LOOKING FOR ASSISTANCE
The Health Care Authority’s mission is: We ensure that New Mexicans attain their highest level of health by providing whole-person, cost-effective, accessible, and high-quality health care and safety-net services.
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Community Benefit Program
In-Home and Community-Based Supports (Community Benefit Program)
The New Mexico Medicaid Community Benefit Program provides long-term services and supports to members who need assistance to live at home or in a community setting rather than in a long-term care facility. The program offers many services, from personal care assistance with daily activities such as bathing and dressing to employment supports and modifications to make your home safer and more accessible. The services available to you are based on your individual needs. Click here for more information and a list of the services available through the Community Benefit Program. Haga clic aquí para obtener más información en español.
- If you are already enrolled in full coverage Medicaid and receive your healthcare services through a Medicaid Managed Care Organization (MCO), you may be eligible for the Community Benefit. Please speak with your care coordinator or another MCO representative about the next steps.
- If you are enrolled in full coverage Medicaid but not enrolled with an MCO, you will need to become a member of one of the MCOs to receive the Community Benefit. Please call 1-800-283-4465 for more information on MCO options and enrollment.
- If you believe you may be eligible for full-coverage Medicaid, but are not currently enrolled, you may visit www.yes.state.nm.us or call 1-800-283-4465 for eligibility information or to start the application process.
- If you need long-term services, but do not currently qualify for full-coverage Medicaid, you may still be able to get an allocation for the Community Benefit program. There is currently a registry for this program, and slots are available based on need. Please contact the New Mexico Aging and Long-Term Services Department (ALTSD) to be placed on the waiting list (“Central Registry”) for Community Benefit services:
ALTSD Aging and Disability Resource Center:
Toll-Free: 1-800-432-2080
Santa Fe: 1-505-476-4846
TTY: 1-505-476-4937
For more information about the New Mexico Aging and Long-Term Services Department (ALTSD) please visit http://www.nmaging.state.nm.us/
More Information for Recipients and Providers
If you are a provider and wish to apply to provide services for the Agency-Based Community Benefit, click the link below.
Agency Based Community Benefits (ABCB) Program
Pursuant to federal law, New Mexico uses an Electronic Visit Verification (EVV) system for some home- and community-based services. If you are a Community Benefit provider or self-directed employee, please click the link below for information on how to ensure prompt payment or address technical issues.
Community Benefit Personal Care Services (PCS) Annual Provider Newsletter
The New Mexico Health Care Authority (HCA) and Mercer have recently finalized the report that describes the analysis of ABCB services. In the report, Mercer provides details about the analysis that includes assumptions for wages and costs to deliver the services, as well as modeled rate range recommendations for each service. Please click here to view the report.