Premium Paid-To-Date Now Included in BCBSNM Eligibility Response for On and Off Exchange Policies
The premium paid-to-date for Blue Cross and Blue Shield of New Mexico (BCBSNM) members who purchased their coverage on or off the Health Insurance Marketplace is now available when verifying eligibility and benefits through your preferred online web vendor or clearinghouse.
The paid-to-date is the last coverage date for the member based on their premium payments. BCBSNM previously returned paid-to-dates for Advanced Premium Tax Credit (APTC) subsidized members once they reach the second month of their grace period. However, the paid-to-date is now returned on all active policies purchased on or off the Health Insurance Marketplace, regardless of grace period involvement.
Verification of eligibility and/or benefit information is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member's eligibility, any claims received during the interim period and the terms of the member's certificate of coverage applicable on the date services were rendered.
Availity is a registered trademark of Availity, LLC. Availity is a partially owned subsidiary of Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), an independent licensee of the Blue Cross and Blue Shield Association. Availity operates a health information network to provide electronic information change services to medical professionals. Availity provides administrative services to BCBSNM, a Division of HCSC. BCBSNM makes no endorsement, representations or warranties regarding any products or services offered by independent third party vendors. If you have any questions about the products or services offered by such vendors, you should contact the vendors directly.