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We are here for you, New Mexico
Your health insurance should help make your life a little easier. That’s why Unitedhealthcare Community Plan's New Mexico Turquoise Care includes extras for your health and everyday life.
Ayudar a las personas es la esencia de todo lo que hacemos
Everyone in New Mexico deserves affordable health care. New Mexico Turquoise Care covers adults, children, families, people with disabilities and pregnant women. UnitedHealthcare has services and extras that can make a real difference. Connecting people with what they need, when they need it most. Our goal is to connect the people with the help they need, when they need it the most.
We offer one of the largest provider networks in New Mexico. That can help you to choose the doctors and specialists that fit your health care needs.
Plans and how to enroll
New Mexico Turquoise Care (Medicaid)
Turquoise Care is the Medicaid Managed Care program for New Mexico, offered by UnitedHealthcare Community Plan.
Medicaid is a federal and state health insurance program. It helps people of all ages get quality health care. Medicaid helps support many groups including:
- Niños
- Familias
- People with low incomes
- Niños y adultos con discapacidades
- Older adults
- People diagnosed with substance use disorder
Long Term Services and Supports (LTSS)
LTSS is designed to improve the quality of life for members of any age who have functional limitations and/or chronic illnesses. Many people who are in this situation want to live independently at home. Our Turquoise Care LTSS plan makes that easier. It offers extra support services such as:
- In-home personal care to help with daily activities
- Adult day centers for social activities
- Support with housing, getting food, going to the store or feeling safe
- Respite support for family members or friends who help with care
Cómo inscribirse
To be eligible for New Mexico Medicaid coverage, you must be a resident of the state of New Mexico, a U.S. national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income.
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También debe cumplir alguno de los siguientes casos:
- Mujeres embarazadas
- Responsible for a child 18 years of age or younger
- Blind
- Disabled or living with a disabled family member
- Son mayores de 65 años.
To check your eligibility and enroll:
Online: Visit the YES New Mexico
By phone: Call: 1-855-637-6574
By mail: Send your signed application to:
Central ASPEN Scanning Area (CASA)
PO Box 830
Bernalillo, NM 87004
Por fax: Send your signed application to: 1-855-804-8960
If you need help
Our New Mexico Turquoise Care plan specialists can answer your questions. We can also assist with interpreter services. To ask for help, please call 1-877-236-0826, TTY 711, Monday through Friday, 8 a. m. to 5 p. m. MT.
Nuestros defensores de Servicios para Miembros hablan varios idiomas (más de 170), de modo que, cuando llame, podrán ayudarle o comunicarle con el servicio de interpretación.
Si tiene problemas para escuchar por teléfono, puede usar un teléfono de texto. Este servicio gratuito permite a las personas con impedimentos auditivos o discapacidades del habla realizar y recibir llamadas telefónicas. Llame al 711, proporcióneles el número de Servicios para Miembros, 1-877-236-0826, de lunes a viernes, de 8 a. m. a 5 p. m. (hora de la montaña), y ellos le comunicarán con nosotros.
Información para miembros
Handbooks and member resources
Read the handbook, look up network providers, find covered drugs and learn more about what our plans offer.
If you do not see a provider or drug listed, check back or call Member Services. 1-877-236-0826, TTY 711, Monday to Friday from 8 a. m. to 5 p. m., local time.
- New Mexico Turquoise Care Handbook: Inglés
- Search online for a network provider
- Search for drugs covered by the State of New Mexico or download the Preferred Drug List (PDL)
Information is available in large print, Braille or audio tapes.
Beneficios adicionales
We offer additional benefits to help you live a healthier life, such as:
- 24/7 Virtual Visits
- Eldercare
- Recompensas para miembros
- Emergency funds
- Scholarships toward earning certificates, degrees or workforce programs
- Enhanced transportation coverage (more rides to more places)
- Maternity support, including doula care
- School-based health clinics
- Beneficio de One Pass Fitness
- Servicios de salud conductual
- Enhanced dental and vision benefits
- Servicios quiroprácticos
- Acupuntura
- Peer support specialists with youth in foster care
- And many more
Contáctenos
- Member Services, call toll-free 1-877-236-0826 (TTY 711), Monday to Friday, 8am to 5pm, local time
- ¿Preguntas sobre salud?
