New Mexico CHIP: Children's Health Insurance Program
Updated August 2026
New Mexico administers a Children's Health Insurance Program (CHIP) under Title XXI of the Social Security Act, folded into the state's Medicaid eligibility rules rather than branded separately. For children under age 6, Medicaid covers household income up to 240% FPL and CHIP covers the band from 240% up to 300% FPL. For children age 6 and older, Medicaid covers household income up to roughly 190% FPL and CHIP covers the band from 190% up to 240% FPL, per New Mexico's Medicaid eligibility rule (8.295.400.11 NMAC).
240% FPL
CHIP upper income limit for children ages 6 and older (300% FPL for children under 6)
Turquoise Care
MCO network delivering CHIP benefits
1-800-283-4465
New Mexico HCA phone line
New Mexico CHIP income bands depend on your child's age
Per New Mexico's Medicaid eligibility rule (8.295.400.11 NMAC), CHIP covers children under age 6 with household income between 240% and 300% FPL, and children age 6 and older with household income between 190% and 240% FPL. Below those bands, children qualify for full Medicaid at no cost; above them, they are not eligible for either program. A single YesNM application checks income against both the Medicaid and CHIP bands for your child's age automatically.
What is New Mexico CHIP?
The same YesNM application at yes.nm.gov covers both Medicaid and CHIP for children. Contact HCA at 1-800-283-4465 with questions.
Who qualifies for New Mexico CHIP?
New Mexico's CHIP income band depends on the child's age: household income between 240% and 300% FPL for children under 6, or between 190% and 240% FPL for children age 6 and older. Below those bands, children qualify for full Medicaid at no cost instead.
- Child must be under age 19
- Family income within the CHIP band for the child's age (240%–300% FPL under age 6; 190%–240% FPL age 6 and older)
- Child must be a New Mexico resident
- Child must be a U.S. citizen or lawfully present immigrant
- Child must be uninsured or have lost coverage
- Child must not have access to affordable employer-sponsored health insurance
- No asset test
What New Mexico CHIP covers
New Mexico CHIP delivers coverage through the Turquoise Care MCOs (BCBSNM, Molina Healthcare NM, Presbyterian Health Plan, and UHC Community Plan NM). Per HCA, the CHIP benefit package is comprehensive and comparable to Medicaid for children.
- Well-child and preventive care visits
- Primary care and specialist visits
- Hospital care — inpatient and outpatient
- Prescription drugs
- Emergency and urgent care
- Dental care (comprehensive)
- Vision care — exams and corrective lenses
- Mental health and behavioral health services
- Physical, occupational, and speech therapy when medically necessary
- Lab tests and imaging
Cost sharing for New Mexico CHIP
Federal CHIP rules cap total annual family cost sharing at 5% of income. Families at or below 150% FPL cannot be charged premiums under federal law (42 USC 1397cc). New Mexico's Medicaid program does not require co-pays, per HCA. Because CHIP-eligible families in New Mexico fall in a higher income band than Medicaid-eligible families, some CHIP cost sharing may apply depending on the child's age and household income.
Contact HCA at 1-800-283-4465 or visit yes.nm.gov for current premium and copayment amounts. Premiums are tied to family income and are substantially lower than private insurance costs.
How to apply for New Mexico CHIP
Apply through New Mexico Medicaid — the same YesNM application at yes.nm.gov covers both Medicaid and CHIP. Online applications are typically fastest and allow document uploads. You can also apply by phone or in person at a local eligibility office.
What CHIP is
CHIP — the Children's Health Insurance Program — is a federal-state partnership that covers children in families whose income is too high for Medicaid but too low to afford private insurance. Congress created CHIP in 1997 under Title XXI of the Social Security Act. Like Medicaid, CHIP is jointly funded by the federal government and each state, and each state administers its own program.
CHIP serves children up to age 19 (some states cover to 21 for children in foster care). It is not available to adults — CHIP is specifically designed to address the coverage gap for children in working families. Nationally, CHIP covers approximately 7 million children, according to CMS data.
New Mexico Medicaid
- YesNM application portal: yes.nm.gov
- New Mexico HCA phone line: 1-800-283-4465
- New Mexico HCA / Medical Assistance Division: hsd.state.nm.us/mad
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