Lipp application 2026

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4.8 out of 5

40 votes

The Low Income Premium Program (LIPP) assists eligible individuals in maintaining coverage under the New Mexico Medical Insurance Pool (NMMIP) by offering reduced premiums based on household income. The document outlines eligibility criteria, income guidelines for premium reductions, and application procedures, including necessary documentation and affidavits for income verification.

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Click ‘Get Form’ to open the LIPP application in the editor.
Begin by filling out the Applicant Information section. Enter your last name, first name, address, city, state (NM), and zip code.
In the Premium Payment Certification field, certify that you or a family member will be paying your premiums by entering the required name.
Next, provide details about your household size and total combined income for all persons over age 18. List each member's name, relationship, and date of birth.
Calculate your Modified Adjusted Gross Income (MAGI) as instructed. Ensure to include necessary documentation such as previous year’s Federal Income Tax forms.
Complete either Affidavit A or Affidavit B based on your filing status and ensure signatures are provided where necessary.

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Versions	Form popularity	Fillable & printable
2019	4.8 Satisfied (40 Votes)
2017	4 Satisfied (34 Votes)
2010	4.4 Satisfied (70 Votes)

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