Blue Cross and Blue Shield, Presbyterian expand footprint in the state

Several New Mexico insurers offer advantage plans and incentives to give its members a plethora of options.

Blue Cross and Blue Shield of New Mexico continues to expand its reach across the state with locations in 30 of the state's counties.

"We have multiple plan offerings and the premiums start at zero depending on what each of those Medicare beneficiaries need, such as low premiums or they're out-of-pocket may be a little bit higher," said Marlene Baca, BCBSNM vice president of sales. "We also have some premium plans, where their out-of-pocket could essentially be nothing. So, you know, we really tried to meet the needs of our diverse population in New Mexico."

Branching out into the rural areas of the state has been welcomed by its communities.

"It's fantastic that we're getting in rural areas with Medicare beneficiaries now," Baca boasted. "We now have low-cost plans available. I've been in this industry for too long. Many years ago, Medicare Advantage was only really in the central part of New Mexico. It's fantastic that we're expanding and getting into rural New Mexico as well."

BCBSNM's prescription services and other incentives continue to grow including embedding hearing benefits in a couple of its plan offerings for 2024.

"In 2024, we're going to be adding Amazon as one of our preferred mail order pharmacies," Baca said. "And then, for a person who qualifies for both Medicare and Medicaid, they're going to be eligible to participate in what is called FarmboxRx. It's a nutrition education provided in every box. And it will include some high-quality produce as well as literature to educate beneficiaries in living, in eating healthier, and having a healthier lifestyle. When it's available, we'll be partnering with local produce (providers). It just depends, of course, on availability and the time of the year. We're really excited about that."

It is important to the health insurance provider to contribute to the community.

"Blue Cross and Blue Shield of New Mexico really wants to be a community partner," Baca explained. "We believe in education and making sure that they're getting the appropriate health insurance coverage. Once they are our members, we really want to partner with them and really try to assist with providing health care coverage that is really going to help them with their healthcare needs."

BCBSNM representatives are available to answer health plan questions by phone at 866-445-1396 and online at bcbsnm.com.

Presbyterian Health Plan looks to entice membersPresbyterian Health Plan has enticing plans that save members money including its Medicare Advantage plans, an HMO, a point-of-service plan called UltraFlex, and a PPO plan.

"I think really the best option is the UltraFlex plan that is available to members that reside in 11 counties throughout the state and we're adding a 12th down in Doña Ana," explained Brian Brown, vice president of sales and marketing at Presbyterian Health Plan. "The UltraFlex has a zero premium plan, zero copay for PPP, and it comes with an $850 flex card that will help pay for over the counter medication, hearing, dental, and vision coverage."

Questions related to initial costs are at the top of the list when consumers are seeking a health plan. But Brown encourages consumers to also inquire about coverage for resources they may require in the future.

"If they are anticipating any health issues or needs in the future, really zeroing in on what they're expecting around the copays for those types of services or the cost," Brown encourages consumers to discuss. "What do they need to do if they're expecting to be overseas or traveling at any point in time? What provides the most coverage for them if they're out enjoying that time outside of the state? You know what to expect after enrollment, after you sign up, then what? When are my materials going to show up? If I need to seek care, how do I do that? How do I get connected to my doctor?"

Brown emphasizes that customers ask and make sure that their preferred care provider is in the network.

"Patients or members that have been seeing a particular provider for a long period of time and have a great relationship with their doctor (should be) making sure that they ask the question, 'Is my doctor in the network?'" he explained. "One of the things that Presbyterian has been trying to do on our Medicare plan is to expand coverage."

Brown suggests consumers learn more about Presbyterian Health Plan seminars. Information on when and where the seminars are happening can be found at phs.org/medicare/attend-a-seminar.

Members and prospective customers also opt for a one-on-one consultation at Presbyterian's new Health Plan Place located at 2100 Louisiana Blvd. NE, Suite 408, in Winrock Town Center. It is open from 8 a.m. to 4:30 p.m. Monday through Friday and walk-ins are welcome.

"We opened Health Plan Place for members that either are existing members or trying to find health benefits," Brown said. "We're a one stop shop for them to come in and ask questions about coverages. What's the right fit for them? And then actually do the enrollment."

Health Plan Place visitors can also learn how to navigate technology relative to Presbyterian services.

"It has very comfortable seating and a local coffee is brewed for them as well," Brown said. "They can have a cup of coffee and sit down and be very comfortable in that environment. And we've got somebody who can help them with any sort of telehealth connections or help them with any technology questions that they may have regarding the MyPres app or any of those types of questions that can surface."

More information on Presbyterian Health Plans can be found at phs.org/health-plans or by calling 505-923-5678 or 1-800-356-2219.