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Alerts and Announcements

Stay informed with the latest Medicare alerts and announcements from Blue Cross and Blue Shield of New Mexico.

Attention Members – The Public Health Emergency (PHE) Will End on
May 11, 2023, Which Could Affect Benefits

Updated 04/19/2023

Per the federal government, the COVID-19 Public Health Emergency (PHE) will end on May 11, 2023. Additional plan flexibilities allowed during the PHE will end May 11, 2023 too and all plan deadlines and requirements will return to normal, according to current plan rules.

Please review your Evidence of Coverage (EOC) for details about your plan.

If you have any questions about these changes, please call the number on the back of your member ID card.

Benefit

End Date

COVID-19 testing covered at no cost-share to the member

Ends on May 11, 2023, with the end of the U.S. Health and Human Services (HHS) public health emergency.

COVID-19 treatment at no cost-share to the member

Ends on May 11, 2023, with the end of the HHS public health emergency.

Telehealth visits at no cost-share

Ends on May 11, 2023, with the end of the HHS public health emergency.

Out-of-network benefits

Ends on May 11, 2023, with the end of the HHS public health emergency.

Extended time to file appeals

Ends on May 11, 2023, with the end of the HHS public health emergency.

Transportation benefits for vaccines

Ends on May 11, 2023, with the end of the HHS public health emergency.

Early refill overrides for covered medications

Ends on May 11, 2023, with the end of the HHS public health emergency.

90-day supply of specialty medications (if applicable)

Ends on May 11, 2023, with the end of the HHS public health emergency.

90-day supply for Long Term Care pharmacy claims

Ends on May 11, 2023, with the end of the HHS public health emergency.

The Inflation Reduction Act of 2022 Affects the Costs of Part B Insulin and Part B Rebatable Drugs

03/14/2023

IRA Section 11101: Part B Rebatable Drug Coinsurance Adjustment

Starting April 1, 2023, cost-sharing for Part B Rebatable Drugs must not exceed the coinsurance amount set quarterly by Medicare for that Part B Rebatable Drug. Part B Rebatable Drugs may be in either of these categories:

  • Chemotherapy administration services to include chemotherapy/radiation drugs
  • Other drugs covered under Medicare Part B

IRA Section 11407: Part B Insulin Cost Sharing Cap

Starting July 1, 2023, Medicare Advantage plans must cover Part B insulin at the coinsurance cap of $35 for a one-month supply of insulin. Medicare mandates that both coinsurance and copayment amounts must not exceed the $35 cap.

Attention Providers – Inflation Reduction Act: Key Messages and Provider Q&A

12/07/2022

The Inflation Reduction Act of 2022 affects the costs of insulin and adult vaccines starting Jan. 1, 2023.

The Inflation Reduction Act (IRA) requires:

  • Insulin cost cap of $35 for a month's supply of covered insulin
  • No out-of-pocket costs for adult vaccines under Medicare Part D

Prime / health plan will make sure that Medicare members don't pay more than $35 per month for insulin or any out-of-pocket costs for adult vaccines.

HOWEVER, until Jan. 23, 2023, it is possible that Medicare members might be charged more than $35 per month for insulin. If that is the case, Prime / the health plan will automatically generate a payment to the member for any amount they paid over $35 for insulin and will mail the member a check. They don't have to do anything to obtain the reimbursement if they were charged more than $35 per month for covered insulin. We expect any reimbursement checks to be mailed by Jan. 31, 2023.

Q&A

What insulin products are included in the $35 monthly cap?
Covered insulin products are insulin products that are included on a Medicare member's health plan's formulary, treated as being included in a Medicare Part D plan's formulary as a result of a coverage determination or appeal, or covered under the transition process in accordance with § 423.120(b)(3) and obtained at a network pharmacy or an out-of-network pharmacy in accordance with § 423.124(a) and (c). These include any new insulin products that become available during the plan year. Medical supplies associated with the injection of an insulin product, when such supplies do not contain insulin and are not approved under section 505 of the FFDCA or licensed under section 351 of the PHSA, are not subject to the requirements of section 1860D-2(b)(9) of the Act.

What vaccines are covered by Part D at $0 copay?
According to the Sept. 26 memo from the Centers for Medicare & Medicaid Services (CMS), there is no cost sharing for an adult vaccine recommended by the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control (CDC). This means a covered Part D drug that is a vaccine licensed by the US Food and Drug Administration (FDA) under section 351 of the Public Health Service Act (PHSA) for use by adult populations and administered in accordance with recommendations of ACIP.

