COVID-19 Information

Providers, find COVID-19 claims and billing information here.

True Health New Mexico members have access to FDA-authorized COVID-19 testing, treatment, vaccines and boosters at no cost.

Testing:

• Tests must be FDA-authorized to be covered without cost-sharing. FDA-authorized tests include tests approved for patient use through pre-market approval or emergency use pathways, as well as tests that are developed and administered in accordance with FDA specifications or through state regulatory approval. Be sure to ask your healthcare provider to order an FDA-authorized test.

Testing sites:

• Access the COVID-19 Testing Sites in Our Network link at the top of this page. To ensure that no cost-share applies, please seek testing from an in-network testing facility.

At-home test coverage:

• If using the FDA-authorized home test, members will need to purchase the test and then submit reimbursement for it by mail, along with their receipts, to True Health New Mexico, using the Member Medical Claim Reimbursement Form on our Member Forms page.
• True Health New Mexico will reimburse members up to $12 per test, up to eight tests per member per month.
• The monthly limit applies per test, so if a package includes two tests, both count towards the eight-test cap. For example, you can purchase four boxes that include two over-the-counter COVID-19 tests.
• COVID tests may not be used for resale.
• COVID-19 testing for employment purposes is not included in this coverage.
• True Health New Mexico members may also request free at-home COVID-19 tests directly from the federal government at https://www.covidtests.gov/. These tests will ship to your home via USPS. These tests do not count toward your eight tests per member per month through your True Health New Mexico benefit.
• In accordance with recently released federal guidance, True Health New Mexico members may obtain select over-the-counter (OTC) COVID-19 tests from pharmacies in the CVS Caremark/True Health New Mexico national pharmacy network. To find a contracted pharmacy, visit our Pharmacy page and click on the red “Find a Pharmacy” button on the left side of the page.
• Beginning February 15, 2022, True Health New Mexico members have access to OTC COVID-19 tests at select CVS Pharmacy locations.
  • These tests do count toward your eight tests per member per month through your True Health New Mexico benefit.
  • You can order online at cvs.com or via the CVS Pharmacy mobile app. Please have your insurance ID card handy when you order. Learn more.

Below is a list of OTC COVID-19 tests that are covered through the direct coverage process.

If a contracted pharmacy is unable to process claims for covered COVID-19 tests, members may still pay out-of-pocket at the pharmacy and request reimbursement from True Health New Mexico, using the CVS Reimbursement Form posted on our Member Forms page.

Treatment:

• There is no cost for COVID-19 treatment for all True Health New Mexico members while the public health emergency remains in effect. Please refer to your Member Handbook (Evidence of Coverage) for additional information.

Vaccines and boosters:

• There is no cost for FDA-approved COVID-19 vaccines and boosters or administration of the vaccines and boosters.

No prior authorization is required for COVID-19 testing and treatment.

If you have any questions about coverage, please call Customer Service at 1-844-508-4677, 8:00 a.m. to 5:00 p.m., Monday through Friday.

COVID-19 is the label given to a new coronavirus found in 2019 that has spread around the world. COVID-19 is a respiratory illness that is thought to spread mainly between people who are in close contact with one another (within about 6 feet) through respiratory droplets produced when an infected person coughs or sneezes. It also may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes.

COVID-19 infections can cause a range of illness, from little to no symptoms to becoming severely ill and requiring hospitalization. Symptoms may appear as soon as two days and as long as 14 days after exposure. The major symptoms are:

• Fever or chills
• Cough
• Shortness of breath or difficulty breathing
• Fatigue
• Muscle or body aches
• Headache
• New loss of taste or smell
• Sore throat
• Congestion or runny nose
• Nausea or vomiting
• Diarrhea

If you suspect you have COVID-19, please call your primary care doctor or the New Mexico Department of Health (NMDOH) Coronavirus Hotline at 1-855-600-3453.

Please call before you go to a clinic or emergency room, as NMDOH is doing its best to keep people who may have the virus out of primary care facilities and emergency rooms.

Unsure if you have been exposed? You can also call the True Health New Mexico Care Connect Nurse Advice Line at 1-844-308-2552. Experienced registered nurses will talk with you about your symptoms and situation.

The True Health New Mexico Care Connect Line has services available for people whose first language is not English.

You can search for a testing site on the NMDOH website. Before you go, read NMDOH’s What to know before you go page about testing sites, current testing and travel public health advisories, cost information, and more. There may be a long wait at the testing site you visit, so be prepared.

Two kinds of tests are available for COVID-19: viral tests and antibody tests. A viral test tells a person if they have a current infection. An antibody test might tell them if they had a past infection.

