Where To Go for Care

Your PCP is your personal doctor. They will give you most of your care. Your PCP knows your health history and the medicine(s) you take. They can help arrange visits to specialists. Your PCP can also help decide if you need to go to a behavioral health provider. They know your present state of health. Knowing all this helps your PCP make the best decisions when you need medical care.

Your doctor’s office is the best place to go for non-emergency care. Examples of when you should go to your PCP are when you:

• Need a checkup or physical
• Have allergies, cold or flu, ear pain, sinus problems
• Have a sore throat
• Have a stomachache
• Need prescription refills or changes
• Get shots

With Turquoise Care you can pick your PCP. Do you need help to find a PCP or change your current PCP? You can log in to Blue Access for Members℠ to do this. After logging in, go to My Health > Find Care. Then, choose to Select a Provider or Change Provider. You can also call Member Services at 1-866-689-1523. The call is toll free.

If you have questions, our nurses have answers. This help line is staffed 24 hours a day with registered nurses. You can get answers to your health questions when you need them. If an unexpected medical situation arises, a nurse can help you decide if you should call your doctor, visit the ER or urgent care, or treat the problem yourself. Our nurses can help with health problems such as:

• Asthma, back pain or chronic health problems
• A baby’s nonstop crying
• High fever or sore throat
• Dizziness or severe headache
• Cuts or burns
• And much more

Call the 24/7 Nurseline at 1-877-213-2567 (TTY: 711).

Sometimes you may need help dealing with stress, grief, or depression. Help is also available for those facing:

• Emotional needs or concerns
• Mental health conditions
• Substance abuse 

Search for Behavioral Health Providers

Find out what is covered by your plan, along with programs and resources.

New Mexico Crisis and Access Line (NMCAL)

NMCAL is available to New Mexicans during a mental health crisis. Use this state-wide toll-free phone line to access local help and resources. There are mental health professionals ready to help 24/7.

• Call NMCAL at 1-855-NMCRISIS (1-855-662-7474).
• If you have a life-threatening emergency, please call 911.

If your doctor’s office is closed and you need urgent medical care, you can visit an urgent care clinic. Urgent care is medical treatment for a condition that is not life-threatening. This can be for sudden illness or injury. Examples of when you should go to an urgent care clinic are when you have:

• Back pain
• Pain with urination
• Asthma with constant wheezing not resolved with your inhaler
• Minor fractures
• Cuts that need stitches
• Flu or cold-like symptoms

Search for an Urgent Care Center

If you are having an emergency, go to the ER or call 911.

An emergency is a sudden medical condition with severe symptoms. These symptoms can include intense pain. Without immediate medical help, your health and life could be in danger. Emergency conditions can damage bodily functions. They can cause serious injury to body organs or parts. Examples of emergencies are:

• Heart attack
• Stroke (sudden weakness on one side, slurring of speech, trouble swallowing, blurred vision)
• Bad chest pain or other pain that does not go away
• Shortness of breath or severe trouble breathing
• Bleeding that does not stop
• Loss of consciousness (passing out)
• Seizures
• Poisoning or drug overdose
• Severe burns
• Serious injury from an accident or fall
• Broken bones
• Injured eye or sudden loss of eyesight
• Feelings of wanting to hurt yourself or others

Services received in an emergency room (ER) or other trauma center must meet the definition of "emergency" to be covered. Services received in a doctor's office or urgent care facility are not considered emergencies.

How to Avoid a Trip to the ER

• Consult your doctor regularly. This is important if you have a long-term health problem such as diabetes or asthma, or if you have ongoing behavioral health needs.
• Take your medicines as prescribed by your doctor.

If it’s hard to visit your doctor in person, virtual care is an option. Do you:

• Need urgent care right now?
• Need access to a virtual primary care provider (PCP) to help with your health care needs on a routine basis or as issues come up?
• Need help dealing with emotional needs or concerns, mental health conditions or substance abuse?

Whether you need help for common health concerns or want to talk with a doctor about setting up a care plan, get access when you need it. Virtual care saves time — you won’t have to travel to a doctor’s office.

Here are ways to access virtual care:

• Virtual PCP by Galileo^® lets you to set up regular visits online for routine care or when issues come up. Learn more
• Virtual Visits by MDLIVE^® lets you speak with a doctor or therapist 24 hours a day, 7 days a week for urgent care. Learn more 
• Virtual Care for Behavioral Health is available when you need therapy, counseling or access to programs that can help with different issues. Learn more

Dental care is administered through DentaQuest^®. Do you need to find a dentist in your area? Or do you want to confirm if a dental treatment needs prior authorization?

Find a Dentist

Learn more about dental care covered by your plan.

Vision care is administered by Davis Vision^®. Do you need to find a vision provider in your area? Or do you want to confirm if a vision treatment needs prior authorization?

Search for a Vision Provider

Learn more about vision care covered by your plan.