Blue Health FOR YOUR SM INSIDE 3 HAVE YOU MOVED RECENTLY? 7 WOMEN: GET THE SCREENINGS YOU NEED Summer 2025 Such services are funded in part with the State of New Mexico. 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
2 Blue for Your Health Summer 2025 To ask for auxiliary aids and services or materials in other formats and languages at no cost, please call 866-689‑1523 (TTY/TDD: 711). Blue Cross and Blue Shield of New Mexico complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 855-710‑6984 (TTY: 711). Díí baa akó nínízin: Díí saad bee yáníłti’go Diné Bizaad, saad bee áká’ánída’áwo’dę́ę́’, t’áá jiik’eh, éí ná hólǫ́, kojį’ hódíílnih 855-710‑6984 (TTY: 711). Blue for Your Health is published for Turquoise Care members. If you would like a printed copy of the newsletter, please call Member Services tollfree at 866-689-1523. You can also visit our website to send an email to Member Services. Medicaid Operations P.O. Box 27838 Albuquerque, NM 87125-7838 Website: bcbsnm.com/turquoise-care All providers referenced in this document are not employed by and are independent from BCBSNM. Information in Blue for Your Health is not meant to be taken as medical advice. If you have any concerns or questions about content that may affect your health, talk to your health care provider. Models may be used in photos and drawings. Programs offered by BCBSNM, such as the 24/7 Nurseline, do not replace your doctor’s care. Always talk to your doctor about any health questions or concerns. Benefit information provided is a brief summary, not a complete description of benefits. Limitations and restrictions may apply. For more information, review your Member Handbook or contact Turquoise Care Member Services at 866-689-1523. If you are speech- or hearing-impaired, call 711 for TTY service. Benefits, formulary, pharmacy network, and/or provider network are subject to change. Prime Therapeutics, LLC, is a separate company and is the Pharmacy Benefit Manager for Turquoise Care. 2025 © Coffey Communications, Inc. All rights reserved. Turquoise Care Summer 2025 Join our hybrid advisory board meetings We want to hear from you! Please join us at an advisory board meeting. Share your experience with programs and services you receive. Your feedback allows us to improve in areas such as care coordination, transportation, member materials, and more. All Blue Cross and Blue Shield of New Mexico (BCBSNM) members are welcome. There are four advisory boards you can join. ■Member Advisory Board ■Native American Advisory Board ■Long-Term Services & Supports Advisory Board ■Youth & Young Adult Advisory Board We know your time is valuable. Members can join in person, online, or by phone. Qualifying members who participate in an advisory board meeting are eligible to receive a $25 gift card. Food and refreshments will be available to participants who attend in person. Members are welcome to bring their children. ■To view the meeting schedule or register for a meeting, visit bcbsnm.com/turquoise-care/ member-resources/member-advisory-board. ■To learn more, call 866-825-6034 or email bcbs_ab@bcbsnm.com. Speech- and hearingimpaired, call 711 for TTY service. $25 GIFT CARD Medicaid PCP update The Turquoise Care provider directory is produced monthly. For information about providers in the network, go to bcbsnm.com/turquoise-care, then click on Getting Care, choose Find a Provider, and click on Search Provider Finder®. If you have questions about the provider network, call Member Services at 866‑689‑1523 (TTY: 711).
