A Medicaid And Healthy Michigan Planmanaged Care Health Plan
Blue Cross Complete of Michigan is a managed care health plan contracted by the state of Michigan. We help Medicaid members get the health care they need in 32 Michigan counties across the state.
We provide members with the care they need, when they need it. This includes a wide range of benefits, such as transportation services, a 24-hour nurse help line, vision, hearing and dental coverage. We also offer pharmacy, maternity care and integrated care management benefits.
The Healthy Michigan Plan is a health care program from the Michigan Department of Health and Human Services. Blue Cross Complete administers Healthy Michigan Plan benefits to eligible beneficiaries.
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About Blue Cross Blue Shield
Blue Cross Blue Shield began as two companies Blue Cross and Blue Shield that offered affordable health care solutions in the early 1900s and started to come together in the 1940s. It was made official in 1982 when they formed the Blue Cross Blue Shield Association, which now includes 34 independent and locally operated companies across the country. Nationwide, it provides health care coverage to 110 million members in the U.S. and Puerto Rico.
The Blue Cross Blue Shield Association has two main offices, in Chicago and Washington, D.C.
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Blue Cross and Blue Shield of Alabama.
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Premera Blue Cross and Blue Shield of Alaska.
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Blue Cross Blue Shield of Arizona.
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Arkansas Blue Cross and Blue Shield.
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Anthem Blue Cross .
Nebraska HeartlandBlue will be available in all 93 of Nebraskas counties. Customers can purchase coverage as soon as the 2023 Open Enrollment Period begins. OEP runs annually from Nov. 1 to Dec. 15.
To purchase individual coverage, Nebraskans will visit HealthCare.Gov or NebraskaBlue.com during OEP or any other Special Enrollment Period for which theyre eligible.
Customers can also consult a health insurance broker for assistance in determining which plan option best fits their needs. BCBSNE will have its sales agents available to help Nebraskans purchase coverage during OEP.
For more information, visit NebraskaBlue.com.
New Mexico Opted For State Subsidies Instead Of Medicaid Buy
In 2017, Nevada lawmakers passed legislation that would have allowed for Medicaid buy-in, but Governor Brian Sandoval vetoed it. If he had approved it, New Mexico would have been the first state with a Medicaid buy-in program.
U.S. Representative, Ben Ray Lujan, who represents New Mexicos 3rd Congressional District, supports the idea of Medicaid buy-in. And Governor Michelle Lujan Grisham, who was a U.S. Representative until winning her 2018 gubernatorial race, introduced legislation at the federal level in 2017 that would have allowed people to buy into Medicaid. The Health Care Choices and Affordability Act did not advance at the federal level, but creating a Medicaid buy-in program may end up being more feasible at the state level.
In early 2018, lawmakers in New Mexico passed two legislative memorials calling for a cost analysis of a potential Medicaid buy-in program in New Mexico. Lawmakers wanted to get a good idea of the costs of allowing New Mexico residents who arent eligible for Medicaid to purchase Medicaid instead of obtaining private coverage or remaining uninsured. They also wanted feedback from stakeholders in terms of the implications and pros and cons of a Medicaid buy-in program in New Mexico.
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How Does Medicaid Provide Financial Assistance To Medicare Beneficiaries In New Mexico
Many Medicare beneficiaries receive Medicaid assistance that can help them with the cost of Medicare premiums, lower prescription drug costs, and pay for expenses not covered by Medicare such as long-term care.
Our guide to financial assistance for Medicare enrollees in New Mexico includes overviews of these benefits, including Medicare Savings Programs, long-term care coverage, and eligibility guidelines for assistance.
New Mexico Medicaid Enrollment
From the fall of 2013 through July 2016, total enrollment in New Mexico Medicaid increased by 303,355 people, or 66%, and reached 761,033. As was the case in most states, enrollment grew sharply in 2014 and 2015, but had mostly leveled off by 2016. By the end of 2017, New Mexico Medicaid enrollment had dropped slightly, and total enrollment growth stood at 63%
But as of November 2021, total New Mexico Medicaid and CHIP enrollment had grown by another 100,000 people, and stood at 861,297. This was an 88% increase over 2013 levels. This large jump in enrollment since 2016 is mostly due to the COVID-19 pandemic and the Families First Coronavirus Response Act, which provides additional federal Medicaid funding as long as states do not disenroll anyone from Medicaid during the COVID public health emergency.
According to U.S. Census data, the uninsured rate in New Mexico fell from 19.6% in 2010 to 10% in 2019 a drop of almost 50%, versus the national average drop of about 40%.
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New Mexico Medicaid Application
You can apply for New Mexico Medicaid online, by mail, or in person at your local Human Services Department field office. To apply online, visit Yes New Mexico.
To apply by mail, to download the English application, or to download the Spanish application. At the bottom of the Medicaid app, youll find the applications for other programs like cash assistance, SNAP, and LIHEAP . You can apply for everything at once, or you can apply solely for Medicaid. Once youve downloaded and completed your application, you can either fax it to 1-855-804-8960 or mail it to the Central ASPEN Scanning Area at PO Box 830 Bernalillo, NM 87004.
