How Turquoise Care's Community Benefit pays for assisted living

Last verified: October 2026

Does New Mexico Medicaid pay for assisted living?

Partly. Assisted living is a service under the Community Benefit of Turquoise Care, New Mexico's Medicaid managed care program, for members who meet nursing facility level of care, but coverage excludes the cost of room and board and 24-hour skilled care, so the resident still pays the facility's room and board charge.

The rule describing the benefit (8.308.12 NMAC) calls assisted living a residential service in a homelike setting with individualized services from the member's care plan, and says nursing and therapy are incidental rather than integral to it. Not every facility accepts Community Benefit residents, so ask each one whether it contracts with the member's health plan.

Sources: 8.308.12 NMAC; HCA Community Benefit Program.

What is the Turquoise Care Community Benefit?

The Community Benefit is the long-term services and supports part of Turquoise Care for members who need help to live at home or in a community setting instead of a nursing facility, ranging from personal care help with bathing and dressing to home modifications, respite, adult day and assisted living.

Turquoise Care began on July 1, 2024 and has four health plans: Blue Cross Blue Shield of New Mexico (866) 689-1523; Molina Healthcare of New Mexico (844) 862-4543; Presbyterian Health Plan (888) 977-2333; UnitedHealthcare Community Plan of New Mexico 1-877-236-0826. A member already on full-coverage Medicaid with one of these plans asks the plan's care coordinator about the Community Benefit.

Sources: HCA Turquoise Care Health Plans.

How do you get the Community Benefit if you are not on Medicaid yet?

Apply for full-coverage Medicaid at yes.nm.gov or 1-800-283-4465; if you need long-term services but do not qualify for full-coverage Medicaid, call the Aging and Disability Resource Center at 1-800-432-2080 to be placed on the Community Benefit Central Registry, the waiting list from which slots are released based on need.

The Central Registry is easy to overlook. A parent who is still paying privately but expects savings to run out can be placed on the registry early, which can shorten the gap between the last private-pay month and the first month of coverage.

How much of an assisted living bill does a Community Benefit member still pay?

The member pays the facility's room and board charge from their own income, while the health plan pays the care services in the member's care plan; the exact split depends on the facility's rates and the member's income, so get both numbers in writing before moving in.

Families sometimes discover that a facility's room and board charge is more than the resident's monthly income. Ask the facility and the plan's care coordinator what the room and board amount will be and whether family can contribute.

Can a Community Benefit member get care at home instead?

Yes. The same benefit can pay for personal care services, respite, home modifications and other supports at home, delivered either through an agency (agency-based Community Benefit) or by self-directing the services and hiring one's own caregivers (self-directed Community Benefit).

For many Albuquerque families the at-home option is the better first step. In-home care vs. assisted living →

What the Community Benefit pays in assisted living