bcbsnm.com/turquoise-care 3 Did you change your address recently? If you moved recently, do you know how to change your address with your local NM Income Source Division? Moving is difficult, with many things to do and remember, and you might have forgotten to let your local NM Income Source Division know. But why is that important? Every month, BCBSNM sends communications to members to notify you of programs available, events to help you with your health, and needed annual testing. If you need to change your address, email, or phone number with the NM Income Source Division, please use one of the following. Online: ■On your computer or smartphone, go to yes.nm.gov. ■Create an account, following the prompts. ■After creating an account, you can log in to yes.nm.gov to change your address any time. Phone: ■Call the NM Health Care Authority call center at 800283-4465, Monday through Friday, 7 a.m. to 6:30 p.m. ■Tell the call center representative you need to change your address. If NM Health Care Authority has your correct address, phone number, and email, BCBSNM can help you get on the path to better health! South Valley Blue Door Neighborhood CenterSM is open to everyone! The center offers classes for men, women, and children. You can learn to take care of conditions such as heart disease and diabetes— or try a fun cooking class or exercise class. You can also play bingo on the second and fourth Tuesday of each month! You can join classes online or in person. All services are offered at no cost. Visit the center at 3925 Las Estancias Way SW, Building 9, Suite A, Albuquerque, NM 87121. To sign up, go to bcbsnm.com/bdnc/lasestancias or call 505-816-5100. Follow the center on Facebook at facebook.com/BlueDoorCenterNM. Your Turquoise Care Member Handbook Your Member Handbook has lots of information about your health care benefits. Some of the benefits you can read about are listed below. ■Benefits and restrictions for: - Medical care - Dental care - Drugs - Behavioral health care ■What services are and are not covered ■Copayments and charges you may have to pay ■Claims information, including when you need to file a claim for an out-ofnetwork service ■Health care providers you can use and services you can receive, including: - PCPs - Specialty care providers - Behavioral health care providers - Hospital services ■How to get care, including: - After-hours care - Primary care - Emergency care - Out-of-area care ■How to file a complaint or an appeal
4 Blue for Your Health Summer 2025 Reap the rewards Value-added services and Turquoise Rewards for pregnant members If you are pregnant, you can receive a car seat or portable crib for your infant. Limit: ■1 car seat per newborn ■1 portable crib per newborn To receive the CAR SEAT or CRIB: ■Participate in Care Coordination through one of our community providers—there is no charge to participate. ■Call FINITY to receive the car seat or crib: 877-806-8964. Turquoise Care Rewards Program Every member of Turquoise Care can enroll in the Turquoise Rewards Program. The program allows you to earn credits by taking part in certain healthy actions. To use your credits, enrollment is required. You can enroll at turquoiserewards.com or call Turquoise Rewards at 877-806-8964. If you would like to know more about this program, please call 877-806-8964. Infant car seat or crib at no cost to you Sources: American Heart Association; Centers for Disease Control and Prevention If you smoke, be a quitter. Smoking can have unhealthy effects on your cholesterol levels. Eat hearthealthy foods. Start by limiting your intake of saturated and trans fats. Keep moving. Walk. Swim. Cycle. Enjoy! Manage your weight. If you’re overweight, losing just 5% of your current weight may help. Listen to your doctor. Take cholesterollowering medications, if prescribed.
bcbsnm.com/turquoise-care 5 Learn to Live—an online behavioral health resource BCBSNM is working with Learn to Live—an online resource available at no cost to eligible Turquoise Care members and caregivers, ages 13 and older—to support their behavioral and emotional well-being. Learn to Live is a mental health program for those living with stress, depression, substance use concerns, insomnia, panic, and/or social anxiety. It can also help improve overall resilience and well-being. Learn to Live key features ■24/7 access to seven self-guided programs and features ■Programs available in English and Spanish ■Can be used in conjunction with other services that members may have access to (in-person therapy, teletherapy, primary care) ■Personal coaching available (phone, text, email) Impacted programs and access Turquoise Care members and caregivers (ages 13-plus): ■Locate Subscriber ID number on the front of Blue Cross member card. ■Visit learntolive.com/welcome/bcbsnmmedicaid and enter access code NMMED. ■Then enter Subscriber ID number when prompted. Learn to Live provides educational behavioral health programs. Members considering further medical treatment should consult with a physician. Learn to Live, Inc., is an independent company that provides online behavioral health programs and tools for members with coverage through BCBSNM. BCBSNM makes no endorsement, representations, or warranties regarding third-party vendors and the products and services offered by them. Know your Medicaid benefits and rights Federal laws ensure that Medicaid members can get certain health care services. Women have the right to use women’s health specialists. They can be used for covered routine and preventive care. No referral is needed. Medicaid members have the right to get a second opinion. They can get one from an in-network provider. Sometimes the right innetwork provider is not available. If that happens, the member can get a second opinion outside of the network. Services from an out-of-network provider are not covered without first getting prior authorization from BCBSNM. Call BCBSNM for help with getting prior authorization at 866-689-1523 (TTY: 711). There may be times when a Medicaid member cannot get a covered health care service inside the network. If this happens, BCBSNM will allow the service to take place outside of the network, but prior authorization is required. BCBSNM cannot delay the service. Scan the QR code or visit rebrand.ly/bcbs-nm-live -to-learn to view a brief video on the Learn to Live offering.
