Get Started Using Your 2025 Health Plan

Use these steps and make the most of your health care coverage.

Know Your Health Plan

Here are some details to know about your health plan. Remember, when you visit a doctor outside of your plan’s network, you may pay more or all of your bill.

Health Maintenance Organization (HMO)

Primary Care Provider (PCP)

You’ll need to select a PCP for your care. This is the one doctor who arranges your care and refers you to specialists. Find an in-network doctor.

Prior Authorization

Some services may require prior authorization (pre-approval).1 Ask your doctor about this so you’re sure who handles this step. Get details on prior authorization.

Plan Network

It's best to visit health care providers in your plan’s network. If you don’t, you’ll pay for most of or the full cost of your care. Review cost examples.

Preventive Care Services

Some screenings, like your Annual Exam, are included with your health plan at no additional cost. Learn why you should schedule your annual exam.

Make Your Care Personal

Here are helpful resources and ways to personalize your coverage.

Find the Right Care When You Need It

Your primary care provider (PCP) should be your first call when you don't feel well. But, based on your symptoms, you have options for where to get care.

When to visit your doctor for care

Your Doctor

Your doctor can help when you need regular checkups or minor sickness.

Examples: Fever, colds and flu

When to call our nurseline for help

24/7 Nurseline

The 24/7 Nurseline is a toll-free number to call for general health-related questions and advice on care options.2

Examples: Headaches, dizziness or what to do if your child is sick

When to schedule a virtual visit

Virtual Visits

Virtual visits connect you with a doctor for live, non-emergency medical or behavioral health help by phone, online video or mobile app.3

Examples: Allergies, depression or pink eye

When to get care at a retail clinic

Retail Clinic

If your doctor isn't available and you want to get walk-in, non-emergency care for common symptoms, you can visit a retail clinic.4

Examples: Minor injuries, pain or sore throat

When to go to an urgent care for help

Urgent Care

When you visit an urgent care, you can get quick medical attention when your life or health isn't at risk.

Examples: Cuts that need stitches, sprains or animal bites

When to visit an ER

Emergency Room (ER)

Emergency rooms should be visited for emergency care if your life or health is at risk.

Examples: Heart attack, heavy bleeding or broken bones

                         Get Annual Preventive Care

                                       Know how to find problems early, set goals and track your progress.

Preventive Screenings

Keep your health information up to date each year with screens for:

  1. Diabetes
  2. Cholesterol
  3. Heart disease
  4. Body Mass Index (BMI)

Some screenings, like your annual exam, may be offered at no cost to you if you stay in-network.

How to find a PCP and schedule your annual exam

Preventive Services

Other preventive services that may have no out-of-pocket costs are:

  1. Immunizations and vaccines
  2. Weight loss programs
  3. Anti-smoking programs
  4. Maternity and well-child visits

Remember, its important to talk with your doctor about your lifestyle and any life changes.

Learn more about preventive care services

Caring For Your Behavioral Health

Making sure you’re well mentally and emotionally is part of staying healthy. Help is available for you.

Learn when to get help for your mental health

Seeking Emotional Care

Your behavioral health is just as important as your physical health. Know where to turn when you need care.

Woman speaking with a mental health expert

Finding Helpful Providers

There are many kinds of mental health experts you can get help from.

Understand Your Pharmacy Benefits

Knowing how your pharmacy benefits work can help lower your prescription drug costs.

Learn which drugs are covered under your plan

Review Covered Drugs

Check to see if your drug is on the 2025 Drug Lists. Review drug lists.

Understand how to use your prescription and pharmacy benefits as an individual and family plan holder. Learn more about Rx coverage.

How to save on your prescriptions

Ways to Save

Generally, you’ll pay less if you go to an in-network pharmacy. Find an in-network pharmacy.

Visit a Preferred Pharmacy Network (PPN) for your lowest costs. Learn more about PPNs and how to find them.

Talk with your doctor or pharmacist and learn if you could save by using a generic drug option instead. Know the difference between generic versus brand name drugs.

More Resources and Contacts

1 Prior Authorization not required in certain circumstances, such as emergency or urgent situations. 

2 The 24/7 Nurseline may not be available with all plans. Check your benefits booklet for details.

3 Internet/Wi-Fi connection is needed for computer access. Data charges may apply. Check your cellular data or internet service provider’s plan for details. Non-emergency medical service in Idaho, Montana and New Mexico is limited to interactive audio/video (video only), along with the ability to prescribe. Non-emergency medical service in Arkansas is limited to interactive audio/video (video only) for initial consultation, along with the ability to prescribe. Behavioral Health service is limited to interactive audio/video (video only), along with the ability to prescribe in all states. Service availability depends on location at the time of consultation.

4 Visiting a Retail Clinic may not be covered with all plans. Check your benefits booklet for details. 

5 The Well onTarget program is offered to you as a part of your employer-sponsored benefits. Participation in the Well onTarget program, including the completion of a Health Assessment, is voluntary and you are not required to participate. Visit Well onTarget for complete details and terms and conditions. Coaching programs are only available to individuals whose employers have purchased the program. Check with your administrator to see if the Coaching programs are available to you. Program rules are subject to change without prior notice. See the Program rules on the Well onTarget Member Wellness Portal for more information.

The Well onTarget member rewards redemption service is provided by an independent third party. Onlife Health is an independent company that provides wellness services for the Well onTarget program. Members can use their Blue Access for Members credentials to access wellontarget.com. Blue Cross and Blue Shield of New Mexico makes no endorsement, representations or warranties regarding third-party vendors and the products and services offered by them.