Blue Preferred EPOSM
Blue Cross and Blue Shield of New Mexico (BCBSNM) offers a health insurance plan designed to give members access to an exclusive statewide network of physicians and hospitals with a high concentration of providers in in the Albuquerque four-county areas (Bernalillo, Valencia, Torrance, and Sandoval).
Blue Preferred EPO, a lower cost alternative to our broad PPO, does not compromise benefits, quality or any services. Support and guidance tools are available to help our members make informed decisions and help them make the best use of their benefits.
- Members select a primary care physician (PCP).
- No referrals are needed.
- There is no benefit coverage when you visit out-of-network providers.
- Standard prior authorization is required
- Presbyterian Healthcare Systems is not included in the Tier 1 network.
Blue Preferred Plus POSSM
The Blue Preferred Plus product uses the Blue Preferred network at the top tier with the large PPO network aligned to Tier 2 and out of network at Tier 3:
- Tier 1 - Blue Preferred - Albuquerque four-county area
- Tier 2 - Statewide PPO
- Tier 3 - Out of Network (OON)
Requires at least a 30% benefit differential between Tiers 1 and Tier 2 (Example: Tier 1 – 90%, Tier 2 – 60%, and Tier 3 – 50%).
Like the Blue Preferred network:
- The Blue Preferred PCP selection is required.
- Referrals are not required.
- Standard NM prior authorization applies.
- Managed care is optional.
- Presbyterian Healthcare Systems is not included in the Tier 1 network.