- Sign in to our member portal and chat with us
Language help and interpreter services
Many on our Member Service team speak several languages. También contamos con servicio de interpretación, que ofrece más de 240 idiomas por teléfono. También incluimos el lenguaje de señas estadounidense.
- If you have trouble hearing or speaking on the phone, use our text telephone (TTY) service at 711 or call 1-877-236-0826 to connect with us.
Programs
Turquoise Rewards
Turquoise Rewards allows members to earn points for completing certain health activities. You can use your reward points to shop for hundreds of fun, healthy items in the Turquoise Rewards catalog.
Por ejemplo, puede ganar puntos de recompensa por:
- Attending an annual checkup with your primary care provider
- Vacunarse contra la gripe
- Completar exámenes de salud, como mamografías, pruebas de detección de cáncer de cuello uterino, entre otras
- ¿Está al día con las vacunas de sus niños?
Visit turquoiserewards.com to see all the eligible activities.
One Pass
This fitness program for members 18 and up, provides unlimited access to many local gyms, including the YMCA. Change locations at any time, or explore workout plans and join classes online.
One Pass hace que la actividad física sea divertida y flexible. Los miembros pueden:
- Visitar muchos gimnasios locales, incluidos centros de la YMCA
- Cambiar de ubicación en cualquier momento
- Explorar los planes de entrenamiento en línea
- Participar en clases en vivo de manera virtual, desde la comodidad del hogar
- Divertirse mientras se ponen en forma
Maternity support and baby care
- Car Seats -- Pregnant members can get a car seat for safe infant travel (limit 1 car seat per baby).
- Transportation -- We cover trips to medical appointments, WIC appointments and more
- Pregnancy and infant support -- Our maternal child health team will help you learn what to expect when you see your doctor and how to take care of your changing body. We will help you learn about:
- Recursos locales
- Nutrición, peso y bienestar
- Actividad física
- Salud sexual
- Abuso de sustancias
- Violencia doméstica
- Healthy First Steps® (HFS) -- This specialized case management program is designed to provide assistance to all pregnant members and those experiencing an uncomplicated pregnancy. También ayuda a gestionar los riesgos médicos, conductuales y sociales.
- BabyScripts -- An education and reward program for pregnant members and new parents
- Doula and breastfeeding support -- We offer in person and virtual support. Doula services offer care and guidance to moms during and after pregnancy.
- Well-child visits – Provide screenings, like speech and hearing tests, and immunizations. These routine visits are also a great time for you to ask any questions you have about your child’s behavior and overall well-being.
- Wellhop -- Helps expectant moms connect with others through online chat and group videos.
Behavioral health and substance use
Si actualmente recibe servicios de salud conductual, infórmeselo a su coordinador de atención de UnitedHealthcare Community Plan. Es fundamental que ellos estén al tanto de todos los servicios que usted recibe o necesita.
Además, infórmele a su proveedor de salud conductual que está inscrito en el programa Turquoise Care de UnitedHealthcare Community Plan. Es posible que tengan preguntas sobre los servicios que recibe a través de Turquoise Care y sobre cómo podemos trabajar conjuntamente para ayudarle a obtener la atención que necesita.
Servicios de salud del comportamiento
Las pruebas de detección de trastornos en la salud conductual se realizan según sean clínicamente necesarias para el diagnóstico y el tratamiento. Cubrimos:
- Terapia individual, grupal y familiar
- Servicios de salud conductual para pacientes ambulatorios
- Servicios de salud conductual para pacientes internados
- Servicios de salud conductual especializados para niños con autismo
Servicios para trastornos de consumo de sustancias
Substance use disorder services are performed as medically necessary for diagnosis and treatment. Cubrimos:
- Tratamiento ambulatorio con opioides (analgésicos)
- Tratamiento residencial
- Tratamiento de casos personalizados
Visit https://member.uhc.com/communityplan?locale=es-USfor addtional resources. Encuentre el equilibrio, la ayuda y los cuidados que necesita para vivir de la manera más saludable posible.
If you believe you need access to behavioral health services, talk with your PCP or call Member Services for help.
