Program, apply via Yes New Mexico. The Human Services Department will review your application and determine if you qualify for Medicaid and other forms of assistance.
You can also apply at a local Income Support Division office, fax your application to (855) 804-8960, apply by telephone at (855) 637-6574 or send your completed application to the following address:
Central Aspen Scanning Area (CASA)
P.O. Box 830
Bernalillo, NM 87004
What Information You Will Need
Gathering documents related to your identity, citizenship and financial situation can reduce the time it takes to apply for Medicaid. To prove your identity, you may need to provide your driver’s license, passport or other government-issued photo ID. Your birth certificate, Certificate of Naturalization or Certificate of Citizenship may be used to prove you’re a U.S. citizen or lawful immigrant. To make it easier to answer questions about your income and assets, locate copies of your bank statements, past tax returns, insurance policies and pay stubs. If you have any investments, make sure you have copies of your account statements.
How to Get Help Applying for Medicaid
New Mexico’s Medicaid application has many questions about your household composition and finances. If you need help answering these questions, contact one of the resources below for assistance.
|Contact||Area Served||Services Provided|
|New Mexico Health Insurance Exchange Enrollment Counselors||Contact a local enrollment counselor.||Entire State||The state insurance exchange has trained enrollment counselors available to help residents complete their applications. If your Medicaid application is denied, an enrollment counselor can help you compare insurance plans and provide information on tax credits to reduce the cost of health coverage. Use the NMHIX website to find an enrollment counselor in your area.|
|New Mexico Human Services Department||(855) 637-6574||Entire State||HSD has trained staff members available to walk you through the Medicaid application and answer any questions you have about the information requested.|
|New Mexico Aging & Long-Term Services Department||(800) 432-2080||Entire State||New Mexico’s ALTSD operates the Aging & Disability Resource Center, which has trained information and assistance coordinators available to answer questions about Medicaid and the Community Benefit waiver.|
Medicare doesn’t pay for non-medical home care, but it can cover the cost of the medical version of home care, called “Home Healthcare” in some situations. In order to be eligible, you need to be homebound and have a referral from your doctor for the specific type of medical care that is needed. There are also other restrictions that apply.
Below is an overview of some of the services typically covered by Medicare for those who are eligible:
As mentioned above, home care is distinctly different from home healthcare, but there is some overlap – so while Medicare doesn’t cover non-medical home care, there are personal care services that may be covered in special circumstances – such as an occupational therapist helping with eating or dressing.
Read our guide to Medicare and Home Care Coverage for more information.
While the above programs can be a great way to make home care affordable for many people, they are not the right solution for everyone. Thankfully, there are other ways to make home care more affordable for you and your family. For more information about your other options, read our section on Other Ways to Pay for this guide.
New Mexico is home to several organizations that exist to help seniors maintain their health, safety and independence. Contact one of these resources if you need legal advice, help with housing expenses or other types of assistance.
|Contact||Area Served||Services Provided|
|New Mexico Legal Aid||(833) 545-4357||Entire State||New Mexico Legal Aid offers free information and legal assistance to low-income consumers in New Mexico. Attorneys handle a variety of civil matters, including difficulty accessing government benefits, landlord/tenant disputes and consumer rights. The organization also runs legal clinics for veterans.|
|Low-Income Home Energy Assistance Program||(800) 283-4465||Entire State||LIHEAP helps eligible participants pay their heating and cooling bills. Crisis benefits are reserved for consumers who are in danger of having their utility services turned off, as well as consumers who are about to run out of oil, wood or other types of fuel. LIHEAP benefits may also be used to pay utility bills, weatherize a home or make energy-related home repairs.|
|Meals on Wheels of Albuquerque||(505) 923-8060||Albuquerque, Rio Rancho||Meals on Wheels of Albuquerque serves seniors in the Albuquerque and Rio Rancho areas. The main meal program has over 500 volunteers delivering hot meals three times per day, five days per week. Meals on Wheels of Albuquerque also has a pantry box program to ensure participants have enough to eat on days when they don’t receive hot meals.|
|Santa Fe County Senior Services||Contact your local Santa Fe County senior center.||Santa Fe County||Santa Fe County Senior Services provides a variety of services to help seniors stay healthy and avoid social isolation. These services include home-delivered meals, exercise classes, transportation to medical appointments and congregate meals served at senior centers in Santa Fe, Santa Cruz, Chimayo and other locations within Santa Fe County.|
|Indian Area Agency on Aging||(505) 383-3900||Tribal lands in New Mexico||The Indian Area Agency on Aging provides a wide range of services to residents of New Mexico’s tribal lands. Service providers understand the unique cultural needs of Native American seniors, allowing them to tailor their offerings accordingly. Services include congregate meals, case management, personal care, transportation and home meal delivery.|
In New Mexico, all home health agencies that serve clients on Medicare or Medicaid must require their staff members to be fully vaccinated against the virus responsible for the COVID-19 pandemic. If an agency that provides in-home care or home health care doesn’t bill Medicare or Medicaid for any services, then it doesn’t have to follow the CMS vaccine rules.
Although this information is current as of April 2022, state and federal agencies can update the requirements at any time. Contact your local Area Agency on Aging for information on the most up-to-date rules. Even if they’re not required to follow the mandate, home care agencies may set their own requirements regarding vaccination and the use of masks, gowns and other personal protective equipment. Check with your provider if you have any questions about their guidelines.
The New Mexico Department of Health regulates home care providers operating within the state’s borders. New Mexico also has a Certified Nurse Aide Registry for those who provide in-home care and don’t have some type of professional license. The regulations for home health agencies are found in Title 7 of the New Mexico Administrative Code.
|What Types of Care Can Be Provided?||In-home care providers are permitted to provide personal care, take vital signs and assist clients with activities of daily living. This includes bathing, grooming, toileting and transferring from a bed to a chair. In-home care providers are also permitted to help clients move around their homes, which may involve providing assistance with walkers, crutches, canes and other mobility aids.|
|Are Care Plans Required?||Home health agencies must have a plan of care for every client. In-home care providers should review these plans regularly to ensure they’re familiar with each client’s current needs.|
|Can Home Care Providers Assist with Medication Management?||Only licensed nurses or certified health care professionals are allowed to administer medications.|
|Are There Special Requirements for Screening Home Care Aides?||Nurse aides must undergo a national criminal background check to qualify for certification. Agencies may also implement additional screening requirements for employees who aren’t licensed or certified.|
|Are Home Care Aides Required to Undergo Special Training?||To be certified, a nurse aide must complete at least 75 clock hours of training on infection control, emergency procedures, personal care skills and other relevant topics. Certified nurse aides must also pass a comprehensive exam to demonstrate their knowledge.|
|Does Medicaid Cover Home Care in New Mexico?||Yes. Home care is covered under traditional Medicaid and the Community Benefit waiver program.|
|How Do I Report Abuse of Myself or a Loved One?||To report abuse, contact Adult Protective Services at (866) 654-3219.|
Whether you are looking for yourself or a loved one, finding a quality home care provider can be a stressful process. To help you overcome this challenge, we’ve created a helpful checklist below that can help guide you through the process of both determining your needs, and finding a home care agency that will be the best fit for you and your family.