New Mexico
BlueHMO
Preferred
SM
Group: 126298
2017 Member Guide
Open enrollment
November 14 - December 12
Dear Federal Employee:
Thank you for your continued loyalty as our member under
the New Mexico BlueHMO Preferred health plan. We know
that you have many choices when it comes to health care.
Please contact us directly if you have any questions related to
your benefit choices with Blue Cross and Blue Shield of New
Mexico (BCBSNM), during the upcoming Open Season, which
begins November 14 through December 12, 2016.
Blue Cross and Blue Shield of New Mexico continues to
provide the highest quality customer service to our members
under the New Mexico BlueHMO Preferred.
We are proud to continue being a health care plan choice for
your health care benefits under the Federal Employee Health
Benefit program.
Your designated Customer Service Unit’s toll-free telephone
number is 1-855-235-1039, which is also located on the back
of your medical ID card.
We look forward to continue serving you as a BCBSNM
member.
Sincerely,
Kurt Shipley, President
Blue Cross and Blue Shield of New Mexico
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bcbsnm.com/fehb-nmbluehmo
Welcome
This guide will help you:
• Understand how your plan works
• Get the most from your New Mexico BlueHMO Preferred
• Navigate the online tools at bcbsnm.com
• Find a health care provider in the BCBSNM network
Glossary of Health Plan Terms
Understanding health insurance isn’t always easy. Here are some
common terms that are helpful to understand.
Claim form: A form you may have to fill out and submit to your health
insurance carrier for payment of benefits under that health care plan for
non-contracted providers.
Coinsurance: A percentage of a covered charge that you are required to
pay toward a service covered by your plan.
Deductible: A fixed amount of the eligible expenses you are required to
pay before reimbursement by your health plan begins.
BCBSNM
PO Box 27630
4373 Alexander Rd., NE
Albuquerque, NM
87125-7630
ATTN: Federal DSU
Phone: 855-235-1039
Provider Finder: Provider Finder from BCBSNM is an innovation for
helping members estimate and manage their costs and select providers
with meaningful quality ratings.
Website:
Network: The group of doctors, hospitals, and other medical care
professionals that a health care plan has contracted with to deliver
medical services to its members.
call 855-235-1039 or go to
New Mexico Retiree Health Care Authority
bcbsnm.com/fehb-nmbluehmo
For more information
bcbsnm.com/fehb-nmbluehmo
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Health Plan Highlights
High Option
Individual Deductible
$250 (Inpatient hospital or
outpatient hospital surgical only)
$500
Individual Out of Pocket Maximum
$5000
$6350
Type of Service
Your Cost In-Network
Your Cost In-Network
Primary Care Services
• Adult
• Child (up to age 26)
$20 (per visit)
No
$30 (per visit)
$30 (per visit)
Specialty Physician Service
$35 (per visit)
$45 (per visit)
Virtual Visits
No Charge
No Charge
Diagnostic/Lab/X-ray
No Charge
No Charge
Inpatient Hospital Services
$250 (per admission) after
deductible is satisfied
30% after deductible is satisfied
Outpatient Hospital Surgical Services
$100 (per admission) after
deductible is satisfied
30% after deductible is satisfied
Emergency Room Care
$100 (per visit)
$200 (per visit)
Urgent Care
$40 (per visit)
$75 (per visit)
Maternity Care
• Initial Visit
• All other visits
• Hospital Delivery
$20 (pcp)/$35 (specialist)
No Charge
$30 (pcp)/$45 (specialist)
30% after deductible is satisfied
30% after deductible is satisfied
EyeMed Vision Care
•One exam every calendar year
•One pair of glasses or one set of contact lenses every calendar year
Hearing Aid Services
Retail Prescription Drugs (30-day Supply)
•Formulary generic drugs
•Formulary brand name drugs (with no generic
equivalent)
•Non-formulary drugs (or brand name formulary
drugs with generic equivalent)
•Formulary Specialty Drugs
Mail-Order Prescription Drugs (90-day Supply)
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Standard Option
Blue365® Vision Discount Program
$5 (per visit)
No Charge up to $150 plan
allowance
No Charge up to $2200 plan
allowance per hearing impaired
ear every 36 months.