1. Viral tests check samples from the respiratory system using a swab to obtain a nasal, oral, or saliva sample to determine whether an infection with the virus that causes COVID-19 is present.
2. Antibody tests check your blood by looking for antibodies, which may tell you if you had a past infection with the virus that causes COVID-19. Antibodies are proteins that help fight off infections and can provide protection against getting that disease again. The CDC does not recommend using antibody testing for diagnosis of acute infection. Viral tests should be used for diagnosing current infection.

It’s important to note that the NM Medical Advisory Team (MAT) does not recommend the antibody test because not all tests are reliable and because these tests are not yet able to determine if you are actually immune to a second infection or if you can transmit the disease. Read more about why the MAT doesn’t recommend this test below.

How do I get an antibody test?

Learn more about the antibody test from the CDC and understand why the New Mexico MAT cautions consumers about this type of testing.

• Talk with your doctor to ensure testing is right for you or your family member.
• Ensure the test ordered by your doctor is FDA-authorized.
• Find a lab location here.

New Mexicans age 16 and older are eligible to receive the COVID-19 vaccine. The New Mexico Department of Health Medical Advisory Team has approved the use of the Pfizer COVID-19 vaccine for children 12 and older.

New Mexicans can register and schedule an appointment for a vaccine without an event code. Register at https://cvvaccine.nmhealth.org/.

New Mexicans can view a vaccination public event calendar at https://cvvaccine.nmhealth.org/public-calendar.html.

COVID-19 Vaccine Hotline: 1-855-600-3453

Users who have questions or would like support with the registration process – including New Mexicans who do not have internet access – can call 1-855-600-3453, press option 0 for vaccine questions, and then option 4 for tech support.

True Health New Mexico members have no cost-share for the vaccine or the administration of the vaccine.

You can learn about the development, availability, possible side effects, and effectiveness of the different COVID-19 vaccines on these reputable websites:

• CVS, our pharmacy benefit manager
• The Centers for Disease Control and Prevention

You may be hesitant about receiving the COVID-19 vaccine. The resources below provide facts that can help you make up your mind. You should also talk to your primary care provider about any questions or concerns you have about getting vaccinated against COVID-19.

• Johns Hopkins Medicine: COVID-19 Vaccine Hesitancy: 12 Things You Need to Know
• Centers for Disease Control and Prevention: Safe and Effective COVID-19 Vaccines Are Now Available
• American Medical Association: What Doctors Wish Patients Knew About the Dangerous Delta Variant
• Johns Hopkins Medicine: COVID-19 Vaccines: Myth Vs. Fact

• The Centers for Disease Control and Prevention (CDC) recommends that you wear a surgical or N-95 mask in public settings where it is difficult to maintain social distancing practices, such as a grocery store or pharmacy. This recommendation does not replace the guidelines put in place to help slow the spread of the virus. Surgical or N-95 masks are critical supplies that should be reserved for healthcare workers and other first responders.
• Avoid close contact with people who are sick.
• Practice social distancing in regard to public gatherings such as concerts, shopping, and other public activities; as well as work, school, travel, and hobbies. Learn more about what social distancing and self-quarantine means from Johns Hopkins Medicine.
• Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
• Wash your hands often with soap and water before eating; after blowing your nose, coughing, or sneezing; and after you get home.
• Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
• Avoid touching your eyes, nose, and mouth.
• Stay home when you are sick.
• Visit the CDC website to review important information about preventing COVID-19 spread in communities.

Individuals who are fully vaccinated can find updated public health recommendations at https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated-guidance.html.

The Centers for Disease Control and Prevention and the New Mexico Department of Health websites both offer comprehensive, reliable, information and resources on the COVID-19 coronavirus.

The New Mexico Office of the Superintendent of Insurance and the New Mexico Office of the Attorney General have warned consumers and businesses that con artists and scammers are taking advantage of the panic, fear, and confusion surrounding the COVID-19 pandemic, and have intensified efforts to defraud and steal. Read the April 8, 2020 press release for examples of scams and tips to protect yourself.

The New Mexico Superintendent of Insurance Russell Toal and New Mexico Governor Michelle Lujan Grisham are helping ensure that New Mexicans who have suffered the loss of income or employment can sign up for low-cost health insurance. Read the April 13, 2020 press release from the Office of the Superintendent of Insurance here.

New Mexicans have three coverage options beyond employer-sponsored insurance:

1. Medicaid. Individuals may determine their eligibility and sign up at www.yes.state.nm.us/yesnm/home/index or call 1-855-637-6574.
2. beWellnm, the state’s Health Insurance Exchange. Individuals who don’t qualify for Medicaid may visit www.bewellnm.com, call 1-833-862-3935, or contact their agent.
3. New Mexico Medical Insurance Pool (NMMIP). NMMIP offers health coverage to all who reside in New Mexico, with discounts for low- and middle-income households. Individuals may visit https://nmmip.org, call 1-844-728-7896, or contact their agent.