At a glance
What New Mexico requires
New Mexico permits fixed indemnity as a supplemental, limited-benefit product, but it is heavily regulated under a 2025 rule. The standard fixed-indemnity categories are statutory excepted benefits under NMSA 59A-23G-2(B), and the New Mexico Office of Superintendent of Insurance (OSI) oversees them. The key rule is 13.10.34 NMAC (effective Jan 1, 2025), which:
(OSI Bulletin 2024-024 moved the compliance deadline to July 1, 2025.)
Because fixed indemnity is an excepted benefit, it sits outside ACA rules. (At the federal level, a 2024 fixed-indemnity consumer-notice requirement was vacated by a court in December 2024, so it is not federally required; an earlier 2014 individual-market notice still applies.) New Mexico's own "NOT major medical" disclosure requirement under 13.10.34 NMAC is separate and does apply.
The core thing to understand is how it pays: fixed indemnity pays a predetermined cash amount when a covered event happens — no matter what your treatment actually costs. That's very different from major medical, which pays a share of your actual bills.
How fixed indemnity works in New Mexico
Fixed indemnity and related excepted benefits come in a few forms (described as coverage types, not specific products):
Each pays a fixed cash benefit you can use toward bills, deductibles, or everyday costs during a covered event. In New Mexico, expect a required disclosure telling you the product is not major medical, and — if the plan is sold as a supplement to major medical — the carrier will need proof that you already hold major-medical coverage before it issues (13.10.34.23). These products are designed to supplement real coverage, not replace it. As an independent, carrier-neutral brokerage, we don't push any single insurer — and we'll be clear that fixed indemnity works best alongside a comprehensive plan, not instead of one.
How to get coverage here
Fixed indemnity isn't sold through the health insurance marketplace, and it isn't tied to Open Enrollment — you can generally apply for it year-round, directly from an insurer or through a broker, subject to the product's terms and New Mexico's requirements.
For the comprehensive coverage that fixed indemnity is meant to supplement, New Mexico runs its own state-based exchange, beWellnm, where ACA plans have an annual Open Enrollment (typically each fall through early winter) and Special Enrollment Periods for qualifying life events like losing job-based coverage, moving, or having a baby. New Mexico has expanded Medicaid, so it's worth checking your eligibility there as well.
What it costs
We don't quote premiums here — prices depend on your situation — but the cost of fixed indemnity in New Mexico is driven by:
Because fixed indemnity pays fixed amounts rather than a share of your bills, the real question is how much cash it pays for the events you're most concerned about — and remember it's supplemental, so weigh it alongside the cost of the comprehensive coverage it's meant to support.
Fixed indemnity insurance is a supplemental, limited-benefit (excepted-benefit) product. It pays fixed cash amounts for covered events regardless of your actual medical costs, is not major medical coverage, and is not minimum essential coverage under the Affordable Care Act. It does not cover the full range of essential health benefits and is not a substitute for a comprehensive health plan.
GetHealthPlans.com is operated by MTG Insurance Agency, an independent, carrier-neutral brokerage. We do not issue insurance and are not a government agency or the health insurance marketplace. Regulatory details on this page reflect New Mexico law and New Mexico Office of Superintendent of Insurance guidance as of the last-reviewed date and can change; confirm current terms and the specific product's approved form before you enroll.