Blue Health FOR YOUR SM Winter 2026 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 INSIDE 5 HAVE DIABETES? GET THE CARE YOU NEED 10 ARE YOUR TEEN’S SHOTS UP-TO-DATE?
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 Blue Cross and Blue Shield of New Mexico (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. 2026 © Coffey Communications, Inc. All rights reserved. Turquoise Care Winter 2026 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 members are welcome. There are three advisory boards you can join. ■Member Advisory Board ■Native American Advisory Board ■Long-Term Services & Supports 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). 2 Blue for Your Health Winter 2026
Please renew your information We want you to stay covered It is time to renew your Medicaid. If you do not renew, you may lose your coverage. ■Call the Health Care Authority (HCA) at 800-283-4465 with questions. ■If you received a letter from the HCA, send your information to the HCA right away. The HCA will send your information to the New Mexico Health Insurance Exchange (NMHIX) if you no longer qualify for Medicaid. Visit the NMHIX at bewellnm.com for more information. Below are some questions and answers you may have about this process. 1 Do I need to do anything to stay covered with Medicaid? If your address or income has changed, report your changes by calling the HCA at 800283‑4465 (TTY: 711). Or go to www.yes.state.nm.us. Do not delay so you and your family can stay covered. 2 Do I need to choose a health plan when I send in my information? If you still qualify for Medicaid, you will stay in the same health plan. If you want to change to a different Managed Care Organization, you can change during your renewal period. For information, call the HCA at 800283-4465 (TTY: 711). 3 What happens if I do not update my information? If you do not update your information, you may lose your Medicaid coverage. Also, your information may not go to the NMHIX, where you can choose another Blue Cross and Blue Shield of New Mexico health plan. 4 What happens if I have more income? If you are no longer eligible for Medicaid due to your income, the HCA will tell you. The HCA will send your information to the NMHIX (bewellnm.com). The Exchange can help you find a new health plan. 5 How long do I have to pick an Exchange plan? You will have 60 days from your Medicaid end date to choose a new plan. 6 Can I stay with the same plan so I can keep my doctors? By choosing the same plan you had with Medicaid, you may be able to keep the same doctors. 7 I will be turning 65 this year. Can I get Medicare too? Some people may get Medicaid and Medicare. If you do, Medicare will be your primary health plan. If you have questions about your Turquoise Care health plan, call Member Services at 866-689‑1523 (TTY: 711). bcbsnm.com/turquoise-care 3
Now is a great time to love your heart See your health care provider for a blood pressure check. You may be due for cholesterol or diabetes tests as well. Discuss medications you may be taking for: ■Blood pressure ■Cholesterol ■Diabetes ■Kidney health Make positive changes, such as: ■Eat foods that are high in fiber, like beans and vegetables. ■Choose proteins that are low in fat. ■Get active with exercises or a sport you enjoy. Pregnant? Consider Care Coordination Our community partners and maternity providers are looking after our pregnant members. The partners may also include early intervention for infants from birth to 3 years old who are having delays in development or health-related needs. As a pregnant member, you may receive a call from a community partner offering Care Coordination. We hope you will respond and take part. Care Coordination can help you: ■With managing your pregnancy through early childhood ■Learn more about plan benefits ■Find the right health care services Care Coordination is voluntary and at no cost. To learn more about Care Coordination, call Blue Cross and Blue Shield of New Mexico at 877-232-5518. If you are speech or hearing-impaired, call 711 for TTY service. This program does not replace your doctor’s care. Always talk to your health care provider about any health questions or concerns. Care for pregnant members with substance use Using a treatment team helps pregnant people who use substances. Your doctors, nurses, and counselors work together as a team to keep you and your baby safe. Your team makes sure that your needs and your baby’s needs are met throughout your pregnancy. You can also learn about healthy eating, rest, and baby care. Getting all your care from one team saves time and helps you stay in treatment. This care lowers the risk of early birth and helps both parent and baby stay healthy. Talk to your doctors, and ask if they are in contact with your other therapists. Ask if they share information about your care with each other. If they don’t, you can give written permission for your providers to share information with each other to support your care. 4 Blue for Your Health Winter 2026