Blue Cross Blue Shield Medicare Advantage 2022 Review
Many or all of the products featured here are from our partners who compensate us. This may influence which products we write about and where and how the product appears on a page. However, this does not influence our evaluations. Our opinions are our own. Here is a list ofour partnersandheres how we make money.
Blue Cross Blue Shield is a collective of 34 independent companies, and together they were the third-largest provider of Medicare Advantage plans in 2021
Although BCBS companies are all licensed by the Blue Cross Blue Shield Association, theyre locally owned and operated and may vary in terms of coverage, benefits and quality of plans. More than 8 in 10 BCBS customers are in a Medicare Advantage contract rated 4 or higher on the Medicare Star Rating scale as of June 2022.
Heres what you should know about Blue Cross Blue Shield Medicare Advantage.
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Blue Cross And Blue Shield Of Nebraska To Offer New Individual Health Care Plan
- Fremont Tribune staff
Blue Cross and Blue Shield of Nebraska will introduce a new individual health care plan called Nebraska HeartlandBlue on the governments ACA Marketplace for 2023, providing Nebraskans and their families not covered under an employers health plan with more choices in coverage.
We exist to serve the people of Nebraska, to provide them with security and peace of mind about the cost of medical care for themselves and their families, said Ron Rowe, BCBSNE executive vice president. We want to give people looking for coverage on the ACA Marketplace more choice. Nebraska HeartlandBlue offers individuals affordable health care coverage and strong provider networks.
Nebraska HeartlandBlue will include gold, silver and bronze plans, which provide customers with the ability to choose the option that best fits their coverage needs and budgets. The plans will use BCBSNEs existing provider networks in the state, enabling Nebraskans to tap into the strong, established relationships the insurer has with health care providers across the state.
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Aim Specialty Health Prior Authorization Program
Blue Cross and Blue Shield of New Mexico has contracted with AIM to provide certain utilization management prior authorization services for certain Commercial, Retail and ASO members and Blue Cross Community Centennial Members. Services requiring prior authorization through AIM are outlined below. AIM is an independent company that provides specialty medical benefits management for BCBSNM.
Use the AIM ProviderPortal for Pre & Post-Service Reviews
Use the AIM ProviderPortal to request prior authorization and respond to post-service review requests by AIM. Do not submit medical records to BCBSNM for prior authorization or post-service reviews for the care categories managed by AIM. Medical records may or may not be needed for pre or post service reviews using the AIM portal due to the smart clinical algorithms within the portal.
Benefits of the AIM ProviderPortal for Pre & Post-Service Reviews
Services requiring prior authorization through AIM:
- Molecular and Genomic Tests
Use the AIM ProviderPortal for Pre & Post-Service Reviews
AIM Contact Information
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What Is Urgent Care
Urgent care is medical treatment for a condition that is not life-threatening. The condition requires prompt medical attention to prevent serious health problems. If you need advice, you can call our toll-free 24/7 Nurseline at 1-877-213-2567 . See the Member Handbook for guidelines on what urgent care is covered.
Nm Managed Care In 2019
The Centennial Care program is managed through four plans in 2019: BlueCross BlueShield of New Mexico, Western Sky Community Care, Presbyterian Health Plan, and UnitedHealthcare Community Plan of New Mexico. The UnitedHealthcare Community Plan is a dual complete plan for members with both Medicare and Medicaid. The coverage through each of the other plans is relatively similar, though they may have different provider networks and offer extra benefits, like:
BlueCross BlueShield of New Mexico:
- Free infant car seats and cribs for eligible members
- Extended adult vision benefits
- Extended lodging for homeless members
Western Sky Community Care:
- School sports physicals for kids ages 12-18
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Blue Cross And Blue Shield Of New Mexico Names New President
ALBUQUERQUE, N.M. Janice Torrez has been named incoming president of Blue Cross and Blue Shield of New Mexico . Torrez will replace current BCBSNM President Kurt Shipley, who will retire on Dec. 31, 2020, after a 24-year tenure with BCBSNM.
I am honored to have served as president of BCBSNM for the past eight years, Shipley said. Our employees are dedicated to making health care in New Mexico more affordable and accessible, and I couldnt be more proud of the accomplishments weve made together. Ive worked closely with Janice for many years. She is equally committed to addressing the health and social challenges facing New Mexico. I am confident that she will be a strong advocate for our members and all New Mexicans.Torrez has been with BCBSNM for more than 12 years, most recently serving as associate vice president of External Affairs and chief of staff since 2012. In this role Torrez led and advanced many important initiatives and played a pivotal role in joint efforts with key stakeholders across the state and the health care industry. She oversaw government relations and the overall planning, budgeting and administration at BCBSNM.
Janices deep knowledge of the health care industry and commitment to the state of New Mexico will serve BCBSNM well, said Jeff Tikkanen, senior vice President, HCSC Markets. I thank Kurt for his exceptional leadership at BCBSNM over the years. Thanks to his work, BCBSNM is in a strong position to continue serving our members.