No Charge up to $2200 plan
allowance per hearing impaired
ear every 36 months.
$5
$35
$10
$50
$60
$75
50% (min $50; max $250)
50% (min $75; max $250)
2 times Retail Copayment
2.5 times Retail Copayment
bcbsnm.com/fehb-nmbluehmo
2017 Rate Information
Postal Categories and Rates
Non-Postal rates apply to most non-Postal employees. If you are in a special enrollment category, contact the
agency that maintains your health benefits enrollment.
Postal rates apply to United States Postal Service employees.
Postal Category 1 rates apply to career bargaining unit employees.
Postal Category 2 rates apply to career non-bargaining unit employees.
For Further Assistance, Postal Service employees should call:
Human Resources Shared Service Center
877-477-3273, option 5 (TTY: 866-260-7507)
Postal rates do not apply to non-career Postal employees, Postal retirees, or associate members of any
Postal employee organization who are not career postal employees.
Premiums for Tribal employees are shown under the monthly non-Postal column. The amount shown under
employee contribution is the maximum you will pay. Your Tribal employer may choose to contribute a higher
portion of your premium. Please contact your Tribal Benefits Officer for exact rates.
High Option Premiums
Non-Postal Premium
Type of Enrollment
Enrollment
Code
Biweekly
Postal Premium
Monthly
Gov’t
Share
Your
Share
Gov’t
Share
Your
Share
Biweekly
Category 1
your share
Category 2
your share
Self Only
Q11
$221.67
$113.04
$480.29
$244.92
$103.81
$100.73
Self Plus One
Q13
$475.79
$243.84
$1030.88
$528.32
$224.01
$217.41
Self Plus Family
Q12
$505.22
$320.18
$1094.64
$693.73
$299.12
$292.11
Standard Option Premiums
Non-Postal Premium
Type of Enrollment
Enrollment
Code
Biweekly
Postal Premium
Monthly
Gov’t
Share
Your
Share
Gov’t
Share
Your
Share
Biweekly
Category 1
your share
Category 2
your share
Self Only
Q14
$221.67
$74.82
$480.29
$162.11
$65.59
$62.51
Self Plus One
Q16
$475.79
$161.67
$1030.88
$350.28
$141.84
$135.24
Self Plus Family
Q15
$505.22
$225.92
$1094.64
$489.50
$204.86
$197.85
New Mexico BlueHMO Preferred
5
Blue Access for Members
SM
Blue Access for Members (BAMSM), our member portal, offers you
information on your health and health plan in one convenient location.
To register for BAM, go to bcbsnm.com and select Register Now in the
BAM log-in box. With your BCBSNM ID card handy, follow the
on-screen registration instructions. Create a user name and password
for instant and secure access to your personal information.
After logging in, from your personal home page you can:
• Check your claims, including payment status and amounts, and
• sort/print claim information
• Confirm who is covered under your plan
• Download and print various forms
• Locate a doctor or hospital in your plans’ network using
Provider Finder
Don’t have access to
a computer or need to talk to
a Customer Advocate?
• Research and estimate costs for common health care services with
the Member Liability Estimator tool
• Request a new or replacement ID card and print a temporary card
• Email Customer Service
Call: 855-235-1039
This toll-free number is also
on the back of your member ID
card.from your mobile device
Web browser for secure and
convenient access.
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Provider Finder
®
Insight for important health care decisions In life.
In one place.
Provider Finder from Blue Cross and Blue Shield of New Mexico is a
new member tool for helping members estimate and manage their
costs and select providers with quality ratings.
Use Provider Finder either online or from a mobile device to:
• Find a network primary care physician, specialist or hospital
• Filter search results by doctor, specialty, ZIP code, language and
gender — even get directions from Google Maps™
• Estimate the cost of a provider’s procedures, treatments and tests —
and gauge out-of-pocket expenses
• View patient feedback or add a provider review
• Check the quality, certifications and recognitions for doctors
• Make an appointment to consult with a provider in select geographic
areasIt’s easy and immediate, secure — and available at
bcbsnm.com, or a mobile phone Web browser*
It’s easy and immediate — and available at bcbsnm.com, or a mobile
phone Web browser — for members and non-members.
