Medicare (Parts A, B, C and D), the standardized Medigap plans, Medicaid and the basics of long-term care insurance are covered in the national Senior and Special Needs guide. This guide covers the New Mexico rules on top: the Medicare supplement statute (NMSA 1978, 59A-24A) and its rule (13.10.25 NMAC), including the birthday rule taking effect January 1, 2027, and the Long-Term Care Insurance Law (NMSA 1978, 59A-23A).

Medicare supplement (Medigap)

• Open enrollment: the six months beginning with the first month a person is both 65 or older and enrolled in Medicare Part B (13.10.25.17(A) NMAC).
• Guaranteed issue periods (for example after losing other coverage) generally run until 63 days after the prior coverage ends (13.10.25.17 NMAC).
• 30-day free look: the policy must state that it can be returned within 30 days of delivery for a premium refund if the buyer isn't satisfied (NMSA 1978, 59A-24A-10).
• Medicaid: a Medigap policy may limit benefits for a Medicaid-eligible insured only when the policy has been suspended at the holder's request for up to 24 months during Medicaid entitlement (NMSA 1978, 59A-24A-15(D)).

The birthday rule (effective January 1, 2027)

A 2026 law (Laws 2026, ch. 10) adds an annual open enrollment for people who already own a Medigap policy (NMSA 1978, 59A-24A-17):

• It starts on the first day of the birthday month and lasts at least 60 days.
• During it, the policyholder may switch to a plan of equal or lesser benefits without medical underwriting.

Until January 1, 2027, only the open enrollment and guaranteed issue periods above apply.

Long-term care insurance

Required protections (NMSA 1978, 59A-23A-6, -7, -8):

• 30-day free look: individual policies (not employer group coverage) must state they can be returned within 30 days of delivery, with the premium refunded within 30 days of the return.
• Outline of coverage: in an agent's sale, it's delivered before presenting the application.
• A policy may not cover skilled nursing only, be canceled or nonrenewed because of age or declining health, or require a prior hospital stay before benefits.
• Pre-existing conditions: a condition treated or advised within 6 months before coverage, excluded only for losses beginning within 6 months after the effective date.
• Contesting the policy: after two years, the insurer must show the insured knowingly and intentionally misrepresented relevant health facts.
• No field issue: an agent or administrator with delegated underwriting authority can't issue a policy based on medical or health status.

Lapse protection. The applicant names at least one other person to receive termination notices, or signs a waiver. A lapse notice can't be sent until the premium is 30 days overdue (13.10.15.17 NMAC).

Inflation protection. The insurer must offer, at purchase, an option for benefits to increase with expected long-term care costs (13.10.15.24 NMAC).

Partnership policies. A producer selling partnership-qualified coverage discloses that the partnership program is available and explains its requirements and benefits (NMSA 1978, 59A-23A-13).

Producer training. A producer needs 8 hours of long-term care CE before selling it and 4 hours in each later compliance period. Partnership topics are required to sell partnership policies (13.4.7.10(C)(2)(c) NMAC).

Common exam traps

• Free look is 30 days for both Medigap and long-term care in New Mexico.
• LTC outline of coverage comes before the application is presented.
• Birthday rule: effective January 1, 2027, 60 days from the start of the birthday month, equal or lesser benefits.
• LTC lapse: a third-party designee or signed waiver, and no lapse notice until 30 days past due.
• LTC training: 8 hours first, then 4 hours each period.
• Medigap open enrollment needs both age 65 and Part B enrollment.