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§ 59A-54-14 NMSA 1978

Deductibles; coinsurance; maximum out-of-pocket payments

Known as the Medical Insurance Pool Act

The act spans §§ 59–59 (23 sections).

1978 Comp., § 59A-54-14, enacted by Laws 1987, ch. 154, § 14; 1991, ch. 200, § 11; 2001, ch. 352, § 9; 2021, ch. 108, § 34.

A. Subject to the limitation provided in Subsection C of this section, a pool policy offered in accordance with the Medical Insurance Pool Act shall impose a deductible on a per-person calendar-year basis. Deductible plans of five hundred dollars ($500) and one thousand dollars ($1,000) shall initially be offered. The board may authorize deductibles in other amounts. The deductible shall be applied to the first five hundred dollars ($500) or one thousand dollars ($1,000) of eligible expenses incurred by the covered person.

B. Subject to the limitations provided in Subsection C of this section, a mandatory coinsurance requirement shall be imposed at the rate determined by the board.

C. The maximum aggregate out-of-pocket payments for eligible expenses by the insured shall be determined by the board.

Official source: NMOneSource (New Mexico Compilation Commission). Reproduced from public-domain New Mexico statutes; confirm against the official source for the current text. Not legal advice.