Welcome, Federal Employees!
True Health New Mexico is delighted to offer health insurance coverage and services to you and your family. As a physician-led health plan, we are committed to keeping New Mexicans healthy and making sure our members’ health care is coordinated at every level.
Why Choose True Health New Mexico?
- Medical Management: We focus on well-care, not sick-care. Our highly qualified and licensed health care medical management professionals work as a team with members and physicians to ensure members are receiving the best care and service.
- Mental Health Focus: We believe mental health is an essential component to one’s physical health. By offering $0 copays for outpatient behavioral health office visits, we work as your partner in health.
- $0 Drug List: Members have access to our zero-dollar copay on select generic medications for the following chronic conditions:
- bipolar disorder
- chronic obstructive pulmonary disorder (COPD)
- congestive heart failure (CHF)
- coronary artery disease
- hypercholesterolemia (high cholesterol)
- hypertension (high blood pressure)
- Extensive Provider Network: Choose from more than 10,000 primary care providers, specialists, medical groups, and facilities around New Mexico and in Amarillo, El Paso, Lubbock, and Muleshoe, TX.
- Value for New Mexicans: Access wellness programs at no extra cost and get rewarded for better health.
Important information you’ll find in these materials:
- Cost-share for the types of visits you and your family use often.
- How the plan covers specific conditions or circumstances.
- Prescription coverage. Be sure to review the formulary (drug list) and prescription costs for any drugs you or your family members currently take.
True Health New Mexico and CVS Caremark® work together to manage your pharmacy benefit coverage.
View the formulary and related drug lists for drugs covered by your True Health New Mexico plan.
2020 Formulary and Other Drug Lists
Prior Authorization for Prescription Drugs
Search the Pharmacy Network
Find Your Member Cost-Share for a Drug
If you have questions about prescription costs, you can use the CVS Caremark Drug Cost Transparency Tool. Please note: The Drug Cost Transparency Tool will provide amounts that represent the member’s cost share after the deductible has been met.
The Drug Cost Transparency Tool can display a one-month cost share, as well as the three-month (mail order) cost share. After you enter the drug name and select the correct product, you will be directed to a screen that will display the “Mail: common dosage” (three-month) cost share and the “Store pickup: common dosage” (one month). The one-month and three-month cost shares are displayed on different tabs within the tool.
Finally, the Drug Cost Transparency Tool displays the most common quantity/dosage for each medication. If your prescription is written for multiple packages/boxes, the tool may not be able to calculate the cost share accurately.
Pediatric Vision Services
Children enrolled who are under the age of 19 are eligible for pediatric vision services through VSP.
Find a Doctor in Our Network
- Click on the button above to search for an in-network doctor, physician assistant, therapist, hospital, urgent care center, lab, and many other kinds of providers.
- PCP is an abbreviation for Primary Care Provider.
- Please check with your provider/practitioner before scheduling your appointment or receiving services to confirm whether the provider is participating and/or accepting new patients. Read an important message about your responsibility to verify your provider’s participation, and what information we verify in our Provider Directory.
- If you can’t find a specific provider, have questions about the providers you will see, or need help with the Provider Search Tool, please call us at 1-844-508-4677.
Helpful Links for Members
- My Account Login – our secure member portal.
- Register at Caremark.com or download the mobile app to learn more about your prescription drug benefits.
- Pharmacy programs for members – visit our Pharmacy page and scroll down to Pharmacy Programs for Members.
- FEHB member newsletter – our quarterly health and wellness newsletter for FEHB members
- Transition of Care program – for new members who are currently undergoing a course of treatment with a provider who is not in the True Health New Mexico network.
- True Health New Mexico Care Connect Line: 1-844-308-2552 – talk to an experienced registered nurse, toll-free, for expert guidance and information 24 hours a day, 7 days a week, 365 days a year (exclusively for True Health New Mexico members and their eligible dependents).
- Case Management and Disease Management services – for help managing complex and/or chronic conditions, at no extra cost and for as long as you need it.
- Understand your rights and responsibilities as a True Health New Mexico member.
- Learn how to protect yourself from and report health care fraud, waste, and abuse.
- Uniform Glossary – a list of important health care terms and their definitions that will help you get the most out of your True Health New Mexico plan.
Forms for Members
- Coordination of benefits form, English
- Coordination of benefits form, Spanish
- Medical claim reimbursement form, English
- Medical claim reimbursement form, Spanish
Health and Wellness
- Fitbit True Wellness Program – take a Health Risk Assessment and earn a credit and discounted pricing toward the Fitbit device of your choice.
- Staying Healthy – resources for physical and behavioral health and wellness, preventive screenings, support groups, and more.
- A.D.A.M. – a comprehensive online health resource with a multimedia library, health navigator to help you learn about symptoms of illness/injury, health risk assessments, and much more.
- Labor of Love – a free program available in Albuquerque and Roswell with perks for mothers to be.
Information for Providers
- Payor ID for electronic claims submission: 85824.
- True Health New Mexico uses Change Healthcare as its clearinghouse. Providers should work with their clearinghouses to ensure they can file their electronic claims to Change Healthcare.
- Providers, facilities, and ancillary care professionals who treat FEHB members should download, complete, and submit this form to request a refund.
- Claims address for paper claims submission: True Health New Mexico, P.O. Box 830955, Birmingham, AL 35283-0955
- Customer service for contracted providers and all True Health New Mexico members: 1-844-508-4677