FAQ

Get Answers To Our Most Frequently Asked Questions

  • I Have a Question About Membership.

    How can I learn more about my benefits?

    For benefits information, please call Customer Service at the number listed on your BCBSNM member ID card.

    Are my medical records kept private? 

    Yes. We are committed to protecting your medical records, and have strict rules to make sure our staff and anyone who needs to review your records keep all your member information confidential. Your medical records or claims details may have to be reviewed. If so, precautions are taken to keep your information safe. In many cases your identity, such as name and address, will not be included in the information provided during the review.

    Has my coverage started? Can I use my health plan?

    Your first premium payment activates your coverage, so you can start using your health plan within 1–2 days of making your payment, depending on how and when you pay. Online payments may mean you get your coverage sooner and mail-in payments may mean a delay in your coverage start date. Generally, your coverage will start on the first day of the following month after you enroll in a plan and make your first payment. 

    Make sure your coverage has been activated before you use your health plan. Otherwise, you may be financially responsible for your medical bills.

    I need to get a prescription filled but don't have my member ID card yet. What can I do?

    Even if you haven't received your BCBSNM member ID card, you should have received a new member welcome letter shortly after your enrollment has been completed.

    Your member identification and group numbers listed on your welcome letter can be used by the pharmacy to verify your benefits. You will need to pay your first premium payment and confirm tat your coverage has begun before you can use your prescription benefits.

    I applied on the New Mexico Health Insurance Marketplace (beWellnm), but don't know if my application has been received and accepted. How do I find out the status of my application?

    If you applied through beWellnm, your application may take some time to get to us. If you just applied recently, we encourage you to wait for more membership information from BCBSNM. If you applied weeks ago and have not received anything from us, it is possible your application has been held up for some reason. To learn about the status of your application, please contact beWellnm.

    I applied for an off-Exchange plan on the BCBSNM website, but don't know if my application has been received and accepted. How do I find out the status of my application?

    To learn about the status of your application, please visit the BCBSNM application tracker. If you still have questions, please call BCBSNM at 1-866-236-1702.

    When will I get my member ID cards, and how many will I get?

    You should get your member ID cards in the mail soon after your application is approved. Individual and family health plan members will receive no more than 2 membership ID cards. Please note that all member ID cards will have only the subscriber name on it but can be used by all of the dependents enrolled under the policy. HMO Individual and family plans will get a card for each member enrolled. You can print a temporary ID card and request additional cards through your Blue Access for Members account.

    I received my member ID cards in the mail but they only have my name on them and not my spouse's. Can I get another ID card with their name on it?

    Your member ID cards will only have the primary subscriber's name on them, but they can be used by all the dependents (in this case your spouse) enrolled under your policy.

    When will I get benefit coverage information and the contract on the plan I selected?

    Within a few days of your application being accepted and your first payment being received, you will get a welcome letter from BCBSNM that includes your member identification number and group number. This information can be used by providers and pharmacies to verify your coverage until you get your member ID card. Your ID card will be sent separately soon after.

    However, your policy information is available through your Blue Access for Members account as soon as your plan goes into effect.

    When I try to register for Blue Access for Members, I get a message telling me it's not available. When will it be available for me to register?

    You may have received this error message during your registration for a number of reasons. Double check that the information you provided matches the information on your ID card. If you still have trouble, please call the number on the back of your ID card. Register now.

    What communications are available in Spanish?

    Members can receive Explanation of Benefits (EOB) statements in Spanish. If you would like to receive available Spanish communications, you can log in to your Blue Access for Members account, go to the Settings tab and choose Preferences. You can also call the customer service number listed on your member ID card. Customer Service will record your preference.

    We also have the following tools available to meet the Spanish language preference of our members:

    • Spanish language website — Browse health plans, get information on member services and tips for using your health insurance.
    • Provider Finder in Spanish — Locate medical professionals who speak Spanish in your area.
    • "Pregúntele a Sara" — Get answers to typical health plan questions using the tool found at the top of the website.
    • Assistance Finder in Spanish — Find a Spanish speaking representative to answer your health insurance questions.
    • BCBSNM App — Access your secured health plan information easily on your mobile device. The App will open in Spanish if the device language is set to Spanish.
    • Facebook Latino  — Follow us on Facebook en español for content and posts in Spanish.
    • Connect Community — Learn how you can stay up-to-date with your health, wellness and BCBSNM member option.
  • I Have a Question About Buying Health Insurance.

    I missed the open enrollment deadline. Can I still buy health coverage?

    In most cases, you can only sign up for a health insurance plan during the Open Enrollment Period (OEP). If you missed open enrollment, you may be able to enroll during the Special Enrollment Period (SEP). To be able to enroll suring SEP, you must have had a qualifying "life event" within the past 60 days or experienced other complications that did not allow you to complete your enrollment. Learn more about special enrollment.

    If you want to enroll in an on-Exchange plan, you can do so through beWellnm. You can also enroll in an off-Exchange plan directly with BCBSNM.

  • I Have a Question About Updating My Health Plan Account.

    I bought my health plan on beWellnm. How can I make changes to that account or profile?

    When you find the change(s) you'd like to make, please contact beWell customer support.

  • I Have a Question About Payments.

    What are my options to pay my premium?

    If you enrolled through beWellnm, you can pay on their website. If you enrolled for an off-Exchange plan directly with BCBSNM, there are a few ways you can pay online, over the phone, by mail, or in person. Learn more about the ways you can make your monthly payment.

