Preferred Provider Plan PPO

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Preferred Provider Plan (PPO)

• State of New Mexico
• For a state of better health!

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Freedom of Choice

• You have the choice to see a Preferred or
  Nonpreferred Provider
• You do not need to choose a Primary Care
  Physician (PCP)
• Referrals are not required for Specialty care
• You have National and International coverage

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Preferred Providers

• Providers that are contracted with Blue Cross and
  Blue Shield
• Providers will file your claims
• Over 9 out of 10 providers in New Mexico contract
  with BCBSNM
• Includes Presbyterian facilities and specialists
  for members living outside Bernalillo, Sandoval,
  Valencia and Torrance counties

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Nonpreferred Providers

• Providers that are not contracted with Blue Cross
  and Blue Shield
• You may be charged more than the PPO plans
  maximum allowable charges
• You may have to file your own claims
• You may be responsible for obtaining
  precertification and prior authorization

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The BlueCard Program1-800-810-BLUE (2583)

• National Coverage
• Coverage for members when working, traveling or
  residing outside of New Mexico
• Largest PPO network in the country
• Centers of Excellence
• Heart Hospital in NM
• Mayo Clinic of AZ and MN
• MD Anderson in TX
• International Coverage
• Providers and Facilities in over 185 countries

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PPO PlanBrief Summary of Benefits
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PPO PlanBrief Summary of Benefits
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For a State of Better Health!

• Blue Access for Members Password protected web
  site that provides you and your family with your
  own account information
• Personal Health Manager Online wellness tools
  and resources to help manage your health and
  adopt healthier behaviors
• Blue Points Accumulate points that can be
  redeemed for gift cards, sporting equipment,
  electronics, etc.
• 24/7 Nurseline Registered nurses offer health
  care information by telephone
• Special Beginnings This maternity program
  offers expectant mothers support and education
  from prenatal to postpartum care

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bcbsnm.com

• E-mail your customer service area
• Link to health and wellness sites
• Link to the SONM web site
• Access Blue Access for Members (BAM)
• Check the status of claims
• Provider Finder
• Treatment Cost AdvisorTM
• Hospital Comparison Tool
• Print a temporary ID card

BAM is password protected giving you immediate,
secure access to your account information.
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BlueExtras Discount Program

• Discounted Alternative Medicine Discounts for
  acupuncture, health clubs and spas, chiropractic
  services, massage therapy, and more
• Weight Management Discounts for Curves and
  Jenny Craig
• Hearing Discounts on hearing aids for members,
  parents, and grandparents
• Vision Discounts on eyewear, laser correction
  surgery, and contact lenses

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Legacy of ServiceState of New Mexico

• Strong tradition and culture of service with
  caring employees!
• We answer your calls in a prompt and timely
  manner
• 9 out of 10 calls are resolved the first time you
  call
• In 2008, the average time to process SONM claims
  was less than 5 calendar daysfast/accurate
  claims turnaround!
• Local, case managers who are available to help
  you and your family for transition of care and
  treatment situations

1-877-994-BLUE (2583)
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Value that the Blues bring to you

• Over 9 out of 10 providers contract with BCBSNM
• The largest PPO network including National and
  International providers
• Extensive health and wellness tools, including
  rewards and discounts
• New Mexicans serving New Mexicans for almost 70
  years

Experience. Wellness. Everywhere.SM
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Division of Health Care Service Corporation, a
Mutual Legal Reserve Company, an Independent
Licensee of the Blue Cross and Blue Shield
Association
Over 100 million Americans choose the
Blues including over 295,000New Mexicans!