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Better You Wellness Program
Welcome, Federal Employees and Retirees!
Members, Tell Us How We’re Doing!
FEHB HMO Plan Brochure
This is your plan’s official approved brochure.
Summary of Benefits and Coverage
A six-page summary of your plan benefits.
Benefit and Resource Guide
A summary of your benefits and our member perks.
Pediatric Vision Benefits
Enrolled children under age 19 are eligible for pediatric vision services through VSP. Find the benefit summary below.
Find Your Prescription Cost-Share
Do you have questions about drug costs? Use the CVS Drug Cost Transparency tool.
Prescription Drug Prior Authorization
Prior authorization can be confusing. This document explains the process.
Pharmacy and Formulary
Pharmacy benefits and programs to support your health, plus a pharmacy locator.
Helpful forms you may need as a True Health New Mexico member.
Our comprehensive Care Management program assists members with complex or chronic health conditions.
Health and Wellness
Tools and programs to help you live a healthier, happier life.
How to Enroll
Visit the Office of Personnel Management’s website to view your enrollment options.
New! Medical Cost Estimator Tool
This new tool will help you research out-of-pocket costs for common procedures and plan for the financial impacts of surgeries, therapies, office visits, and screening procedures and compare cost estimates across our provider network.
*True Health New Mexico’s medical cost estimator is an online tool designed to help members select value-based services. This tool will provide cost and quality comparison for services within the True Health New Mexico network. Benefits will be determined once True Health New Mexico receives a claim and will be based upon the member’s eligibility, benefits, limitations and exclusions, and the terms of the member’s certificate of coverage in effect on the date services are rendered.
This tool does not guarantee benefits. Please refer to your official FEHB brochure to understand how your plan benefits work.
Frequently Asked Questions
Select the Pharmacy and Formulary button above to go to the Pharmacy page, then select the Federal Employees Formulary button to view a list of the prescription medications covered on your True Health New Mexico plan.
What will the cost of my medication be?
In the second row of gray boxes above, select the Find your Prescription Cost-Share button. Find a pharmacy and enter the name of your medication to find the cost of your medication.
Do I need a referral to see a specialist?
No, True Health New Mexico does not require a referral from your primary care physician in order to see a specialist. However, some specialists may request a referral from your primary care physician prior to scheduling a visit.
What hospitals can I go to?
On our Quick-Search PDFs page, open the Hospitals in New Mexico and Texas document. You can download this document to your computer if you wish.
If I am an existing member, will I receive a new ID card for the 2021 plan year?
No, if you are an existing member in 2020, you will continue to use your current member ID card in 2021. However, if you have requested a replacement ID card, you will receive one.
New members will receive ID cards.
What is my monthly premium?
In the FEHB HMO Plan Brochure button above, select the 2021 link. View detailed premium rate information on page 82.
Is preventive care covered?
Yes, your True Health New Mexico plan covers routine physicals once every calendar year. In addition, well-child visits, examinations, immunizations, and routine screenings, based on current recommendations, are covered.
What if I am receiving an ongoing course of treatment from an out-of-network provider at the time of my enrollment?
You may be eligible to continue to receive services from this provider and have the services covered under your True Health New Mexico plan. This is called transition of care. Please visit our Care Management page to learn more.
Does my plan offer dental and vision coverage?
True Health New Mexico does not offer a dental plan. We do offer vision coverage for children through age 18 (no adult vision plan).
Can I pay for my doctor’s office visits with my wellness points?
No, wellness points may be used only to redeem select reward items.