New Mexico Medicaid for seniors and long-term care

Last verified: June 2026

Long-term care Medicaid rules are complex

Asset and income rules for long-term care Medicaid differ significantly from standard Medicaid. This page provides general information. For situation-specific guidance, consult a Medicaid planning attorney or contact New Mexico Medicaid.

New Mexico's Mi Via waiver lets members self-direct their care and hire their own workers — including family members

New Mexico Medicaid covers nursing facility care and home and community-based services through Turquoise Care MCOs and the CoLTS (Coordinated Long Term Services and Supports) program. Notably, New Mexico operates the Mi Via waiver — a self-directed HCBS program that gives participants control over their own care budget and lets them hire, train, and schedule their own support workers, including certain family members. Per the HCA, Mi Via is available for seniors, adults with physical disabilities, and people with developmental disabilities. Contact HCA at hca.nm.gov or 1-800-283-4465.

Financial eligibility for New Mexico Medicaid long-term care

New Mexico LTC Medicaid uses non-MAGI financial rules. Applicants must meet income and asset limits and demonstrate a functional need for nursing facility-level care. These criteria differ from the MAGI rules used for expansion adults and children.

Factor	Standard (2025)	Notes
Income limit	$2,901/mo (300% FBR / SSI)	Miller Trust (Qualified Income Trust) available for income above the limit
Countable asset limit — individual	$2,000	Primary home, one vehicle, household goods, burial funds exempt
Asset limit — community spouse	Up to $154,140 (2025 CSRA)	Federal spousal impoverishment protections apply
Level-of-care requirement	Nursing facility level of care	HCA functional assessment; determines nursing vs. HCBS eligibility

Mi Via — New Mexico's self-directed care waiver

Mi Via is nationally distinctive. Unlike standard HCBS waivers where a care agency provides workers, Mi Via gives the participant control over a personal care budget. The participant decides what services they need, hires their own workers, and manages their care schedule. Key features per HCA:

Participant-employer model — you are the employer of your own workers
Family members (other than a spouse or legal guardian) may be hired as paid workers
Allowed services: personal care, respite care, homemaker services, community transition, assistive technology
A Consultant helps develop the Individual Service Plan and budget
A Fiscal Management Agency (FMA) handles payroll and compliance so the participant does not do the administrative filing
Annual spending budget set based on assessed need level

Mi Via enrollment is not capped the same way as traditional 1915(c) waivers in New Mexico — it operates under a 1115 waiver framework. Contact HCA at 1-800-283-4465 for Mi Via enrollment information and to request a functional needs assessment.

Other HCBS options through Turquoise Care

In addition to Mi Via, Turquoise Care MCOs coordinate CoLTS services for members who qualify for LTC but prefer care at home or in community settings. Services include:

Personal care aide services
Home health aide and skilled nursing visits
Adult day health services
Respite care
Homemaker and chore services
Home modification for accessibility
Assistive devices and medical equipment
Nursing facility care when home-based options are not sufficient

Spousal impoverishment protections

New Mexico follows federal Spousal Impoverishment rules (42 USC 1396r-5). The community spouse retains:

Up to $154,140 in countable assets (2025 CSRA — federal maximum)
A Minimum Monthly Maintenance Needs Allowance of approximately $2,555/month minimum (2025 federal floor)
The primary home, exempt while the community spouse lives in it

New Mexico estate recovery — Medicaid may recoup costs from an estate after age 55

New Mexico operates a Medicaid Estate Recovery Program (MERP) required by 42 USC 1396p. After a Medicaid recipient who was 55 or older and received nursing facility or HCBS waiver services passes away, HCA may file a claim against the estate. Recovery is deferred while a surviving spouse or dependent minor or disabled child lives in the home. New Mexico allows hardship exemptions. The 5-year asset look-back period applies — asset transfers within 5 years before applying may trigger a penalty period of ineligibility. Source: New Mexico HCA estate recovery documentation at hca.nm.gov.

Medicaid as the primary payer for long-term care

Medicare does not cover custodial nursing home care beyond 100 days following a qualifying hospital stay. Private long-term care insurance covers only those who purchased it. For the majority of Americans who need extended nursing home care, Medicaid ends up as the payer — after they have spent down their own assets to the program's limit.