Provider Finder delivers information that puts you in charge.
• Do you want to know more about your network providers?
• Do you want to know the actual cost and your share of a medical
procedure?
• How do you choose where to go for medical services?
New Mexico BlueHMO Preferred
7
Powered by
Virtual Visits
Convenient health care
at your fingertips
Getting Care When and Where
You Need It Just Got Easier
Getting sick is never convenient, and finding time to get to the doctor can be hard. Blue Cross and Blue Shield of New Mexico
(BCBSNM) provides you and your covered dependents access to care for non-emergency medical issues through MDLIVE.
You can speak to a doctor immediately or schedule an appointment for later. The doctor can send prescriptions electronically
to a pharmacy of your choice (when appropriate).
MDLIVE doctors can help treat the following conditions and more:
General Health
Pediatric Care
• Allergies
• Nausea
• Cold
• Ear problems
• Asthma
• Sinus infections
• Flu
• Pinkeye
You can access a virtual visit anywhere through the mobile app, online video or telephone.*
Website:
Visit the website MDLIVE.com/bcbsnm
• Choose a doctor
• Video chat with the doctor
• You can also access through
Blue Access for Members
Mobile app:
• Download the app from the Apple
App Store , Google Play Store or
Windows Store
• Open the app and choose a doctor
• Video chat with the doctor from your
mobile device
SM
TM
®
SM
Register today!
To register, go to MDLIVE.com/bcbsnm. Enter your first and last name, date of birth and BCBSNM member ID number.
* Internet/Wi-Fi connection is needed for computer access. Data charges may apply when using your tablet or smartphone. Check your phone carrier’s plan for details. Service is limited to interactive-audio consultations (phone only), along with the ability to prescribe, when clinically appropriate, in Texas. Service is limited to
interactive-audio/video (video only), along with the ability to prescribe, when clinically appropriate, in Idaho, Montana, New Mexico and Oklahoma. Virtual visits are currently not available in Arkansas. Availability depends on member’s location at the time of service. Virtual visits may not be available on all plans. MDLIVE is not an
insurance product nor a prescription fulfillment warehouse. MDLIVE operates subject to state regulations and may not be available in certain states. MDLIVE does not guarantee that a prescription will be written. MDLIVE does not prescribe DEA-controlled substances, non-therapeutic drugs and certain other drugs that may be
harmful because of their potential for abuse. MDLIVE physicians reserve the right to deny care for potential misuse of services.
Blue Cross and Blue Shield of New Mexico, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association
Blue Cross®, Blue Shield® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans.
MDLIVE, an independent company, provides virtual visit services for Blue Cross and Blue Shield of New Mexico. MDLIVE operates and administers the virtual visit program and is solely responsible for its operations and that of its contracted providers.
MDLIVE and the MDLIVE logo are registered trademarks of MDLIVE, Inc. and may not be used without written permission.
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478468.0616
24/7 Nurseline & Additional Programs
24/7 Nurseline
Special Beginnings® Maternity Program
Health concerns don’t always follow a 9-to-5
schedule. Fortunately, registered nurses are on call
at 1-800-973-6329 to answer your health questions,
wherever you may be, 24 hours a day, seven days a
week.
Special Beginnings can help you better understand
and manage your pregnancy. Available at no additional
cost, this maternity program supports you from early
pregnancy until six weeks after delivery through:
The 24/7 Nurseline’s registered nurses can
understand your health concerns and give general
health tips. Get trusted guidance on possible
emergency care, urgent care, family care and more.
• P
regnancy risk factor identification to determine
the risk level of your pregnancy and appropriate
range for ongoing communication/monitoring
• Educational material on various pregnancy and
infant care related topics
The toll-free Nurseline can help you or a covered
family member get answers to health problem
questions, such as:
• Personal telephone contact with program staff
to address your needs and concerns and to
coordinate care with your physician
• Asthma, back pain or chronic health issues
• Assistance in managing high-risk conditions such
as gestational diabetes and preeclampsia
• Dizziness or severe headaches
Take good care of yourself and your baby — enroll
in Special Beginnings today! Enrollment is easy and
confidential. Just call 1-888-421-7781, 7 a.m. to
5:30 p.m., MT.