6 Blue for Your Health Summer 2025 DIABETES RETINAL EYE EXAMS See the difference What is diabetic retinopathy? Diabetic retinopathy is the leading cause of blindness in working-age adults who are diagnosed with diabetes. Over time, diabetes can cause damage to your eyes that can lead to poor vision or even blindness. About 1 in 3 people with diabetes who are older than age 40 already have some signs of diabetic retinopathy. Finding and treating diabetic retinopathy early can reduce the risk of blindness by 95%. Often there are no early symptoms of diabetic eye disease. You may have no pain or change in your vision as damage begins to grow inside your eyes, particularly with diabetic retinopathy. When symptoms do occur, they may include: ■Blurry or wavy vision ■Frequently changing vision—sometimes from day to day ■Dark areas or vision loss Take action to protect your vision! To prevent diabetic eye disease or to keep it from getting worse, manage your diabetes ABCs: 1. Complete an A1c test at least twice per year. 2. Work with your health care provider to manage: ■Blood pressure ■Cholesterol 3. Complete a diabetic retinopathy eye exam at least once per year—or more often if recommended by your eye care professional (ophthalmologist or optometrist). Every member with diabetes, ages 18 and older, can have a diabetic retinopathy exam AT NO COST! Even if you don’t have a vision plan, this exam is covered under medical claims with a diagnosis of diabetes. Schedule an exam today! Preventive care services Preventive checkups and screenings can help find illnesses and medical problems early. They can improve your health and the health of everyone in your family. There are no out-of-pocket costs for Turquoise Care members who receive covered preventive checkups and screenings from providers in the Turquoise Care network. Examples of covered preventive care services include general wellness exams each year; recommended vaccines; and screenings for things like diabetes, cancer, or depression. For preventive services that are covered for you or your family member, visit bcbsnm.com/turquoise-care. Click on Learn about benefits and select the link for Member Handbook. You can also call Member Services at 866689‑1523 (TTY: 711). Visit bcbsnm.com/turquoise-care for a summary of preventive care guidelines. Click on Member Resources. Choose Health and Wellness. There you will find the Preventive Care Guidelines for Adults and Children. You can also call Member Services at 866-689‑1523 (TTY: 711) to ask for a copy of the guidelines to be sent to you by mail.
bcbsnm.com/turquoise-care 7 CERVICAL CANCER When to get screened Cervical cancer screenings save lives. You can help protect yourself. Here’s how. Cervical cancer begins in the cells of the cervix. The cervix is at the lower part of the uterus, where a baby grows. Cancer starts when abnormal cells grow too quickly in your cervix. Screening tests Two types of tests are often done to help prevent cervical cancer or to find it early. 1. The HPV test looks for a virus called HPV (human papillomavirus). This virus can cause cells to change. The test will show if you have a type of HPV that is more likely to involve cervical cancer. 2. Pap tests, or Pap smears, can also find abnormal cervical cells before they become cancerous. Removing these precancerous cells prevents cervical cancer over 95% of the time. The current U.S. Preventive Services Task Force guidelines for most women are that women ages 21 to 29 should get a Pap test every three years. Women 30 to 65 years old should get one of the following: ■A Pap test every three years ■An HPV test every five years ■A Pap test and HPV test together every five years Women over 65 should ask their health care provider if they need to continue screening. This also applies to women without a cervix who have never had cancer or any abnormal test results. Sticking to recommended screening schedules is key to reducing your risk for cervical cancer. Don’t delay seeing your health care provider if you are due for a screening. Get your mammogram A screening mammogram can detect breast cancer early, which is helpful when treating cancer. Women 40 and older should get mammograms regularly. During a mammogram The mammography technologist may ask if you: ■Have ever had breast cancer, or if anyone in your family has ever had it ■Have noticed any recent changes in your breasts ■Have breast implants ■Think you may be pregnant ■Are breastfeeding Mammograms may be uncomfortable. However, any discomfort goes away soon. After the exam You should receive your results from the radiologist within a couple of weeks. The radiologist also will send a copy to your health care provider. If the radiologist finds anything abnormal, they will ask you to return for additional screening. These extra pictures can help the radiologist understand what the abnormality is. Keep in mind that being called back for additional screening doesn’t necessarily mean you have cancer. Most of the time, breast changes do not indicate cancer. But it’s important to know for sure. Make an appointment Don’t put off your mammogram! For help finding a mammogram provider, call Member Services at 866-689-1523.
