How to Choose a Health Insurance Plan

Understand your plan options. Find shopping resources. Compare your options and enroll in our shopping platform.

Prefer to shop through the New Mexico Health Insurance Exchange? Visit beWellnm.com.

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Gather Information on Health Care Plans

Compare plans' cost and coverage differences.

Find a plan that fits your lifestyle and budget. Start by understanding our plans' metallic levels.

Our Gold, Silver and Bronze metallic levels offer different levels of care and costs to help our plans better fit your needs.

The New Mexico Health Insurance Marketplace also offers an affordable Turquoise plan for those eligible.

Find the doctors and hospitals in each plan's network.

Each plan has a network of covered doctors, hospitals and pharmacies. Using in-network care helps keep your plan's costs low. Use our Find Care tool to:

  • Check that your current doctor is covered
  • Find a new in-network primary care provider (PCP)
  • Search for covered specialists

Make sure your prescriptions are covered.

Each year, the BCBSNM drug lists are updated to note which drugs are covered by your plan and what their costs are.

The drug lists also show if your prescription has other considerations, like if it has a dispensing limit or requires prior authorization.

What's Covered in Each Plan?

While all plans offer coverage for essential benefits, they differ in access to:

  • Networks: which covered doctors and hospitals are covered by your plan
  • Virtual care tools: if BCBSNM telehealth services are an included benefit
  • Specialists: if your plan requires you to get a referral to meet with a specialist — most HMO and POS plans do
Man getting virtual care through his cell phone's video calling
Young doctor and their patient at an appointment

How Are the Costs Different?

Most plans vary in the costs they offer and you owe, like:

  • Deductible: the annual amount owed before your plan covers the bill
  • Premium: the amount owed each month to keep your plan active
  • Copays: the cost ($) you may owe after meeting your deductible
  • Coinsurance: the cost (%) you may owe after meeting your deductible

Explore Provider Networks

  • Find in-network doctors, hospitals and specialists: use our Provider FinderSM tool to explore the doctors, hospitals and specialists covered by each plan.
  • Check for your preferred providers: Want to keep your current doctor? If you're choosing a new plan, check its network to make sure they're still covered.
Man getting virtual care through his cell phone's video calling

Factor In Flexibility and Convenience

Sometimes, planning ahead isn't possible. From needing care when you're away from home to staying covered in an emergency situation, it's important to understand how your plan works.

Compare the tools and benefits that help you stay covered when life doesn't go according to plan.

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  • How can you help cover unexpected health care costs?

    While your plan helps cover your health care costs, medical bills can still leave members with a charge they hadn't planned for. To plan ahead, you can:

    • Contribute to a Health Savings Account (HSA), if your plan offers one
    • Use in-network providers
    • Check that your prescriptions are covered
    • Choose a plan that matches your needs
  • What are your out-of-network and emergency care options?

    An easy way to save money is by using in-network providers. Using out-of-network often results in higher bills or, depending on your plan, even a denied claim. 

    If you're experiencing an emergency, please know that you do not need to visit an in-network hospital. It's important you prioritize getting care over your plan's network.