• High fever
• A baby’s nonstop crying
• Cuts or burns
• Sore throat
Plus, when you call, you can access an audio library
of more than 1,000 health topics — from allergies
to women’s health — with more than 600 topics
available in Spanish.
Note: Special Beginnings is not a substitute for professional medical guidance. It is important to share any health concerns with your physician.
Note: For medical emergencies, call 911 or your local emergency services
first. This program is not a substitute for a doctor’s care.
Talk to your doctor about any health questions or concerns.
Could your child’s fever or sore throat turn into something more serious?
Is your 1 a.m. asthma attack cause for a trip to the emergency room?
The 24/7 Nurseline can help you figure out if you should call your doctor, go to the
emergency room, or treat the problem yourself.
New Mexico BlueHMO Preferred
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Well onTarget
®
A New Way to Experience Wellness
Well onTarget offers personalized tools and resources to help all members —
no matter where you may be on the path to health and wellness.
Well onTarget is designed to give you the support you need to make healthy
choices. All while rewarding you for your hard work.
Explore Your Wellness World
The heart of Well onTarget is the member portal, available at wellontarget.
com. It uses the latest technology to offer you an enhanced online
experience. This engaging portal links you to a suite of innovative programs
and tools.
• onmytime Self-directed Courses
Online courses let you work at your own pace to reach your health goals.
Learn more on nutrition, fitness, weight management, tobacco cessation
and stress. Track your progress as you make your way through each lesson.
Reach your milestones and earn Blue PointsSM.
Wellness is more than healthy
eating and working out. It
involves making healthy choices
that enrich your mind, body and
spirit.
• Health and Wellness Content
The health library teaches and empowers through evidence-based,
user-friendly articles.
• Tools and Trackers
Interactive tools help keep you on course while making wellness fun Use a
food and exercise diary, symptom checker and health trackers.
onmyteam Wellness Coaching
Certified wellness coaches offer you guidance in nutrition, fitness and stress management. You can interact
with your coach by phone or send a secured message through the portal. onmywayTM Health Assessment
(HA) The HA features adaptable questions to learn more about you. After you take the HA, you will get a
personal wellness report. This private record offers tips for living your healthiest life. Your answers will be
used to tailor the Well onTarget portal with the programs that can help you reach your goals.
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bcbsnm.com/fehb-nmbluehmo
Well onTarget
®
onmyteam Wellness Coaching
Fitness Program**
Certified wellness coaches offer you guidance
in nutrition, fitness and stress management. You
can interact with your coach by phone or send a
secured message through the portal. onmywayTM
Health Assessment (HA) The HA features adaptable
questions to learn more about you. After you take
the HA, you will get a personal wellness report. This
private record offers tips for living your healthiest life.
Your answers will be used to tailor the Well onTarget
portal with the programs that can help you reach
your goals.
Fitness can be easy, fun and affordable. The Fitness
Program is a flexible membership program. Gain
unlimited access to a nationwide network of fitness
centers. With more than 9,000 gyms on hand, you
can work out at any place or at any time. Choose a
gym close to home and one near your office.
onmyway
TM
Health Assessment (HA)
The HA features adaptable questions to learn more
about you. After you take the HA, you will get a
personal wellness report. This private record offers
tips for living your healthiest life. Your answers will
be used to tailor the Well onTarget portal with the
programs that can help you reach your goals.
Blue Points* Program
Blue Points will help motivate you to maintain
a healthy lifestyle. Earn points by taking part in
wellness activities. Points can be redeemed in the
new online shopping mall. Real-time granting of
points lets you instantly use your points. To earn
a larger reward, you can add to your point total at
checkout.
Fitness Tracking
Earn Blue Points for tracking your fitness activity
using popular fitness devices and mobile apps.
Online Wellness Challenges
Challenge yourself with wellness, stress
management, fitness and nutrition challenges. Team
challenges let you join forces with others to compete
in monthly contests.
Other program perks are:
• No long-term contract required. Membership is
month to month. Monthly
• fees are $25 per month per member, with a onetime enrollment fee of $25.
• Automatic withdrawal of monthly fee.
• Online tools for locating gyms and tracking visits.
