In-Home Care in New Mexico

More than 2.1 million people call New Mexico home, including almost 381,000 seniors aged 65 or older. New Mexico boasts 56 hospitals, including several high-performing hospitals. Presbyterian Hospital in Albuquerque snagged eight high-performing U.S. News & World Report designations.

The state waives income tax for centenarians, but until then, most seniors pay taxes on their retirement funds. Those who meet income restrictions, however, earn a retirement-income exemption of up to $8,000.

The Land of Enchantment got a little more enchanting for seniors in 2022. The state previously taxed Social Security benefits, but as of the 2022 changes, single filers with an adjusted gross income of $100,000 or less and joint filers with an AGI of $150,000 or less are not taxed for Social Security benefits.

Property taxes are on the low side, and New Mexico offers property tax credit and deferral programs for low-income seniors, providing a perk for those living at home with the help of in-home care. New Mexico has a relatively low average cost of home care at $4,605 per month, and the home health care average is only higher by approximately $50. Home care provides personal assistance, while home health offers medical services, including various therapies.

The average cost of in-home care in New Mexico is about $350 less than the national average according to the 2021 Genworth Cost of Care Survey. It’s also lower than all but one bordering state. Texas boasts the lowest average at $4,576 per month for in-home care. Oklahoma has a higher average of $4,862. Of the three remaining adjacent states, Arizona is higher by more than $700 at $5,339, and Utah is more than $1,000 above New Mexico’s average with its rate of $5,625. Colorado has the highest monthly price; at a cost of $6,387, Colorado is higher than New Mexico by nearly $1,800.

Although it’s the second-most populous city in the state, Las Cruces in southern New Mexico has the smallest average monthly cost of in-home care of all New Mexico cities listed on Genworth. It averaged $4,195, well under the state average of $4,605. The state’s most populated city, Albuquerque, was close to the state average at $4,671. Farmington in the northwest has a much higher average cost at $5,529, but the state’s capital, Santa Fe, is significantly more than all the other cities highlighted. Its rate of $6,378 makes it nearly $2,200 more than the state average.

Adult day health care costs much less than home and home health care, but it offers limited services in a group setting. Assisted living offers many of the same services as in-home care and home health care combined at a lower cost. However, at $4,498 compared to $4,605 for home care and $4,652 for home health care, assisted living has only a slightly lower price. It also requires seniors to move to a congregate residential setting. Nursing homes also require a congregate residential setting but offer much more support. This option runs the highest cost at $7,604 per month.

New Mexico’s Medicaid program is called Centennial Care, and it provides health care services for eligible seniors through four managed care organizations (MCOs). Centennial Care went into effect on January 1, 2014, and the switch changed some features and benefits of the state’s Medicaid program. One significant change was within the Home and Community-Based Services (HCBS) waiver program.

HCBS Waiver programs no longer exist under Centennial Care, so New Mexico doesn’t currently have a Medicaid Waiver specifically for seniors. However, it does directly cover home care through its Community Benefit Program for Medicaid recipients and some non-recipients.

Former recipients of the Coordination of Long-Term Services (CoLTS C) Medicaid Waiver, also referred to as the Disabled and Elderly Waiver, now receive their in-home care services through the Community Benefit Program. This program provides services to help seniors live independently in their homes and community instead of in long-term care facilities.

Seniors who qualify for Medicaid and want to receive in-home care must also apply for the Community Benefit Program. Seniors already enrolled in full coverage Medicaid with a Medicaid Managed Care Organization (MCO) should speak with their care coordinators or MCO representatives about enrolling in the Community Benefit Program. Allocations are also available for those who don’t qualify for Medicaid to receive Community Benefit Services, but these applicants must join a waiting list and receive services as they become available.

The quickest way to apply for Centennial Care/Medicaid in New Mexico is online via its YesNM Online Portal. Applicants who apply for Medicaid on YesNM may receive their results in as little as 10 minutes through the state’s Express Eligibility process. Other options for applying for Medicaid include:

• Completing an application over the phone by calling the Consolidated Customer Service Center at 1-800-283-4465
• Taking a completed application to the nearest Income Support Division Office
• Mailing a completed, signed application to Central ASPEN Scanning Area, PO Box 830, Bernalillo, NM 87004
• Faxing a completed, signed application to 1-855-804-8960

What Information You Will Need

Medicaid applicants must submit various documents based on their situation. The following information and/or documentation may be required:

• Social Security Number
• Proof of identity and age, such as driver’s license, birth certificate, Social Security card, Certificate of Indian Blood, voter registration card, passport or other approved form of ID
• Proof of U.S. citizenship or immigration status
• Medical records proving disability, if applicable
• Tax filing information
• Information on earned income, such as check stubs, tax records or letters from employers
• Documentation of other income, including Social Security, pensions, retirement, rental income, unemployment, capital gains, royalties, financial gifts and gambling winnings
• Unpaid medical bills from the last three months
• List of all public and private health insurance, including Medicare
• Indian Health Services information, if applicable
• Proof of residency, such as mortgage, rental agreement, utility bill or letter to the applicant addressed to them at the address provided on the application

In general, Medicare does not cover the cost of non-medical home care. That being said, there are situations in which Medicare provides some coverage for medical home care, referred to as “Home Healthcare.” There are several eligibility restrictions for coverage, including that individuals must be homebound and have a referral from their doctor specifically for home healthcare services.

Below is an overview of some of the skilled medical professionals whose in-home services are typically covered by Medicare – for more in-depth information, refer to our Guide to Home Healthcare.

• Physical Therapists: Physical therapy is used to help patients recover from injuries (broken bones, knee injuries, etc.), treat ongoing conditions such as arthritis, and assist in recovery from surgeries and procedures such as a knee or hip replacement.
• Visiting Nurses: Licensed nurses can provide a number of medical services for those who don’t need to stay in the hospital, but do need regular medical services such as wound care, changing feeding tubes, etc.
• Occupational Therapists: Occupational therapists help seniors regain or maintain the ability to accomplish normal, daily tasks, such as bathing, dressing, eating, and other daily activities.
• Speech Therapists: Speech therapists help seniors who are struggling to adequately communicate due to a stroke, dementia, or any other cause regain the ability to functionally communicate using a variety of means. Additionally, speech therapists help to keep seniors independent by modifying diets, teaching special techniques to swallow safely, and retraining associated muscles.

As mentioned above, in-home care is distinctly different from home healthcare. But, there can be some overlap in services between the two types of care. So, while Medicare doesn’t cover non-medical in-home care, there are in-home care services that may be covered in special circumstances when they’re provided in conjunction with home healthcare (such as an occupational therapist helping with eating or dressing)

To find quality home care providers near you, simply input the zip code or city where you would like to start your search. We have an extensive directory of home care agencies all across the nation that includes in-depth information about each provider and hundreds of thousands of reviews from seniors and their loved ones.