for Our Medicaid Members
At Blue Cross and Blue Shield of New Mexico (BCBSNM), the health, safety and well-being of our members is our top priority. We want to help you stay informed about COVID-19 and get the care you need.
During this time of uncertainty, BCBSNM continues to stand with our members. As part of that pledge, we are making some changes to better serve you. We want you to continue to get Medicaid services during the COVID-19 outbreak. BCBSNM has loosened some of the requirements for services shown below. The changes listed below will be in place for the duration of this public health emergency. If you have any questions about your plan and what it covers, please call Member Services at 1-866-689-1523 (TTY: 711).
During the COVID-19 public health emergency, you can receive certain services by phone. These services can be from your physical or behavioral health care provider. You can also receive certain dental services by phone. If you have a computer or smart phone, you can access services by video. With a video visit, you can hear and see your provider. Visits over video can be done using an app like Skype or FaceTime. Your provider or dentist may want to offer services to you this way. This will keep you from going into their office. These services are available at no cost to you.
Prior Authorizations/DME Coverage
BCBSNM has made these changes: COVID-19 testing does not require an authorization. Some services that normally must be approved will not require it during this time. If you have an approved service but cannot receive it because the business is currently closed, BCBSNM will extend approval for a longer period. These services may include elective surgical procedures, physical therapy sessions, home health services, and more. For members who are in the hospital and need to be placed in a skilled nursing facility, long-term acute care unit, or inpatient rehabilitation facility, your provider will not have to wait for an authorization to move you to that facility. You do not need to see your PCP in person to obtain new or replacement Durable Medical Equipment (DME).
BCBSNM has made these changes: Drugs used to treat COVID-19 do not require authorization. Pharmacies may override “refill too soon” rejections. They can do so without having to call a help desk. Members can fill 90-day supplies of medicines they take on a regular basis at any network pharmacy. BCBSNM will continue to monitor drug supplies. This is so that members have access to the drugs they need. BCBSNM has extended all prior authorizations until the COVID-19 disaster declaration has been lifted.
BCBSNM is extending the number of days for a member to request a state fair hearing. This a request a member can make if they have received an adverse action determination (denial). Currently, members have 90 days to request a state fair hearing. This will be extended to 120 days for the duration of the COVID-19 public health emergency.