• Earn 2,500 bonus Blue Points for joining the
Fitness Program. Earn additional points with
weekly visits.
• Access to discounts through a nationwide
Complementary and Alternative
Medicine (CAM) network of 40,000 health and
well-being providers such as massage therapists,
personal trainers and nutrition counselors.
Sign up for the Fitness Program today!
Call toll-free at 888-762-BLUE (2583), Monday
through Friday, 8 a.m. – 9 p.m. in any continental
U.S. time zone.
* Blue Points Program Rules are subject to change without prior notice. See
the Program Rules on the Well onTarget Member Wellness Portal for further
information. Your company may have additional reward programs in place to
encourage you to take advantage of certain preventive care and wellness
activities or for making healthy changes. Check your employee benefits.
** The Fitness Program is provided by Healthways, Inc., an independent
contractor which administers the Prime Network of fitness centers. The
Prime Network is made up of independently-owned and managed fitness
centers.
Start experiencing the new wellness today by logging on to wellontarget.com. If you have any questions about the Well
onTarget program, call Customer Service at 877-806-9380.
New Mexico BlueHMO Preferred
11
Blue Points
With the Blue Points program,
you will be able to earn points by
regularly participating in a range
of healthy activities. You can then
redeem your points for popular
health and wellness merchandise
and services.
Blue Points offers you many
features:
Instant recognition of points
Real-time granting of points2 gives
you instant notice of your healthy
efforts.
Easily manage your points
The interactive portal makes it
easy to understand how many
points are available to be earned.
You can also track the total
number of points earned year-todate. All of your point data will be
displayed on one screen.
Get more Blue Points
The Blue Points program gives
you the option to supplement your
Blue Points balance using a credit
card to redeem your points for a
larger reward.
Expanded selection of rewards
Redeem your hard-earned points
in an expanded online Shopping
Mall. Reward categories include
Apparel, Books, Health & Personal
Care, Jewelry, Electronics,
Music and Sporting Goods. In
addition, check out the “Rewards
on Sale” section for discounted
merchandise
Blue Points and Well onTarget
feature convenient online tools
and personalized services
that help support, inform and
motivate you on a journey of
wellness.
Look how quickly your Blue Points can add up! Sample activities that help you earn
Blue Points include:
Completing the onmywayTM Health Assessment (once every six months)
2,500 points every 6 months
Taking all 12 lessons of a Self-directed Course
1,000 points per quarter
Tracking progress in the online tools on the Well onTarget Member
Wellness Portal
10 points, maximum 70 points
per week
Enrolling in the Fitness Program3
2,500 points
Adding weekly Fitness Program visits to your routine
up to 300 points each week
Completing any Self-directed Course Milestone Assessment
up to 250 points per month
Participating in a Biometric Screening through the Well onTarget program
2,500 points per year
Connecting compatible fitness device or app
2,675 points
Tracking progress using compatible fitness device or app
55 points per day
Log on to wellontarget.com to access all the interactive tools and programs you need to start racking up Blue Points.
Check out the online Shopping Mall with an expanded array of rewards to help motivate you to earn more points.
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Blue365
®
Discounts to Make Health and Wellness More Affordable
Blue365 is just one more advantage of being a Blue Cross and Blue Shield of
New Mexico (BCBSNM) member. With this program, you may save money
on health and wellness products and services from top retailers that are not
covered by insurance. There are no claims to file and no referrals or preauthorizations.
Once you sign up for Blue365 at blue365deals.com/BCBSNM, weekly
“Featured Deals” will be emailed to you. These deals offer special savings for
a short period of time.
Below are some of the ongoing deals offered to Blue365 members.
Davis VisionSM | TruVision®
Blue365
Offers members and covered
Members may save on eyeglasses as well as contact lenses, exams and
accessories. Davis Vision is made up of national and regional retail stores as
well as local eye doctors. Members may get possible savings on laser vision
correction through the TLC/TruVision group.
dependents access to savings
TruHearing® | Beltone™
website at
Members may get possible savings on hearing tests, evaluations and hearing
aids. Discounts may also be available for your employees’ immediate family
members.
blue365deals.com/BCBSNM.
on a number of health care and
wellness products and services.
