Individual and Family Plans
CMS Resumes Risk Adjustment Payments
Aug. 6, 2018
BCBSNM is pleased the Centers for Medicare and Medicaid Services (CMS) announced it will resume risk adjustment payments to health insurers. These transfers between insurance carriers are designed to keep costs down and make sure all consumers regardless of health status have access to health insurance and receive the care they need.
CMS Suspends Risk Adjustment Payments
Jul. 16, 2018
On July 7, the Centers for Medicare and Medicaid Services (CMS) announced it will suspend risk adjustment payments under the Affordable Care Act (ACA). BCBSNM is concerned with this decision. Risk adjustment payments are transfers between insurance carriers. They are meant to keep costs down and make sure all consumers have access to health insurance and get the care they need, no matter if they’re healthy or not. There is no immediate impact to our members. We will continue to review what this may mean for our members and will post more information here.
Proposed Short-Term Health Plan Policy
Mar. 1, 2018
On Feb. 20, the Departments of Health and Human Services, Labor, and the Treasury proposed a new rule on short-term health insurance plans. For now, nothing changes. The federal government still needs to gather and review feedback from the public. Once we know what the final proposal is, we’ll let you know how it may impact you.
Developments on the Tax Reform Bill
Dec. 04, 2017
The Senate passed the tax reform bill on December 2. The differences between the Senate version of the tax bill and the one passed by the House must be settled before it's signed into law.
Nothing will change for now. We encourage customers to keep shopping for or renew their coverage during this open enrollment period which ends December 15. There's only one open enrollment period each year so, customers need to purchase by December 15 to make sure they have coverage in 2018.
Open Enrollment for Individual Health Plans is Here
Nov. 01, 2017
For more than 75 years, Blue Cross and Blue Shield of New Mexico (BCBSNM) has been committed to providing access to quality, cost-effective coverage to as many people as possible, and we’re once again ready to help consumers in New Mexico choose the individual coverage that best meets their needs.
BCBSNM is proud to offer retail products statewide in all 33 New Mexico counties, with plan options both on and off the exchange. There are resources available to help consumers shop for a plan:
- BCBSNM Product Specialist – available every day from 7 a.m. - 9 p.m. Mountain Time at 855-813-1465
Our business starts and ends with our members, and BCBSNM is ready to serve as a go-to resource for customers for help reviewing all their choices and finding the best fit for their health care needs.
Important Actions on Health Care from the White House
Oct. 25, 2017
Recent executive action, along with the announcement to stop funding of cost-sharing reduction payments (CSRs), has once again put a spotlight on health care. Regardless of the action taking place in Washington, D.C. one thing is certain: our continued focus on providing access to health care in New Mexico.
The decision to stop the CSR payments doesn’t impact our market participation. BCBSNM has accounted for the uncertainty around the federal government’s funding of the member’s CSR benefit in our rates.
It's also important to note that the Administration's decision on CSRs isn’t related to the Advanced Premium Tax Credit (APTC).The APTC is federal aid available for people who earn less than 400 percent of the Federal Poverty Level (FPL), and lowers the monthly premium for Marketplace (on-exchange) plans. The APTC is paid by the federal government straight to insurers each month. No payments are made directly to consumers.
Recent Notice about Updates to Our Individual Health Plan Options
Oct. 02, 2017
Blue Cross and Blue Shield of New Mexico (BCBSNM) is proud to again offer a variety of health plan options for individuals and families in every county of New Mexico in 2018. For 2018, we’ve simplified our health plan options to make them easier for you to review and select the coverage that best meets your needs.
While we’ll have fewer plan options at each metallic level, we’ve worked to make sure you get the same quality of benefits you expect from BCBSNM. There won’t be any major changes to our provider networks.
You may have received a legally-required notice informing you that you’ll need to select a new individual plan for 2018. There’s nothing you need to do right now. To help make the transition as seamless as possible we’ve taken the step of identifying a recommended plan that is similar to your current coverage. You will be automatically enrolled in this similar plan, or you can select any plan from our 2018 offerings during the Open Enrollment period, which runs from Nov. 1, through Dec. 15, 2017.
Details on all 2018 plan options will be included in an enrollment package each member will get in the mail before open enrollment. We understand you may have questions, and we’re committed to helping you find the plan that best meets your needs. We have increased the number of sales and customer service representatives during open enrollment to offer support throughout the enrollment process.
You can reach a Customer Advocate at the number listed on the back of your BCBSNM member ID card Monday – Friday, 7 a.m. – 7 p.m. (Mountain Time), 7 a.m. – 5 p.m. (Mountain Time) on Saturdays and 9 a.m. – 5 p.m. (Mountain Time) on Sundays. You can also check this webpage for further updates.
2018 Individual Market Participation Update
Sept. 27, 2017
BCBSNM is proud to announce that we will continue to offer consumers health insurance options both on and off the individual marketplace in 2018. Specific plan, network and benefit information will be available closer to the open enrollment period that begins on Nov. 01, 2017.