DIABETES CARE IN 2026 Make and keep your appointments If you have had difficulty trying to see your health care provider regarding diabetes, you are not alone. New Mexicans face challenges getting in to see their health care provider to discuss problems related to diabetes. When New Mexicans diagnosed with diabetes are told the next available appointment is possibly three or more weeks away, it can cause additional confusion and frustration with a diagnosis that already causes those feelings. Tips for making appointments Make your appointment EARLY: ■Members diagnosed with diabetes need to see their health care provider at least twice per year, or more as needed, for routine diabetes discussions, care plan updates, and updates to their medication prescriptions. ■ Call and make your regular appointments ahead of schedule, earlier rather than later. KEEP your appointment: ■If you cancel your appointment, more than likely there won’t be another available appointment for a long while. Pushing your needs, questions, and care plan updates farther back can lead to complications and possible emergency room visits. If you need an appointment sooner: ■Ask to be put on the waiting list. Health care provider offices routinely have patients cancel their appointments or not show up. When a patient cancels, provider offices look to their waiting list and will call to offer you that appointment date and time. ■When the provider office calls to offer you an appointment from a patient who has canceled, try to attend that appointment to meet your needs. Care at your fingertips As a Blue Cross and Blue Shield of New Mexico member, you have, at no cost, access to Galileo (a telehealth primary care provider). You can access primary care around-theclock, all year-round, even on nights and weekends: ■Receive care by text, phone, or video in the Galileo app. ■Skip the scheduling. ■Request labs and referrals, and even get your prescriptions refilled. ■Call 855-648-8859 to talk with a Galileo representative to find out more. Get the tests you need Each year members diagnosed with diabetes need an A1C test, kidney health testing, and a diabetic retinopathy exam. Please remember to talk with your provider about ordering these needed tests and for help getting in to see an eye doctor yearly. Early appointments lead to early testing and help, which is needed to maintain your health and prevent serious diabetes complications. bcbsnm.com/turquoise-care 5
Measuring member outcomes Are you getting the care you need, when you need it? Each year Blue Cross and Blue Shield of New Mexico (BCBSNM) collects information to see if you got the care you needed when you needed it. BCBSNM looked at last year’s results and compared them to this year’s results. BCBSNM wanted to see improvements in your care. Compared to last year’s results, BCBSNM saw improvement in many areas. Annual dental exam It is important to have a yearly dental checkup. BCBSNM looked to see if children ages 2 to 20 had a dental visit in 2024. BCBSNM had a decrease in the dental rates for members ages 2 to 20 years old. 2024 (measuring 2023 visits) 2025 (measuring 2024 visits) Getting yearly dental visit 50.69% 49.46% Care of members with asthma Asthma and its symptoms can be hard to manage. If you have asthma, it is important to see your provider on a regular basis. Your provider can make sure you are taking the right medication to control your asthma symptoms. BCBSNM has a pediatric asthma disease management program that can help children learn how to take care of their asthma. See bcbsnm.com/turquoise-care/pdf/tc-disease -mgt-program-nm.pdf. 2024 (measuring 2023 visits) 2025 (measuring 2024 visits) Refilling asthma medication 83.41% 85.06% Controlling blood pressure If you have high blood pressure, work with your provider so you can control it. Having your provider check your blood pressure regularly will help. If you take medication, remember to always take your blood pressure medication. Controlling your blood pressure is an important step in preventing heart attacks, strokes, and kidney disease. 