Are you navigating the complexities of healthcare in New Mexico, seeking clarity on your options and access to vital services? Understanding the intricacies of health insurance, particularly in the context of Medicaid and managed care programs, is crucial for ensuring you receive the care you deserve.

As a resident of New Mexico, you have access to a network of healthcare providers. The resources available to you are designed to streamline your healthcare experience, from finding a provider to understanding your coverage. One of the key aspects of healthcare in the state is the Medicaid program, a cornerstone of accessible healthcare for many residents.

The New Mexico Medicaid managed care program, known as Turquoise Care, began on July 1, 2024. This program is designed to provide comprehensive healthcare services to eligible individuals. It is essential for Medicaid members to understand the structure of this managed care system and how it impacts their access to care. Most Medicaid members are enrolled in managed care, which offers a variety of health plans to choose from. Managed Care Organizations (MCOs) play a vital role in this system. They are health plans that provide healthcare services to Medicaid members. Blue Cross and Blue Shield of New Mexico (BCBSNM) is one of the MCOs offering Medicaid coverage in the state, dedicated to ensuring its members receive the necessary healthcare services.

To aid in this understanding, here's a breakdown of key aspects related to BCBSNM and the broader healthcare landscape in New Mexico. This information is designed to help you make informed decisions and navigate the healthcare system with confidence.

Category	Details
Program Name	Turquoise Care (New Mexico Medicaid Managed Care Program)
Start Date	July 1, 2024
Key Players	Blue Cross and Blue Shield of New Mexico (BCBSNM) Presbyterian Health Plan Western Sky Community Care
Purpose	Provide comprehensive healthcare services to eligible individuals.
Managed Care Organizations (MCOs)	Health plans that provide healthcare services to Medicaid members.
Provider Finder	Easily search for providers in your area.
Coverage Options	Individual, family, Medicare supplement, and Medicaid plans.
Eligibility	Learn whos eligible to enroll in New Mexico's Medicaid program.
Contact Information	For general information, see the Blue Cross Blue Shield of New Mexico website.
Additional Information	To file a grievance or an appeal with Blue Cross Blue Shield of New Mexico, see the resources web page. Inquire on recipient eligibility, claims, payments, and prior authorizations. View or print remittance advices and other reports. Explore options for 2025 health insurance coverage. Find New Mexico behavioral and mental health providers.
Links	Blue Cross Blue Shield of New Mexico Website

As a Turquoise Care member, you benefit from access to a wide array of healthcare providers across New Mexico. BCBSNM offers a dedicated provider finder to assist you in locating healthcare professionals within your area. This tool streamlines the process of finding doctors, specialists, hospitals, and urgent care facilities that best suit your needs.

To initiate your healthcare journey, you can purchase health insurance directly from BCBSNM. They provide a range of plan options to cater to your specific requirements, including individual, family, Medicare supplement, and Medicaid plans. To explore these possibilities, you are encouraged to obtain a free quote, which will provide detailed information on available plans and associated costs.

The cornerstone of the New Mexico Medicaid program is managed care. Most Medicaid recipients are enrolled in managed care, where they select from a selection of health plans. Managed Care Organizations (MCOs) like BCBSNM play a crucial role in this system, delivering healthcare services to Medicaid enrollees. This ensures a coordinated approach to healthcare, with a focus on preventive care and timely treatment.

BCBSNM is committed to ensuring you receive the healthcare you need. Their plans cover services that are medically necessary, ensuring you have access to essential treatments and procedures. You can also inquire about recipient eligibility, claims, payments, and prior authorizations to keep track of your benefits and healthcare expenses. For administrative convenience, the system enables you to view and print remittance advices and other reports.

The scope of healthcare coverage extends beyond immediate needs. You can learn about enrollment eligibility, application procedures, Medicaid expansion updates, and the effects of disenrollment. For those seeking plans in their area, providing your zip code enables a customized search. Additional services provided include increased Medicaid reimbursable provider types and services for IHS and tribal clinics.

If you lose your Medicaid coverage, there are options to ensure continued access to healthcare. Your child or children may be eligible for Blue Cross Community Centennial SM. Additionally, you can buy your own coverage through BCBSNM's health plans or via BeWell NM during the special enrollment period. The majority of special enrollment periods last 60 days from the date you lose coverage, providing a window to secure alternative health insurance.

BCBSNM extends a range of health plan options to suit individual needs. These include individual health care coverage for yourself and your family, Medicare plans, and Medicaid plans for those who qualify. Their comprehensive offerings are intended to provide flexibility and choice in selecting the right health plan.

BCBSNM also strongly encourages the electronic submission of claims, allowing for faster processing. Claims can be submitted electronically 24 hours a day, seven days a week. To assist you in finding the care you need, they provide tools to search for doctors, hospitals, urgent care centers, and other healthcare providers. You can explore these resources via the BCBSNM app, downloadable through the Apple App Store or Google Play Store. Texting "BCBS NM APP" to 33633 is another option.

If you need transportation to and from your doctor's office or a healthcare facility, BCBSNM contracts with Modivcare. This service ensures you have access to transportation when you need it, as long as you are receiving covered services, with trips being medically necessary. The team at Modivcare will review your medical needs before arranging the rides.

For those seeking health insurance coverage for 2025, BCBSNM offers resources to explore your options. You can get a quote and, if eligible, enroll in a plan. As of 2023, the Centennial Care Medicaid managed care program in New Mexico includes three insurers: Blue Cross Blue Shield of New Mexico, Presbyterian, and Western Sky Community Care. The program has evolved over the years, with four insurers having Centennial Care contracts through the end of 2018: Blue Cross Blue Shield of New Mexico, Molina, Presbyterian, and UnitedHealthcare.

To assist you in accessing mental health services, you can find New Mexico behavioral and mental health providers within the BCBSNM network. For additional support, BCBSNM provides a variety of resources. They distributed monetary and food contributions to food banks, schools, and shelters across the state. Grants were also provided to different organizations to address food, medical, and support services, reflecting their commitment to community welfare.

The initiatives undertaken by BCBSNM and other healthcare organizations in New Mexico demonstrate a commitment to comprehensive care, access, and support for the states residents. From the convenience of a provider finder to the peace of mind of knowing your healthcare needs are covered, BCBSNM offers the support you need to navigate the healthcare system.