ACIP is a group of medical and public health experts that is part of the Centers for Disease Control.

Do the insulins/vaccines need to be included in the plan's formulary to be eligible for the cost reductions?
Insulins and vaccines that are included on the formulary are eligible. Any vaccine or insulin that is approved in transition or due to a formulary exception request is eligible as well.

What if a Medicare member has a coverage determination for a Non-Formulary product?
If a Medicare member requested a formulary exception for insulin or vaccine and has received an approval, those products are subject to the $35 cap (insulins) or the $0 copay (vaccines).

Get Answers to Your Medicare Questions

10/19/2022

Join us at our free Walk-In Event and meet with a Medicare Plan Specialist. No appointment needed.

Oct. 17 – Dec. 7
Monday – Friday, 9 a.m. – 5 p.m.
Blue Cross and Blue Shield of New Mexico
5701 Balloon Fiesta Pkwy
Albuquerque, NM 87113

For more information, call 1-866-650-4064 (TTY: 711).

AllianceRx Walgreens Prime is Now AllianceRx Walgreens Pharmacy

06/22/2022

Beginning June 24, 2022, AllianceRx Walgreens Prime prescription home delivery service will change its name and logo to Alliance Walgreens Pharmacy.

  • This is solely a name change. There will be no changes in services (including customer service phone numbers), terms or conditions.
  • AllianceRx Walgreens Pharmacy has been communicating this change to members in their prescription shipments.
  • Existing printed materials in Medicare Advantage and PDP Welcome Kits can still be used with the former name; however, all new materials printed for 2023 will reflect the new name.

Medicare to Cover Over-the-Counter (OTC) COVID-19 Testing Kits

04/06/2022

The Centers for Medicare and Medicaid Services (CMS) announced on Apr. 4 that beneficiaries with Medicare Part B, including those enrolled in Medicare Advantage plans, now have access to FDA-approved COVID-19 tests at no cost. Medicare members may be asked to present their red, white and blue Medicare identification card to get their free OTC COVID-19 tests. Each person with Medicare Part B can get up to eight free OTC tests each month, until the end of the COVID-19 Public Health Emergency. The link above also lists participating pharmacies.

COVID-19 At-Home Tests and Medicare

01/24/2022

The Biden Administration recently announced that the cost of FDA-approved COVID-19 over-the-counter testing kits would be covered by private health insurers. This order excludes Medicare beneficiaries at this time, however, there are no-cost options for COVID-19 testing for our Medicare members:

  • COVID-19 tests ordered by a health care professional continue to be covered at no cost under your medical benefits.
  • You may request free Over-the-Counter COVID-19 tests through the federal government's site.

USPS Delays May Impact Delivery of Premium Notices

02/24/2021

Due to recent delays in the U.S. Postal Service (USPS) mail delivery, some communications from Blue Cross and Blue Shield of New Mexico (BCBSNM) may not reach you as quickly as usual. This includes premium payment notices, member ID cards, explanations of benefits and other benefit materials. 

We are aware of these delays and apologize for the inconvenience. To prevent any break in benefits:

  • You can pay your premium by phone. Call the Customer Service number listed on your BCBSNM member ID card for help paying your premium. 

  • You can print a new member ID card, review your explanation of benefits and other coverage information by logging into your Blue Access for MembersSM (BAMSM) account online or by using the mobile app.

Blue Cross Medicare AdvantageSM Members May be Eligible to Receive Electronic Tablets

10/01/2020

During the COVID-19 pandemic, we’re lending electronic tablets to Blue Cross Medicare AdvantageSM members who meet program qualifications. Members can use the tablet to schedule telehealth visits with their doctors and to access plan benefits. For more information, call customer service at the number on your member ID card.

Keep Your Health Care Coverage During COVID-19

05/04/2020

If you are losing or have lost your health care coverage during these uncertain times, we are here to help. Learn more about Medicare Special Enrollment Periods.

Help Me Choose a Plan

Already a BCBSNM member? If you are age 64 or older, use the Help Me Choose tool to find the plan that's right for you.

Not a BCBSNM member? If you’re not sure what plan you need, answer a few questions to help you decide.

Now that you’ve picked a plan, it’s time to enroll.

Last Updated: Aug. 04, 2023