SeniorLink
SeniorLink es un programa para cuidadores no remunerados y que son familiares. The goal is to make sure caregivers have the tools and resources they need to succeed. Los cuidadores completan una evaluación sobre sus conocimientos y habilidades. SeniorLink compares this assessment with the member’s health needs and challenges. Luego, SeniorLink elabora un plan de atención que permitirá a cada miembro vivir de manera segura en su hogar.
Beneficio comunitario
Community Benefit is the home and community-based services (HCBS) benefit package from Turquoise Care. These services allow eligible members to receive care in their home or community as an alternative to being placed in a long-term care facility. They are intended to supplement natural supports and support community living reducing unnecessary nursing home admissions.
Elegibilidad
To qualify for this benefit, you must:
- Have a full Medicaid category of eligibility or approved waiver
- Meet nursing facility level-of-care criteria
- Be a resident of New Mexico
On My Way (OMW)
OMW ayuda a preparar a los miembros jóvenes a vivir por su cuenta. Esto incluye cosas como encontrar vivienda, conseguir un empleo y administrar el dinero. O enseña importantes habilidades para la vida, tales como:
- Establecer y alcanzar objetivos personales
- Administrar el dinero
- Encontrar vivienda
- Redactar un currículum
- Conseguir un empleo
- Presentar una solicitud de ingreso a la universidad
Línea directa de enfermería
Members who have questions about their health have access to a nurse 24 hours a day, 7 days a week by calling a hotline.
Nuestros enfermeros:
- Escucharán cuáles son los síntomas
- Ayuda para que pueda cuidarse usted mismo
- Advise if you can get care at your next doctor visit or need urgent care
- Le harán saber cuándo es momento de ir a la sala de emergencias
Rides and transportation
Benefits include assistance with transportation. We cover round trips to:
- Citas medicas
- Food banks and pantries
- Pharmacy visits
- Women, Infants and Children (WIC) appointments
- Citas de elegibilidad de Medicaid
- Clases de preparación para el parto
- Lugares de culto
- Tiendas de comestibles
- Actividades relacionadas con el trabajo
- Support group meetings
You may also qualify for a bus pass or mileage reimbursement for friends and family.
Call Member Services to schedule a ride or ask questions about getting transportation services.
Traditional healing and Alternative treatments
Reimbursement to member or healer for Traditional Healing services performed are covered. Benefits include:
$300 por año para servicios de curación tradicional. Este beneficio incluye, entre otras cosas, lo siguiente:
- Ceremonias y curaciones de nativos estadounidenses
- Curanderismo
Su proveedor deberá enviar un formulario para obtener un reembolso. Los formularios pueden solicitarse llamando a Servicios para Miembros al 1-877-236-0826. Para personas con dificultades auditivas: TTY 711.
Directivas anticipadas
Directivas anticipadas
An advance directive is a set of written steps you want taken when you are too sick to make decisions about your health care. It says what you want or do not want.
You should talk about your wishes with your provider, family and friends.
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¿Qué son las directivas anticipadas para la atención médica?
Según la ley federal y del estado de New Mexico, usted tiene derecho a elaborar una directiva anticipada. This document lets you say exactly how you wish to be treated if you are too sick to make health care decisions. Una directiva anticipada les ayudará al médico y a su familia a tomar decisiones sobre su atención médica. You can also name someone to make your health care decisions. That person, called a surrogate or an agent, has the right to refuse or stop treatment for you in some cases.
An advance health directive may also be called, mental health advance directive, psychiatric advance directive or PAD, living will, durable health care power of attorney and/or durable mental health care power of attorney.
UnitedHealthcare Community Plan polcy is to inform members that they can create advance health care directives. State and federal laws require hospitals, nursing homes, and other providers to tell you about advance directives and explain your legal choices about medical decisions. These laws are intended to ensure that your wishes are taken into account when you may not be able to express them.
UnitedHealthcare Community Plan sigue las regulaciones de la Ley sobre Decisiones de Tratamiento de Atención Médica para la Salud Mental [24-7B-1 NMSA 1978] y la regulación federal 42 CFR 489 subparte I y 42 CFR 422.128.
¿Cómo obtengo una directiva anticipada?
Contact Member Services or your Care Coordinator at 1-877-236-0826. Llame al TTY 711 si tiene dificultades del habla o de la audición.
You can also call the State of New Mexico Aging and Disability Resource Center at 1-800-432-2080.