2024 (measuring 2023 visits) 2025 (measuring 2024 visits) Controlling high blood pressure 54.01% 43.31% Pregnancy care If you’re pregnant, it is important to see a provider or obstetrician-gynecologist as soon as you find out. This should be done early, in the first three months of pregnancy. Going to all appointments will help keep you and your baby healthy. One to 12 weeks after your baby is born is also a good time to see your provider. Please talk with your provider and let them know if you’re feeling sad or depressed after your baby is born. Your postpartum visit with your provider is important. Your provider can help you understand how to manage being a new mother. 2024 (measuring 2023 visits) 2025 (measuring 2024 visits) Getting a prenatal visit done in time 85.16% 81.02% Getting a postpartum visit done in time 72.26% 72.99% Breast cancer screening If you’re a woman over the age of 40, talk with your provider about getting a mammogram to help you stay healthy. Mammograms are tests that could find abnormalities in your breast tissue. These are the recommendations: ■Women 40–74 should have a mammogram to screen for breast cancer every one to two years. ■Women 75 and older should ask their provider about continuing with mammograms. 6 Blue for Your Health Winter 2026
2024 (measuring 2023 visits) 2025 (measuring 2024 visits) Getting a mammogram 45.63% 47.31% Other health care topics 2024 (measuring 2023 visits) 2025 (measuring 2024 visits) Getting immunizations by 2nd birthday 64.72% 63.99% Getting tested for a sore throat 75.44% 79.18% Getting the right treatment for upper respiratory infection 81.18% 81.38% Avoiding antibiotics for acute bronchitis treatment in adults 55.61% 55.69% Taking depression medication regularly for 84 days 42.52% 42.09% Seeing a doctor within 7 days after being in hospital for mental health issue 34.16% 47.33% Checking weight—body mass index for children and adolescents 73.24% 71.53% Talking about nutrition (ages 3–17) 69.10% 58.88% Talking about exercise (ages 3–17) 64.96% 59.12% This information is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Schedule a visit with your provider to seek the advice of your provider with any questions you may have regarding a medical condition. Source: Healthcare Effectiveness Data and Information Set Measuring member satisfaction You may have gotten a satisfaction survey in 2025. BCBSNM wanted to find out how happy you are with BCBSNM and your providers. BCBSNM would like to thank those members who completed the survey. Members answered survey questions over the phone, by internet, or by mail. The survey is called the Consumer Assessment of Healthcare Providers and Systems (CAHPS). From the adult survey results, BCBSNM had improvements in eight areas: Getting care quickly, Getting needed care, Rating of health plan, Rating of all health care, Rating of personal doctor, Rating of specialist seen most often, Coordination of care, and How well doctors communicate. Adults: Percent who said they were “always” or “usually” satisfied with: 2024 2025 Getting care quickly 70.77% 74.83% Getting needed care 77.16% 79.25% Customer service 91.79% 91.35% Rating of health plan 53.30% 55.31% Rating of all health care 46.43% 55.36% Rating of personal doctor 58.59% 64.71% Rating of specialist seen most often 63.04% 68.12% Coordination of care 70.77% 82.89% How well doctors communicate 90.36% 91.82% From the child survey results (see page 8), BCBSNM had improvements in six areas: Getting care quickly, Customer service, Rating of all health care, Rating of personal doctor, Coordination of care, and How well doctors communicate. —Continued on page 8 bcbsnm.com/turquoise-care 7
Children with chronic conditions—percent who said they were “always” or “usually” satisfied with: 2024 2025 Getting care quickly 81.33% 87.87% Getting needed care 87.27% 84.55% Customer service 86.96% 88.53% Rating of health plan 72.59% 71.62% Rating of all health care 61.48% 63.09% Rating of personal doctor 71.84% 71.96% Rating of specialist seen most often 71.43% 64.29% Coordination of care 77.05% 81.54% How well doctors communicate 91.13% 92.17% 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! —Continued from page 7 Measuring member outcomes BCBSNM cares about you and the care you receive. BCBSNM continuous quality improvement efforts try to improve your health and satisfaction. Your satisfaction is important to BCBSNM. BCBSNM can make changes that address your concerns. BCBSNM wants to ensure that you get the care you need when you need it. You may be picked to complete a satisfaction survey. This happens every year during the springtime. If you are selected to take the survey, BCBSNM hopes you will have the time to answer the satisfaction survey. You can complete the survey you got by mail or by telephone. You can also complete the survey online. Your feedback helps BCBSNM improve the care you receive. You can always tell BCBSNM about your satisfaction and/or experience. You can call Member Services at 866-689-1523 (TTY: 711). 8 Blue for Your Health Winter 2026