To learn more, visit the Blue365
Procter & Gamble (P&G) Dental Products
Members may get savings on dental packages with Oral B® power toothbrushes and Crest® products.
Packages may include items such as an electric toothbrush, mouth rinse, teeth whiteners and floss.
Dental SolutionsSM
Blue365 members may get dental savings with Dental Solutions. They may receive a dental discount
card that provides access to discounts of up to 50 percent at more than 61,000 dentists and more than
185,000 locations.*
CORD:USE® | CorCell®
Members can protect their family’s cord blood at a stateof- the-art laboratory using high-quality cord blood
banking practices and technologies. Cord blood contains stem cells (like those in bone marrow) that have the
ability to develop into additional cells and can be used to treat possible life-threatening diseases in the future.
Members may save on cord blood processing and storage fees.
Jenny Craig® | Seattle Sutton’s® | Nutrisystem®
Members may reach their weight loss goals with savings from leading programs. They may save on healthy
meals, membership fees (where applicable), nutritional products and services.
New Mexico BlueHMO Preferred
13
RetrofitSM
Blue365 members receive 15 percent off Retrofit’s online, private weight loss
coaching sessions. Retrofit includes the use of a wireless Fitbit® device and
smart scale, one-on-one videoconferencing with a personal team of experts
and unlimited online support. Members enjoy flexibility in scheduling and the
ability to meet with coaches anywhere there is an Internet connection.
Reebok | SKECHERS®
Reebok, a trusted brand for more than 100 years, makestop athletic
equipment for all people, from professional athletes to kids playing soccer.
SKECHERS, an award winning leader in the footwear industry, offers
exclusive pricing on select Performance, Sport, Work and Corporate Casual
styles. Blue365 members enjoy 20 percent off plus free shipping for their
online orders.
SeniorLink Care™
For more great deals or to
With SeniorLink Care, Blue365 members may find support to
help their aging family members or friends lead fulfilling and comfortable
lives. From planning care to helping caregivers, SeniorLink Care assists older
adults and their loved ones in finding the programs and services they may
need most. Members can save on a three- or 12-month membership.
learn more about Blue365, visit
blue365deals.com/BCBSNM.
Handstand Kids
Handstand Kids brings the family together in the kitchen, spending more time cooking and eating healthy,
delicious meals. The Handstand Kids Cookbook series features the languages and cuisines of Italy, Mexico,
China and many other countries. Every book also introduces the language and culture of each country.
Members may save up to 25 percent on cooking accessories and Cookbook Kits.
Blue365 is a discount program only for BCBSNM members. This is NOT insurance. Some of the services offered through this program may be covered
under your health plan. Please check your benefit booklet or call the customer service number on the back of your ID card for specific benefit facts. Use of
Blue365 does not change your monthly payment, nor do costs of the services or products count toward any maximums and/or plan deductibles. Discounts
are only given through vendors who take part in this program. BCBSNM does not guarantee or make any claims or recommendations about the program’s
services or products. You may want to talk to your doctor before using these services and products. BCBSNM reserves the right to stop or change this
program at any time without notice.
The relationship between all Blue365 vendors and Blue Cross and Blue Shield of New Mexico (BCBSNM) is that of independent contractors.
BCBSNM makes no endorsement, representations or warranties regarding any products or services offered by the above-mentioned vendors.
* Dental Solutions requires a $9.95 signup and $6 monthly fee. Blue365 is a discount program only for BCBSNM members. This is NOT insurance. Some of
the services offered through this program may be covered under your health plan. Please check your benefit booklet or call the customer service number on
the back of your ID card for specific benefit facts. Use of Blue365 does not change your monthly payment, nor do costs of the services or products count
toward any maximums and/or plan deductibles. Discounts are only given through vendors who take part in this program. BCBSNM does not guarantee
or make any claims or recommendations about the program’s services or products. You may want to talk to your doctor before using these services and
products. BCBSNM reserves the right to stop or change this program at any time without notice.
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Notes
New Mexico BlueHMO Preferred
15
Blue Cross®, Blue Shield ® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent
Blue Cross and Blue Shield Plans.
Blue Cross and Blue Shield of New Mexico, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the
Blue Cross and Blue Shield Association
478919.0816