Shop & Enroll
Do you sell Medicare supplemental insurance? We do not at this time, but we anticipate selling Medicare supplemental insurance starting in 2018.
You no longer offer individual PPO plans. How would I be covered under an HMO while traveling? Under the Affordable Care Act, all urgent and emergent care must be covered anywhere in the country – just as if you were receiving care from an in-network provider. If you get sick or have an accident and you are in another state, you should go to the nearest urgent care center or emergency room.
What do I do if I have a child away at school and I have an HMO plan? As stated above, anyone is covered anywhere in the country for urgent and emergency care at in-network levels. If your child is sick or has an accident, he will be covered at an urgent care center or emergency room the same as if he were using a facility in our network. We have national pharmacies in our network that can fill your child's prescriptions anywhere, as well as national laboratories that can conduct necessary lab tests in most cities.
What if my current doctor is already in your network? Do I have to make any changes? You will need to notify your doctor of your change in health insurance. If you have any procedures already scheduled or are in current treatment with your current doctor, please refer to the If You Need to Continue Existing Care and If You Are Taking Prescription Medications pages for instructions regarding these situations.
What preventive healthcare services are covered by your plans with no cost-sharing? By law, we are required to cover a wide range of preventive health services for men, women, and children – when those services are provided by an in-network provider. To find a list of these covered services, please visit the U.S. Department of Health & Human Services website.
What is a broker? Why would I use one rather than purchasing coverage directly from your website? A broker is someone who is independent of us. Brokers are licensed with the state to sell health insurance, so they know all of the plans the different health carriers in the state offer, and they can help you differentiate between them. Brokers can meet with you face-to-face, if you wish, and spend the time to explain and recommend the coverage that would best fit you. And best of all, it does not cost you anything to use a broker's services. A broker is a liaison between you and the insurance company. He can help you after the sale with any claims or billing questions, and each year at renewal time he will meet with you to explain any new options. To find a broker, please refer to the Looking for a Producer/Broker? page.
What is an enrollment counselor, and how can I find one? Enrollment counselors can help you with any questions or concerns you have about enrollment. They are available throughout the state and are located in community venues such as hospitals, clinics, and schools. They are similar to brokers in that they can help guide you through the enrollment process. However, unlike a broker, enrollment counselors cannot recommend a specific plan to fit your needs. What they can do is can provide you with unbiased plan information as you make your decision. To find an enrollment counselor, please visit the BeWellNM website and search by zip code.
How do you evaluate medical necessity, appropriateness, and efficiency of the use of healthcare services, procedures, and facilities? We follow strict utilization management (UM, sometimes called utilization review) procedures. To learn about UM, please visit our New Members page and scroll to the bottom of the page.
Do you share information about me with others? We take your protected health information (PHI) very seriously. We may share your PHI without your written authorization when necessary while providing your health benefits. You can find a list of the instances when we share your PHI on our Protecting Your Privacy page. Scroll to the bottom of the page and click on the Notice of Privacy Practices. We do not share your PHI with your employer or your health plan sponsor without your authorization.