Blue Medicare Advantage (HMO)SM
Welcome to Blue Cross and Blue Shield of New Mexico (BCBSNM) Blue Medicare Advantage (HMO), a Medicare Advantage Prescription Drug Program which provides affordable health care coverage to the people of New Mexico in Bernalillo and Sandoval counties.
Our strong brand recognition and our historical relationship with Medicare makes BCBSNM an excellent choice for Medicare eligible individuals seeking new health coverage opportunities. Blue Medicare Advantage (HMO) maintains and monitors a network of participating providers including physicians, hospitals, skilled nursing facilities, ancillary providers, and other health care providers through which members obtain covered services.
Participating physicians, professional providers, and facility providers must submit claims to Blue Medicare Advantage (HMO) within 180 days of the date of service, using the standard CMS-1500 or UB-04 claim form, or electronically. Services billed beyond 180 days from the date of service are not eligible for reimbursement.
See Section 7.4 of the Blue Medicare Advantage section of the Blues Provider Reference Manual 
All providers who contract with BCBSNM to provide Medicare Advantage services are expected to abide by the Centers for Medicare & Medicaid Services (CMS) rules for marketing when it involves BCBSNM or Blue Medicare Advantage (HMO) products or benefits.
View the guidelines that are applicable to providers in the Provider Medicare Marketing Guidelines Excerpt
- Blue Medicare Advantage section of the Blues Provider Reference Manual
- Provider Directory
- Provider Finder ®
– search for doctors, hospitals, and other health care providers in the Blue Medicare Advantage network. - Sample ID Card – See Section 2.1 of the Blue Medicare Advantage section of the Blues Provider Reference Manual
Forms
- Preauthorization Request for Blue Medicare Advantage (HMO Members
- Predetermination Request for Blue Medicare Advantage (HMO) Members
- Medicare Part B Medication Prior Authorization Request Form
To view the following forms, go to the Attachments section of the Blue Medicare Advantage section of the Blues Provider Reference Manual .
- New Mexico Optional Advance Health Care Directive Form
- Notice of Medicare Non-Coverage
