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Welcome, Federal Employees and Retirees!
A Farewell from True Health New Mexico
By now you have received a letter from me telling you that, effective January 1, 2022, True Health New Mexico will cease offering health insurance through the Federal Employee Health Benefits (FEHB) program.
We have truly appreciated the opportunity to serve you. This was a very difficult decision, reached after carefully analyzing our long-term organizational goals and how they align with those of the Office of Personnel Management. Our decision affects only the FEHB program. Going forward, we will continue to grow our individual and family, small group, and large group lines of business in New Mexico.
TRUE is committed to continuing to provide our comprehensive health coverage to you through December 31, 2021, and to addressing issues that arise thereafter for health services received during the 2021 calendar year. For more information, please refer to the letter and FastFacts sheet you have received.
On behalf of everyone at TRUE, I want to thank you for choosing us to provide your healthcare coverage. It has been an honor and a privilege to be a part of the FEHB community. We hope that we can serve you and your loved ones again at some point in the future.
Mark Epstein, MD, MBA
President and CEO
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.
Frequently Asked Questions About Your Plan
Do you cover my medication?
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.
Truly accessible care
The healthcare industry is advancing at a rapid pace. As we progress down this path, new and evolving ways for people to access care are emerging. At True Health New Mexico, we believe in ensuring our members have the ability to see a doctor no matter where they are.
What is virtual care?
Virtual care is a term that includes all the ways healthcare providers can remotely interact with patients. These services may also be referred to as virtual visits, telehealth, or telemedicine appointments.
Virtual care allows you to seek non-emergency services with an in-network provider who can treat and diagnosis medical conditions, mental disorders, and other conditions without a traditional in-person office visit, urgent care visit, or emergency care visit.
Telehealth visits during the COVID-19 pandemic
During the coronavirus pandemic, it’s important for you to continue receiving the healthcare services you need to be healthy. Your regular provider(s) may be offering telehealth visits as a safe option for receiving non-emergency care during this time.
Contact your provider(s) to learn if telehealth visits are an option for you. True Health New Mexico covers these visits at the same benefit level as in-person visits.
Care Connect Nurse Advice Line
All True Health New Mexico members have access to our Care Connect Nurse Advice Line that is available 24/7 at 1-844-308-2552. Experienced registered nurses will talk with you about your symptoms and situation.
Your mental health is just as important as your physical health. Here are a few options to help you get the care you need as soon as possible.
- If you already have a behavioral health provider, ask if they offer telehealth/virtual visits.
- The National Suicide Prevention Lifeline offers 24/7 support through online chat. Visit https://suicidepreventionlifeline.org/chat/. You also can call the Lifeline at 1-800-273-8255.
- If you are having a mental health crisis, you can receive 24/7 support via the New Mexico Crisis and Access Line at 1-855-662-7474.
- Visit our Behavioral Health page for more resources.
Medical Cost Estimator Tool
This tool will help you research average costs for basic services such as lab and radiology 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.