Nationally, Medicaid pays for roughly two-thirds of all nursing home residents, per CMS data. New Mexico's share of that population is administered through New Mexico Medicaid. The rules that determine eligibility — income, assets, lookback periods, and exempt property — differ from the MAGI-based rules used for standard Medicaid.

Long-term care Medicaid also includes home and community-based services (HCBS), which allow people to receive care at home or in assisted living rather than a nursing facility. These programs operate through Section 1915(c) waivers and have waiting lists in most states.

Nursing facility coverage

New Mexico Medicaid covers skilled nursing facility care for seniors who meet clinical and financial criteria. Clinical eligibility requires a documented need for skilled nursing care — typically assessed through a standardized instrument. Financial eligibility means income and countable assets fall within the program's limits.

Once approved, Medicaid pays the nursing home directly. The resident contributes most of their monthly income toward the cost of care — typically all income minus a personal needs allowance (which varies by state but is often $30–$50 per month). Medicaid covers the gap.

If income exceeds the institutional Medicaid limit, New Mexico may use a "Miller Trust" (qualified income trust) arrangement to route excess income through a trust account, making the person financially eligible. Not all states allow this; verify whether New Mexico uses this approach with New Mexico Medicaid.

Home and community-based services (HCBS)

HCBS waivers let states cover long-term care services outside nursing facilities — in a person's home, adult day program, or assisted living. Section 1915(c) of the Social Security Act authorizes these waivers. Each state designs its own waiver programs, so what's available through New Mexico Medicaid differs from what's available in neighboring states.

Common HCBS services include personal care assistance, home health aide visits, adult day health care, respite care for family caregivers, and modifications to make a home accessible. Some states cap the number of waiver slots, creating waiting lists that can run for months or years.

Contact New Mexico Medicaid to ask which HCBS waiver programs are currently open for enrollment and whether there is a waiting list.

Asset limits for long-term care Medicaid

Unlike MAGI-based Medicaid, long-term care Medicaid has an asset test. Countable assets — bank accounts, investments, second vehicles, vacation property — must fall below the state's limit. The specific threshold varies by state and is updated periodically; it is not a figure this page can reliably publish.

Exempt assets are not counted. The primary home is exempt while the applicant lives there or intends to return, as well as when a spouse, minor child, or disabled adult child lives there. One vehicle is typically exempt. Personal belongings and a prepaid funeral arrangement are also generally exempt.

Medicaid has a 60-month (5-year) lookback period for asset transfers. Transfers of assets for less than fair market value within those 60 months can result in a penalty period during which Medicaid will not pay for care. Consult New Mexico Medicaid or a Medicaid planning attorney before transferring assets.

Spousal protections

When one spouse needs nursing home care, federal law protects the other spouse from complete impoverishment. The community spouse (the one still at home) is entitled to keep a minimum amount of assets — called the Community Spouse Resource Allowance (CSRA) — and a minimum monthly income.

The CSRA allows the community spouse to keep between a federal minimum and maximum, with the exact amount varying by state and updated annually. New Mexico's current CSRA is set by New Mexico Medicaid and published on their website.

The community spouse's own income is not counted toward the institutionalized spouse's Medicaid eligibility. If the community spouse has insufficient income, a portion of the institutionalized spouse's income may be allocated to them — the minimum monthly maintenance needs allowance (MMMNA).

Estate recovery applies to long-term care recipients age 55 and older

After a Medicaid long-term care recipient dies, the state must seek to recover Medicaid costs from the estate under the Medicaid Estate Recovery Program (MERP). This can affect the home. See the estate recovery guide for how MERP works and what protections exist.

What long-term care Medicaid typically covers

Skilled nursing facility care — room, board, nursing services, and most medical care in the facility
Physical, occupational, and speech therapy provided in a nursing home
Personal care assistance with daily activities (bathing, dressing, eating) through HCBS waivers
Home health aide visits for those receiving care at home
Adult day health care programs
Respite care to give family caregivers temporary relief
Durable medical equipment prescribed by a physician
Transportation to and from medical appointments