We remain committed to working with lawmakers, regulators, providers and the entire health care system to ensure a stable, sustainable individual marketplace and to improve the quality and cost of care for all our members.
Health Care is Complicated, Understanding Individual Insurance Rates
August 01, 2017
Blue Cross and Blue Shield of New Mexico has filed proposed rates and products in the individual marketplace with the Office of the Superintendent of Insurance in the hopes of continuing to offer quality, affordable coverage to New Mexicans in 2018.
On August 1, the federal government released the rates from insurers across the country who submitted 2018 products in the individual insurance market. While this may be the subject of conversation and media attention, it’s important to keep a few things in mind:
- Rate submission and review is an annual process and necessary to participate in the individual marketplace.
- Rates should be viewed in context, or include, any premium assistance for those who may receive subsidies. Actual out-of-pocket costs will differ based on the financial assistance consumers receive from the government to offset their total monthly premium cost.
- There is still a lot of uncertainty on the rules and regulations of the individual market for 2018. Our 2018 product pricing reflects that uncertainty and the associated risks that exist within this marketplace. We will continue to work with legislators, regulators and other stakeholders toward getting the necessary certainty around issues like the continued funding of cost-sharing reductions ("CSRs") and mechanisms that encourage broad and continuous coverage.
- Our rates also account for keeping pace with escalating health care costs. and the growing use of that care. If we want to control premiums, then we must focus on the cost of care and the amount of care being used.
It is important to note that while we have submitted rates, our level of participation has not yet been finalized. If we receive regulatory certainty within an acceptable time frame we will review and, where appropriate, adjust our rates if time allows.
Please continue to visit this page for updates to our 2018 products and services in the individual marketplace, as well as through employer and Medicare coverage.
Medicare and Medicaid
Navigating Medicare Annual Election Period
Oct. 16, 2017
The Medicare Annual Election Period (AEP) is now under way, and Blue Cross and Blue Shield of New Mexico (BCBSNM) is proud to again offer a variety of health coverage options centered around optimized networks, flexibility and affordability.
During AEP, which runs from Oct. 15 through Dec. 7, Medicare-eligible customers can sign up for a plan or make changes to their current coverage. We know that choosing a health care plan can be hard. That’s why BCBSNM is committed to helping you understand your options and pick the best coverage for your unique needs.
Plan benefit and network information for 2018 BCBSNM Medicare plans is now available at www.bcbsnm.com/medicare. We also have dedicated Medicare experts ready by phone at 1-877-213-1821, every day from 8 a.m. – 8 p.m. to answer questions and offer personalized enrollment help. Or, you can find a licensed, approved BCBSNM agent in your area at www.bcbsnm.com/medicareagents.
Need more help? Find an educational seminar in your area at www.bcbsnm.com/medicare/seminars.
Our top priority is providing access to care for our Medicare members to help them get and stay healthy. We are here as a resource for you each step of the way through AEP and beyond.
Update on Medicare Advantage Plans in New Mexico
Oct. 02, 2017
For 2018, we will continue to offer Medicare plan options throughout New Mexico. However, you may have recently received a notice informing you that we will no longer offer a Medicare Advantage Prescription Drug (MAPD) plan in your area.
Providing access to high quality health care for our Medicare members remains one of our top priorities. If you received this notice, please know that we will offer any support needed to help make your transition to a new Medicare option as seamless as possible. Plan benefit and network information for 2018 Blue Cross and Blue Shield of New Mexico Medicare plans is now available at www.bcbsnm.com/medicare. We have dedicated customer service representatives and product specialists available every day from 8 a.m. to 8 p.m. to answer your questions and help you find the right health coverage for your needs. If your current plan will not be offered for 2018, you can select a new Medicare plan anytime between Oct. 15, 2017 and Feb. 28, 2018. But remember, to maintain continuous health coverage, you’ll need to enroll in a new plan by Dec. 31, 2017.
We’ll be here as a resource for you every step of the way through this transition and beyond. Our teams work in partnership others across the health care industry every day to help our members live healthy lives.
Employer Based Plans
Update for Our Small Business Customers
Oct. 03, 2017
Small group employers who currently offer Blue Cross and Blue Shield of New Mexico (BCBSNM) coverage to their employees through the Small Business Health Options Program (SHOP) are getting notifications that BCBSNM will not take part in the SHOP exchange, effective Jan. 1, 2018. However, it's important to know that members currently enrolled in a SHOP plan will have coverage through the full term of the existing contract.
We are also sending letters to employers and members to let them know that certain off-exchange small group plans as well as other group plans are being discontinued. Federal regulations require that small group plans must be discontinued if they are significantly modified.
We will continue to serve the Small Group Market with a range of robust plans off exchange that enable employers in New Mexico to continue offering quality, cost-effective coverage from BCBSNM.