Books at no cost for kids Children can get books at no cost through a partnership between Dolly Parton’s Imagination Library and local programs. The Blue Door Neighborhood CenterSM has teamed up with Libros for Kids. They have given out 250 books. Sign up at librosforkids.org/sign-up. Families can sign up to get new books mailed to their home each month if the child is less than 5 years of age. The first book is received 8 to 12 weeks after signing up. Books are available in English and Spanish. Families can choose what works best for their child. We are proud to support the love of reading with Libros for Kids. To learn more, call 505-816-5100. Follow us on Facebook at facebook.com/BlueDoorCenterNM. Mammograms are for younger women too It is very important to have a mammogram. Breast cancer screening is recommended for women every one to two years starting at age 40 and continuing through age 74. Some women may need to start screening at a younger age. Talk with your health care provider or OB-GYN. They can guide you on when to have your mammogram and how often. After you have your mammogram, you can expect to have results within 30 days. Your results will include information about the density of your breast tissue. Women with dense breast tissue may need more testing, such as a breast ultrasound. Ask your health care provider or OB-GYN what’s best for you. For help finding a mammogram facility, call Member Services at 866-689-1523. Vaccines your child needs by age 6 Have you ever wondered why babies get vaccines starting from the day they are born? One big reason: The youngest of us are most at risk of getting sick. It is also the time in your child’s development when their immune system learns the most from the vaccine. Early vaccinations help children build immunity before they are exposed to germs that can make them very sick. We can prevent life-threatening diseases with vaccines. That’s why most of the childhood vaccines are recommended during your baby’s first 12 to 18 months of life. How many diseases does a child’s immune system learn to resist by kindergarten? By the time a child is old enough to start school, vaccines provide their immune system information to resist 16 diseases! From birth to 6 years of age, infants and children get the following vaccinations: hepatitis B, respiratory syncytial virus (RSV), rotavirus, diphtheria, tetanus, whooping cough (pertussis), Haemophilus influenzae type b, polio, pneumococcal disease, COVID-19, flu (influenza), measles, mumps, rubella, chickenpox (varicella), and hepatitis A. bcbsnm.com/turquoise-care 9
Immunizations: Is your teen up-to-date? Immunizations, also called vaccines, help keep people healthy throughout their lives. Your teenager needs vaccines. Here’s why: ■Their bodies are still growing and need protection. ■Some vaccines work best with the immune system during the teen years. ■Colleges and universities may require students to have certain vaccinations. Shots your teen needs The following vaccines are recommended for teens between 13 and 18 years old: Flu (influenza). The flu virus changes from year to year. Experts recommend that everyone over the age of 6 months receive a flu shot every year, preferably by the end of October. Meningococcal. This series of vaccines protects your teen from meningococcal disease. It can cause serious illness, even death, and can spread easily in crowded places like college dorms. Tetanus, diphtheria, and pertussis (whooping cough). This combined vaccine, also called Tdap, protects against three diseases. Human papillomavirus (HPV). The HPV vaccine series prevents six types of cancer. Your teen may need other vaccines too. They may have missed some childhood vaccines, be preparing to travel to another country, or be going to college. Talk with your teen’s provider to make sure all their vaccinations are up-to-date. Vaccination tips Keep this advice in mind: ■Nobody likes needles, but shots are over quickly. Your teen may have mild side effects afterward, like redness and soreness where the needle pierced the skin. A cool, damp cloth placed over that area can ease discomfort. ■Some teens may feel like fainting after a vaccine. To help prevent this, they should sit or lie down while getting the shot and stay seated for 15 minutes afterward. ■Serious side effects from vaccines are rare. ■If your teen has a mild illness, like a cold or a low fever, it’s probably safe for them to get vaccinated. But first, ask their provider just to be sure. Blue Cross and Blue Shield of New Mexico 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. 10 Blue for Your Health Winter 2026
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