8 Blue for Your Health Summer 2025 5 things to know about birth control If you’re sexually active and want to delay becoming pregnant, it’s important to use birth control. Here are five key facts you should know. ■Most types of birth control do not protect you from sexually transmitted infections (STIs). ■It’s best to use two forms of birth control. Use a condom plus another form of birth control every time you have sex. This could be a pill, patch, ring, or other method. Follow the instructions for any form you use. ■Contraception takes two. Talk with your partner about contraception before sex. ■Emergency birth control can be an option in some situations. You might be able to use it if your normal method didn’t work or if you didn’t use any birth control during sex. Emergency birth control shouldn’t be used as your regular form of contraception. ■There are many birth control options. When choosing which methods to use, think about ease of use, cost, effectiveness, and potential side effects. Consider your reproductive health goals, such as whether you want children and—if so—when. Your health care provider can help you understand your options. Overcoming stigma and pausing substance use while pregnant When pregnant, it’s important to do all you can to be sure you and the baby are healthy. Certain substances, such as opioids, alcohol, or amphetamines, can be harmful to you and your baby. Deciding to quit may be helpful to the health of your pregnancy. It may seem hard, and some tough feelings might come up. You may feel as though others might judge you or not understand your circumstances. Get help Don’t let that stand in the way of getting help. There is help, and you are not alone. There are people who want to help without judging or shaming. Having supportive professionals around helps you feel more confident about getting treatment. It can help you feel stronger and more able to make positive changes. BCBSNM has help available to you so that you can feel safe and supported in your health journey and for the health of your growing baby. Call the Member Services number on the back of your membership card (866-689‑1523) for assistance. Possible resources include: ■Scheduling a virtual counseling appointment via MD LIVE at mdlive.com. ■Support groups at postpartum.net/get-help/ psi-online-support-meetings. Visit rebrand.ly/bcbs-nm-video or scan the QR code to watch a short video on how to start and succeed at substance use treatment.
bcbsnm.com/turquoise-care 9 Stay healthy this summer with virtual care from Galileo Galileo is here to help you with your physical and mental health, so you can have a happy, healthy summer. With the Galileo app, you can get care for many health conditions, such as: ■Sunburns and heat rash ■Bug bites and poison ivy ■Seasonal allergies ■Sun safety tips You can talk to a provider through chat, phone, or video. Your care team will work with you to create a plan to meet your care needs. They can also answer any questions you may have about your health. Getting started is easy: Scan the QR code or visit galileo.health/BCBS-NM. After creating an account, you can get care right away. You can also download the Galileo app from the Google Play Store or Apple App Store. Have your BCBSNM member ID ready to create your account. With Galileo, you can also get help with: ■Yearly checkups ■Managing chronic conditions (diabetes, asthma, high blood pressure, and more) ■Birth control and sexual health ■Mental health support (depression, anxiety, insomnia, and more) ■Everyday issues (acne, hair loss, and more) ■Medication prescriptions ■Referrals to specialists If you have any questions, Galileo is ready to help. You can call 855-648-8859 to connect with their team. Galileo is an independent company that has contracted with Blue Cross and Blue Shield of New Mexico to provide care and disease management, health information content, member health platform and tools, mental health administration/network and wellness for members with coverage through BCBSNM. BCBSNM makes no endorsement, representations or warranties regarding third-party vendors and the products and services offered by them. Your Turquoise Care health care You and your PCP work together to decide what medical services you need. Our health care management staff can help. They can help you and your PCP plan for your access to services covered by your Turquoise Care health plan. We call this utilization management (UM). UM means we look at medical records, claims, and prior authorization requests to make sure services are: ■Medically necessary ■Provided in the right setting ■Consistent with the condition reported If this is done before a service is received, it is part of prior authorization. If it is done while a service is still being received, it is called a concurrent review. If it is done after a service, it is called a retrospective review. If you have questions about your health care coverage, you can call Member Services at 866-689‑1523 (TTY: 711). Our staff can help you Monday through Friday, from 8 a.m. to 5 p.m. If you need to call Member Services after hours, leave a message. Your call will be returned by 5 p.m. the next business day. When our Member Services staff calls you, they will always tell you their name, title, and the company they work for.
