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• What is Guest Membership?
• Three Types of Guest Membership
• Prescriptions
• What is the difference between the Away From Home Care Program and the BlueCard Program?
• How do my employees apply for Guest Membership?
• How long does it take to set up Guest Membership?
• Can my employees extend or renew a Guest Membership?
Blue Cross and Blue Shield of New Mexico (BCBSNM) HMO Plan Members: For eligibility information and locations where the Away From Home Care Program is available, please call 1-800-423-1630.
Host Blue Plan Members: For eligibility information and locations where the Away From Home Care Program is available in New Mexico, call BCBSNM at 505-816-4562, or contact the Blue Cross and Blue Shield Association's Away From Home Care office at 1-800-423-1630.
Guest Membership (also known as Away From Home Care) allows your employees with HMO coverage to be "guests" of a participating HMO while out of the BCBSNM service area for 90 consecutive days or more. Guest Members remain members of their BCBSNM HMO plan, and their premiums continue to be paid to BCBSNM.
The Guest Membership benefit ensures your employees have ongoing access to the care they need. Common situations include:
- Temporary work assignments or personal business that keeps them out of state
- Retirees with dual residency in another state
- Divorced or separated families with covered dependents who live in another state
- A dependent child who is attending school in another state
Three Types of Guest Membership
There are three types of Guest Membership, each based on member eligibility and the length of time that the member will be out of the BCBSNM service area.
Long-Term Traveler: The Long-Term Traveler Guest Membership is available to qualified HMO members and their spouses or dependents who will be away from home for at least 90 consecutive days, but not more than 180 days. This type of Guest Membership is typically used for long-term work assignments or for a retiree with a dual residence.
Families Apart: The Families Apart Guest Membership is available to qualified HMO members' spouses or dependents who do not reside in New Mexico for 90 or more consecutive days. Your employees are not eligible for this type of Guest Membership. This type of membership is typically used when divorced or separated families permanently reside outside the BCBSNM service area. (There is no administrative time limit on the length of a Families Apart Guest Membership.)
Student: The Student Guest Membership is available to qualified HMO members' dependents who are out of the state of New Mexico for 90 or more consecutive days attending school. (There is no administrative time limit on the length of the Student Guest Membership.)
HMO members on Guest Membership must use their HMO ID cards when purchasing prescriptions.
Host Blue Plans do not cover prescriptions for BCBSNM Guest Members. BCBSNM Guest Members need to follow their plan's prescription guidelines when they are out of the state of New Mexico.
Members from other Blue Plans temporarily on Guest Membership in New Mexico do not have prescription coverage under HMO USA. Your employees should contact their home Blue Plan for benefit information.
What is the difference between the Away From Home Care Program and the BlueCard Program?
The Away From Home Care program is designed for HMO members who are out of the service area for 90 or more consecutive days. The BlueCard program, a Blue Cross and Blue Shield Association program in which all Blue Plans participate, is designed for members of most BCBSNM plans who need medical care while traveling for short periods of time (less than 90 days). See the chart below for additional information about when HMO members should use either program.
| Emergencies/Short Trips - BlueCard Program | Extended Stays - Away From Home Care Program |
If your employees need emergency or urgent care while away from home for less than 90 consecutive days, they should follow these easy steps: |
If your employees or their qualified dependents will be in a different service area for at least 90 consecutive days (a dependent attending school in another state, for example), the guest membership benefit ensures ongoing access to medical care. |
How do my employees apply for Guest Membership?
To set up Guest Membership, your employees should follow these steps:
- Call a customer service representative at the number listed on their member ID card to get more information about Guest Membership. The representative can tell them if there is a participating HMO in the location where they'll be staying.
- If there is a participating HMO in the area, the customer service representative or Guest Membership coordinator will help your employees complete a Guest Membership application and forward the application to the participating "Host" HMO in the other location.
- The Host HMO will provide your employees with a member ID card, a primary care physician (they may be asked to choose a PCP), and information on how to access their benefits.
Your employees will not have to submit claim forms or pay up-front for their health care services, except for those out-of-pocket expenses (copayments, coinsurance or noncovered services) that they normally pay. Please note that payments may be different from those required by the HMO plan.
How long does it take to set up Guest Membership?
Your employees will receive notification from their Home Plan within 15 days from the date their application is received. Urgent care or emergency room visits are available to your employees during the notification period, if necessary.
Can my employees extend or renew Guest Memberships?
Renewals are sent out two months prior to the termination date. If your employees do not return renewals, their Guest Membership is terminated. The Long-Term Traveler Guest Membership can only be renewed once.
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