Value Plan Benefits

Medical Plan Benefits

The NMRHCA Value Plan offers a choice of providers and access to resources to help you stay healthy. Some highlights of this plan include:

• No referrals to specialists are required
• 100% coverage for preventive services
• No lifetime maximum benefit limit

2024

• Benefit Summary

2023

• Benefit Summary
• Benefit Booklet

PPO Transition of Care Request Form – Please complete this form if you are currently receiving medical care from physician(s) who are not listed in your provider directory and would like assistance in coordinating your medical care with the new medical plan. It may be necessary to request medical information from your current physician(s). Transitional Care Benefits, for covered services, may be available for up to 90 days after your Group's effective date of coverage.

The Value Plan is only offered to New Mexico residents. There is no out-of-network coverage except for emergency and urgent care.

Prescription Drug Benefits

Your prescription coverage is provided by a third-party pharmacy benefits manager. Contact your company’s pharmacy benefits manager for more information.

Blue Access for Members^SM

Take control of your health and get the most out of your plan with Blue Access for Members℠. Just a few minutes online and you'll have access to services and features that save you time and money. Blue Access for Members allows you to:

• Review claims status and plan information
• Set-up and receive email alerts when a claim is final
• Request a replacement ID card and print a temporary one
• Research health and wellness information
• Take an online health assessment to learn possible health risks and what you can do to improve your health
• Explore ways to help you lose weight, quit smoking, make healthier food choices or start a fitness program – and keep track of your results