Paying for assisted living in New Mexico
Most New Mexico families pay for assisted living out of pocket at first, drawing on savings, a pension, Social Security, the proceeds of a home sale, or a long-term care insurance policy. Costs vary quite a bit depending on where in the state you look, the size of the apartment, and how much day-to-day help a resident needs. You can compare current pricing for communities in your area using the pricing tables below.
As needs and finances change over time, some families become eligible for help through Medicaid or veterans benefits. It helps to understand those options early, because the qualifying process can take time.
Does Turquoise Care (New Mexico Medicaid) cover assisted living in New Mexico?
New Mexico Medicaid operates as a managed care program called Turquoise Care. Medicaid does not pay for room and board in an assisted living community anywhere — that cost is always the resident's responsibility. What Medicaid can help with is the care a person receives.
Through the Home and Community-Based Services (Community Benefit) offered under Turquoise Care, eligible members who would otherwise need a nursing-home level of care can receive personal care and support services while living in their own home or in an assisted living setting. Highlights:
- You generally must meet both financial limits (income and assets) and a functional "nursing facility level of care" assessment.
- Financial eligibility is determined by the Health Care Authority's Income Support Division; the functional assessment is handled through your managed care plan.
- Apply for Medicaid online at YES.NM.GOV or by phone, then ask about the Community Benefit. The Aging and Disability Resource Center can walk you through the process.
Does Medicare cover assisted living in New Mexico?
No. Medicare does not pay for assisted living room and board or for long-term custodial care (help with bathing, dressing, meals, and supervision), which is the bulk of what assisted living provides.
Medicare may still cover medically necessary services a resident uses, such as doctor visits, hospital stays, and a limited period of skilled nursing or rehabilitation after a qualifying hospitalization. For free, unbiased help understanding what your Medicare plan covers, contact New Mexico's State Health Insurance Assistance Program (SHIP), available through the Aging and Disability Resource Center.