    I applied for a plan through beWellnm and a plan directly with BCBSNM, so now I'm getting a bill for both. How do I cancel one?

    We cannot process a cancellation request for an on-Exchange plan. If you want to cancel the plan you enrolled in through beWellnm, you can contact their customer support team. If you want to cancel your off-Exchange plan, or the plan you enrolled in through BCBSNM, please call us at 1-800-432-0750. You can also log in to your Blue Access for Members account and send us a secure email message.

  • I Have a Question About My HMO.

    What is an HMO? How is it different from other health care plans?

    A Health Maintenance Organization (HMO) is a type of health plan that gives you access to certain doctors and hospitals that have contracted with the HMO, often called a provider network or just network. An HMO is different from other health care plans in a number of ways:

    • An HMO is designed to control costs through preventive health care services that help you avoid serious and costly health problems.
    • An HMO typically has lower monthly premium and lower copays than other types of plans.
    • HMO networks are not limited to doctors and hospitals. HMO networks include clinics, pharmacies, labs, imaging centers and medical equipment vendors.
    • When you join an HMO, you select or are assigned a primary care physician (PCP) to coordinate all your health care services.
    • Also, HMOs generally only cover health care services provided by a network of health professionals and hospitals that together provide a full range of health care services. When choosing your new plan, make sure the doctors and hospitals you want to use are all in the HMO's network.


    What types of doctors can be a Primary Care Physician (PCP)?

    The following doctors can be selected as a PCP:

    • Family medicine doctor
    • OB/GYN
    • Pediatrician
    • Internal medicine doctor


    How do I select a PCP?

    Use our Provider Finder® online directory to find a PCP in the HMO network who best fits your needs. Be sure the doctor you select is accepting new patients.

    It's easy to use the Provider Finder by registering for Blue Access for Members:

    1. Visit Blue Access for Members
    2. Use the information on your BCBSNM member ID card to complete the registration process.
    3. Once you are registered, log in to Blue Access for Members. The Provider Finder tool is located under the Find Care tab.
    4. Know the name of your plan and choose it from the dropdown box "Select network type".
    5. Continue to search until you find a doctor who meets your needs and is accepting new patients.


    TIPS:

    • Check your Benefit Booklet for your network type
    • Make sure you are searching within your network
    • Enter as much information as you know
    • Use filters to help narrow your search


    What happens if I don't select a PCP?

    You must have a primary care physician assigned. If you don't select your own, we will assign one to you.

    Do I need a referral to schedule an appointment with a specialist?

    No, you do not need a referral. However, if the specialist is not in your plan's network, in most cases, you may have to pay for services which are considered out-of-network.

    Can I keep my current doctor when I join the HMO plan?

    Yes, if your current doctor is a part of the HMO’s network. If your doctor is not in the network, you will need to select a new primary care physician (PCP). To make sure a provider is in the HMO network, search Provider Finder.

    Do I have coverage if I am traveling?

    In an emergency, go directly to the nearest hospital. For non-emergencies, some HMO plans allow you to get health care services from a Blue Cross and Blue Shield-affiliated doctor or hospital when you are traveling outside of New Mexico. If you aren't sure, contact customer service at the number listed on your member ID card before you go. And always remember to carry your current BCBSNM member ID card. It contains helpful information for accessing health care at home or away.

    What if I'll be away for more than 90 consecutive days?

    If you or a covered family member will be temporarily living outside of New Mexico for 90 days or more, you may be eligible for guest membership in a Blue Cross and Blue Shield-affiliated HMO. In some circumstances, moving can also qualify you to be able to enroll in a new plan in your new location. You can call the customer service number listed on your member ID card to find out if your plan covers you when living outside New Mexico and to discuss all your options.

    What if I'm already in treatment when I enroll and my provider isn't in the network?

    We'll work with you to provide coverage for the most appropriate care for your medical situation, especially if you are pregnant or receiving treatment for a serious illness. You may still be able to rely on your current provider for a brief time. Call us at the customer service number listed on your BCBSNM member ID card for more information.

    What if I have a chronic health issue like heart disease or asthma?

    If you are already visiting a specialist for your condition, make sure your doctor is in your plan's network. If the doctor is not in your plan's network, you will pay more in most cases. Also make sure your specialist uses providers and facilities in your plan's network when sending you for other services or hospitalization. If you have any questions, please call us at the customer service number listed on your member ID card. If you are looking for a doctor for your chronic condition, you can use the Provider Finder tool. Click on "Network Type" at the top and select the name of your HMO plan to find a list of doctors and hospitals in your plan's network.

    Does my plan cover prescriptions?

    Your BCBSNM HMO benefits also cover prescription drugs. Not all drugs are covered. You can visit our website to view the list of prescriptions your plan covers. This list is called a preferred drug list. To look for your medicines, you will need to know:

    • The medicine's exact name
    • The dose you take
    • How many pills your doctor often prescribes for you

    While costs can vary depending on your benefit plan, you usually pay less for generic drugs and more for brand name drugs. Your plan may cover some of the costs of drugs not on your preferred drug list. You can learn more by looking in your benefit book, or calling the customer service number listed on your member ID card.

* BCBSNM has contracted with a third-party vendor, Alacriti Payments, LLC, to process your ACH/electronic check payment. In order to process this payment, you will be redirected to Alacriti's secure payment site, OrbiPay. If you have any problems with your payment, please contact BCBSNM customer service at 1-800-538-8833.