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New Mexico Medicaid is changing: are you ready?

Doctors

Here at HealthInsight, no matter what our titles may be, we each have a role in helping those in our community to understand changes in health care. This came to mind recently in my “off-hours” while I was getting my nails done. The manicurist asked me what I did for a living, and my answer opened up an interesting conversation about her mom.

She explained that although her mom works, she would like to qualify for Medicaid so she can have access to health care. I was glad to provide her with some ideas and resources for additional information. I also let her know that Medicaid in New Mexico is changing.

The current program is called Centennial Care and two of the four Medicaid managed care organizations (MCOs) that contract with the State to provide health care coverage for New Mexico Medicaid beneficiaries are changing. The new MCOs will be:

  • Blue Cross and Blue Shield of New Mexico (BCBS)
  • Presbyterian Health Plan, Inc. (PHP)
  • Western Sky (Centene)

For New Mexico Medicaid beneficiaries, the change will start this fall. On Jan. 1, 2019, the Medicaid program is renewing and will be called Centennial Care 2.0. Despite the appearance of just a minor name change, the consequences are significant. With the new waiver, a shift occurred in the previous MCO contract holders. What this means to my manicurist’s mom and other current enrollees is they may need to choose a new MCO for their care.

Although the enrollment dates have not yet been announced, enrollment will likely begin in October and end in December 2018 for the Jan. 1 deadline. Prepare now: January may seem like a long way off, but like Tax Day on April 15, there is always a long line at the post office at midnight. Allow plenty of time to research and compare your health care options.

What you can you do to be prepared for these changes? If you are current Medicaid enrollee:

  1. Start first at the Frequently Asked Questions section on the New Mexico Medicaid website.
  2. Ask questions of your current health plan. The MCO representatives will have the latest information about the change.
  3. Talk to your primary care providers about the change. Will your doctor or pharmacist still be enrolled in Medicaid? Can you still see your chosen clinicians?
  4. Be prepared to sign release forms if they are needed to have your medical records sent from your current provider to new providers.
  5. Talk to your family about this change: how does it affect them in helping you?
  6. Make sure you have all of your financial documentation nearby in case you need to provide this information to your health plan.
  7. Be ready to compare plans. Know what services you currently receive by gathering your current health care records and make sure your new plan can provide comparable coverage.

If you know someone on Medicaid:

  1. Let them know changes are coming at the end of the year.
  2. They need watch for advertising in the community or letters from their health plan about how to handle the change.
  3. Share with them the information resources in this blog.
  4. Time gets away: check back with them to be sure they are on track.
  5. Be informed and be prepared for the new changes.

Information Resources

Albuquerque Journal – Health section

KUNM – Public Health New Mexico has new reports

FAQs about Centennial Care 2.0

Documents about Centennial Care 2.0

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