What Should I Do If I Lose My Id Card
Call Blue Cross Community Centennial Member Services at 1-866-689-1523 to ask for a new ID card. It will take up to two weeks to receive a new card. If you need a temporary ID card while you wait for your new card, you can print a letter to give to your provider. Just log in to Blue Access for MembersSM. Go to My Coverage. Click on Print Temporary ID Card.
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Frequently Asked Questions About New Mexico’s Aca Marketplace
New Mexico has a state-run exchange, beWellnm . For coverage effective in 2021 and previous years, the state used the federal enrollment platform at HealthCare.gov for individual enrollments. But as of November 2021 , New Mexico is running its own exchange platform and is no longer using HealthCare.gov.
New Mexico had initially planned to make this transition by the fall of 2020, but the board voted in 2019 to push the transition date out to the fall of 2021. For small businesses, New Mexico has long had its own SHOP exchange enrollment platform.
New Mexico previously had a unique exchange the state ran the small-business portion, and while the individual exchange was also technically state-run, HealthCare.gov was used to enroll people in individual insurance . But as of November 2021, the state fully runs both the small business and individual/family enrollment platforms.
Nevada transitioned back to having its own exchange platform as of the fall of 2019. Pennsylvania and New Jersey did so in the fall of 2020. Kentucky and Maine also transitioned to their own fully state-run exchanges in the fall of 2021, along with New Mexico. Virginia and Oregon are in varying stages of a future transition to fully state-run exchanges as well.
For 2022 coverage, there are six insurers that offer exchange plans in New Mexico:
New Mexicos Official Health Insurance Marketplace
The New Mexico Health Insurance Exchange, also known as beWellnm, is now your State-Based Health Insurance Marketplace.
Emergency Order in place to help New Mexicans who have been affected by the Wildfires
Click here to learn more.
New Special Enrollment Period
BeWellnm has launched a new special enrollment period that provides qualified New Mexicans, an opportunity to enroll in coverage. The new SEP for New Mexicans with household incomes below 200% of the federal poverty level who arent eligible for Medicaid or the Childrens Health Insurance Program, can enroll anytime.
Examples of how the FPL amounts are valid through December 31, 2022 that applies to you:
A single person making less than $2,147 a monthA family of 3 making less than $3,660 a month
Both are examples of eligible to enroll at any time this year.
Click hereto learn more.
New Mexicans who experience a certain life events have a 60-day window to enroll in coverage. This is known as a Special Enrollment Period. . Apply now!
Shop and Compare Plan Options!
You can shop and compare to find the right plan for you and your family.
A certified assister can help you find coverage that meets your needs and budget.
Financial Assistance!
Thanks to the American Rescue Plan there is more financial assistance available to help pay for your coverage.
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Available Part D Prescription Drug Plans
While many of Blue Cross Blue Shields Medicare Advantage plans include Part D drug coverage, the company also sells stand-alone Part D prescription drug plans, also known as PDPs. These plans, which are meant to accompany Medicare Part A and Medicare Part B, dont provide medical coverage.
All states offering a stand-alone prescription drug plan have both a basic and an enhanced option. For instance, if you live in Grand Rapids, Michigan, you have the option of the following two PDPs from Blue Cross Blue Shield of Michigan:
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Prescription Blue PDP Select.
Heres an example of how they compare:
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Plan feature |
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$35. |
$40. |
*For a one-month supply of a covered Part D prescription drug at a preferred retail pharmacy after meeting any applicable deductible.
These plans differ by premium, by the drugs they cover, by the costs associated with each tier of drugs and by the pharmacies that are in their network of preferred retailers. To find the best drug plan for you, consider plans that offer the lowest costs for your regular prescriptions and preferred pharmacies.
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About Blue Cross Blue Shield Association
The Blue Cross and Blue Shield Association is a national federation of 34 independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide health care coverage for one in three Americans.
The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies.
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Aim Specialty Health Prioe Authorization Program
Blue Cross and Blue Shield of New Mexico has contracted with AIM to provide certain utilization management prior authorization services for certain Commercial, Retail and ASO members and Blue Cross Community Centennial Members. Services requiring prior authorization through AIM are outlined below. AIM is an independent company that provides specialty medical benefits management for BCBSNM.
Use the AIM ProviderPortal for Pre & Post-Service Reviews
Use the AIM ProviderPortal to request prior authorization and respond to post-service review requests by AIM. Do not submit medical records to BCBSNM for prior authorization or post-service reviews for the care categories managed by AIM. Medical records may or may not be needed for pre or post service reviews using the AIM portal due to the smart clinical algorithms within the portal.
Benefits of the AIM ProviderPortal for Pre & Post-Service Reviews
Services requiring prior authorization through AIM:
- Molecular and Genomic Tests
Use the AIM ProviderPortal for Pre & Post-Service Reviews
AIM Contact Information
