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Medicaid Waiver Guide – New Mexico

As a parent, you know that raising a neurodivergent child is a unique journey filled with love, joy, and, yes, challenges. But don’t fret! Resources are available to help; one of the most important is New Mexico Medicaid. This guide is your roadmap to understanding and navigating this essential program, helping you secure the best care for your child.

What is New Mexico Medicaid?

Before we dive deeper, let’s get the basics down. Medicaid is a joint federal and state program designed to provide health coverage for people with limited income. But what does that mean for you? In New Mexico, Medicaid, or Centennial Care, offers various services and supports for eligible individuals, including neurodivergent kids. It’s like having a trusty sidekick, like Goally, to help you navigate the healthcare world.

So, how does it work? Well, it’s all about meeting certain criteria. Let’s break it down.

Eligibility Criteria

First, you must know if your child is eligible. The criteria are based on income, age, disability status, and other factors. Sounds complicated? Don’t worry, we’re here to help.

  • Income: Your household income should be within the limits set by the program. Think of it as a threshold you need to meet.
  • Age: Kids under 19 are eligible for the Children’s Health Insurance Program (CHIP). It’s like a safety net for our young ones.
  • Disability: Neurodivergent kids may qualify under the disability category. It’s all about recognizing and supporting their unique needs.

Applying for New Mexico Medicaid

Once you’ve determined eligibility, it’s time to apply. Think of it as a quest, and you’re on a mission to secure the best care for your child. But don’t worry, you’ve got options.

  1. Online Application: You can apply online through the YesNM portal. It’s simple convenient, and you can track your application status. It’s like having a personal assistant at your fingertips.
  2. Mail or Fax: If you prefer the traditional route, you can mail or fax your application to the Human Services Department. Old school, but it works!
  3. In-Person: If you’re more of a face-to-face person, you can apply in person at a local Income Support Division office. Sometimes, there’s nothing like a friendly face to help you through the process.
new mexico medicaid. a parent is meeting with a medicaid specialist.
Read more: Does My Child Qualify for Medicaid?

Medicaid Waivers in New Mexico

Did you know that New Mexico offers several Medicaid waivers that can provide additional support for neurodivergent kids? These waivers can cover respite care, personal care services, and home modifications. It’s like an extra layer of support, helping your child thrive in their home and community, much like Goally’s learning tablet.

These waivers are about healthcare and quality of life. They aim to help kids with special needs live in their homes and communities like any other kid. It’s about inclusivity and equality, and that’s something we can all get behind.

Goally Waiver ScorecardScore
Website clarity and ease of navigation2/5
Access and requirements of qualification0/5
Healthcare coverage3/5

Other online resources for New Mexico:

  • New Mexico Autism Society has tons of resources from waivers to therapy providers to support groups.
  • page with information on New Mexico’s Department of Health’s resources for autism.
  • Parents Reaching Out can help you with advice, information, and support from other parents in New Mexico

Telephone Resources

  • Statewide Case Management Coordinator Leah Manning — 505-476-8915
  • University of New Mexico offers Autism Programs that include clinical services. Call (505) 272-1852 or 1-800-270-1861 to find out more.

Navigating the System

Let’s be honest: navigating the Medicaid system can feel like a maze. But with the right tools and information, you can conquer it. Here are some tips to help you along the way.

  • Stay Organized: Keep track of all your documents, appointments, and communications. Think of it as your personal command center.
  • Ask Questions: Don’t hesitate to ask questions or seek clarification from your caseworker or healthcare provider. Remember, there’s no such thing as a silly question.
  • Advocate: Be your child’s biggest advocate. Ensure they receive the services and support they need. After all, you’re their superhero.

Support Along the Way

Remember, you’re not alone in this journey. Numerous resources and support groups are available to help you navigate the Medicaid system in New Mexico. For example, the Parents Reaching Out organization offers workshops and resources to help parents understand Medicaid and advocate for their kids. It’s like having a supportive community right at your fingertips.

Understanding and navigating New Mexico Medicaid can be complex. But with the right information and support, you can secure the best care for your neurodivergent child. And remember, just like Goally is there to support your child’s learning journey, you have support in your journey, too. You’re doing an incredible job and making a significant difference in your child’s life.

Who Can Apply?

Circumstances/Diagnosis: Any kid or adult who has an either an intellectual and/or developmental disability (this includes autism). There are no age restrictions on this waiver and eligible applicants require an intermediate care facility level of care. There is a technical definition for intermediate care facility level of care, but it essentially just means that the child is unable to get through the day without a lot of supervision. You can find out more about eligibility here.
Income: Eligibility is based solely on the child’s income so if they are not making any money they are eligible for the waiver.

What do I get?

Provides case management, community integrated employment, customized community supports, living supports, respite, nutritional counseling, occupational therapy for adults, physical therapy for adults, speech and language therapy for adults, supplemental dental care, adult nursing, assistive technology, behavioral support consultation, crisis support, customized in-home supports, environmental modifications, independent living transition service, intense medical living supports, non-medical transportation, personal support technology/on-site response service, preliminary risk screening and consultation related to inappropriate sexual behavior, socialization and sexuality education

How do I apply?

The first step in the process is to complete the HCBS Registration Form.
Follow the rest of the step by step instructions on this webpage

What does the Goally Team Think?

New Mexico’s waitlist typically lasts 8-10 years. This is totally unacceptable and needs to be shortened especially because earlier intervention produces lifelong improvements for children with autism. There are some options for services while you are on the waitlist. You can apply for the Family Supports and Reimbursement program to get nearly $1,500 in funds to pay for special services such as assistive technology devices like Goally. You can also receive $2,500 from the Autism Flexible Services Program.

This post was originally published on 02/16/2021. It was updated on 09/18/2023.