10 Blue for Your Health Summer 2025 BCBSNM Drug List updates BCBSNM and the Prime Therapeutics Pharmacy and Therapeutics Committee have made changes to the BCBSNM Drug List. To see a complete summary of the changes, go to bcbsnm.com/turquoise-care. Click on Plan Details. Choose Drug Coverage, and click on Preferred Drug List Updates. While there, you can view the entire Drug List and learn more about your drug benefits. You can also call Member Services at 866-689-1523 (TTY: 711) to get this information. Member Services: 866-689-1523 (TTY: 711) Hours: Monday through Friday, 8 a.m. to 5 p.m. MT Weekends and holidays: Closed If you call after hours, please leave a message. Your call will be returned the next business day. Care Coordination: 877-232-5518 (press 3 and then press 2) (TTY: 711) The role of the Care Coordinator is to help members with special health care needs, whether at home, in a skilled nursing facility, or in the hospital. If you believe you or your child has special physical, behavioral, and/or long-term health care needs, please call the number listed above. 24/7 Nurseline/Audio Health Library: 877-213-2567 (TTY: 711) Need to know if an injury should be checked? Worried about your child’s fever? Get answers to your health questions 24 hours a day, 7 days a week, by calling the 24/7 Nurseline and talking with a registered nurse. The nurse can help you decide what to do. There is also a phone library of more than 300 health topics available through the 24/7 Nurseline. Many of the topics are offered in Spanish. For medical emergencies, dial 911. For urgent care, you can go to an urgent care provider. See the Turquoise Care provider directory for a list. Or call Member Services at 866-689-1523 (TTY: 711). ModivCare®: 866-913-4342 (TTY: 866-288-3133) Hours: Monday through Friday, 8 a.m. to 5 p.m. MT Call for non-emergency medical transportation. Do you need after-hours transportation or a ride home from your appointment? Call Ride Assist at 866-418-9829 (TTY: 866-288-3133). Ride Assist is available 24 hours a day, 7 days a week. Ombudsman Specialist: 888-243-1134 (TTY: 711) The Ombudsman Specialist explores unresolved problems and deals with them fairly. The ombudsman advocates for your rights. This is done by using Medicaid guidelines and BCBSNM resources to help you. The ombudsman is independent from BCBSNM management. 988 Suicide & Crisis Lifeline: Call or text 988 or visit 988lifeline.org/chat to chat, available 24 hours a day, 7 days a week. ModivCare is an independent company that has contracted with Blue Cross and Blue Shield of New Mexico to provide transportation services for members with coverage through BCBSNM. BCBSNM makes no endorsement, representations, or warranties regarding third-party vendors and the products and services offered by them. Keep these Turquoise Care phone numbers handy clip and save! Your rights and responsibilities As a Turquoise Care member, you have certain rights and responsibilities. For example, you have the right to ask about your treatment plan. You have the responsibility to follow the plans and instructions for care that you have agreed upon with your health care provider. A full list is included on pages 9 through 11 of your Turquoise Care Member Handbook.
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