Turquoise Care

Turquoise Care is the new name for the New Mexico Medicaid Managed Care program that will begin on July 1, 2024. Turquoise Care benefits and coverage will be the same as Centennial Care.

Presbyterian Turquoise Care gives you all the care you need. The plan covers things like:

• Preventive care: Yearly checkups, mammograms, lab tests and immunizations (shots).

• Care for pregnant people: Includes prenatal care and classes, follow-up care after your baby is born and special help for moms with high-risk pregnancies.

• Dental and vision services: Routine exams to keep your teeth and gums strong. Plus, eye exams to keep your eyes healthy.

• Transportation (ride) services: Help to get you to and from your medical appointments.

• Disease management: Programs to help you manage your chronic health issues like diabetes, high blood pressure or asthma.

• Urgent or emergency care: Get the care you need right away for major or minor medical problems.

• Long-term services and supports: Help to manage your complex care that may be provided in your home, a community setting or a nursing facility.

• Behavioral health and substance use disorder treatment: A wide-range of services for all ages, including a 24-hour crisis line and other behavioral health support and resources for you or your family.

• Prescription drug coverage: Covered prescriptions, including some over-the-counter medications.

Current Presbyterian Health Plan (PHP) members who wish to remain with PHP you do not have to actively select an MCO during open enrollment (April 1 through May 31, 2024). You will be automatically re-enrolled with PHP.

If you are not currently enrolled with PHP and would like to be a PHP member, you will need to select PHP during open enrollment (April 1 through May 31, 2024).

Most individuals on Medicaid in New Mexico are in managed care. Native Americans may opt-in to managed care. For more information on applying for Medicaid, please visit our website at https://www.yes.state.nm.us/yesnm/home/index or call

There are 3 ways to apply for Medicaid:

• Online Online at the YESNM website

• By Phone Call the New Mexico Medicaid Call Center for free at

  1-888-997-2583
  . They can also mail you an application.

• In Person Visit your local Income Support Division Field Office. Find your local phone numbers and addresses

You will need to have these available when you apply:

Proof of identity

Tip: You will need:

• Your driver’s license or a photo ID

• The Social Security numbers of anyone in your household applying for Medicaid benefits

Proof of citizenship or legal residence of those who are applying to get Medicaid

Tip: You should use things like a U.S. birth certificate or immigration records.

Proof you live in New Mexico

Tip: You can use things such as a recent utility bill or rental agreement.

Proof of income of everyone in your home

Tip: You can take things like:

• Your paycheck stubs from the last [30 days]

• A letter from your employer with the hours you work and the pay you are given

• A letter from the Social Security office about your benefits

• A letter from the unemployment office about your benefits

In April 2024, you will receive a letter in a yellow envelope from the Human Services Department (HSD). It will tell you about the changes to the MCOs and what you need to do to choose your MCO. HSD is currently developing a schedule for upcoming outreach events for members and providers.

Yes! Presbyterian Health Plan (PHP) will continue to provide services after June 30, 2024.

Covered services that exist today will remain. New covered services such as chiropractic services will be added.

CISC will automatically be enrolled with Presbyterian Health Plan (PHP). This will be the only MCO managing care for non-Native American CISC.

Native American CISC can choose to enroll in any MCO. If Native American CISC members do not opt-in to managed care, services will be provided via the Fee for Service plan. Please see the Native Americans section of this document for additional information.

Phone:

TTY: 711

Navajo Hotline:

Children in State Custody Phone:

Phone hours: Monday through Friday, 8:00 a.m. - 6:00 p.m.

Email: info@phs.org

We have free interpreter services to answer any questions you may have about our health or drug plan. Just call us at

All Native Americans have the choice of enrolling in Turquoise Care (managed care) or Fee-For-Service Medicaid. Native Americans who receive long-term care services (Community Benefits) such as personal care, and long-term Nursing Facility care are required to be in Turquoise Care.

Under Fee for Service Medicaid, you receive the basic Medicaid benefits package. Under Turquoise Care, you will receive additional services such as expanded care coordination, community benefits, and the value-added benefits that each MCO offers its members.

Yes. You can continue to see your doctors at Indian Health Services and still be enrolled in Turquoise Care. The MCO would pay your doctors, lab, pharmacy, etc.

Native Americans can choose to opt-out of Turquoise Care at any time by contacting the Customer Service Center at

Yes. Each MCO is required to have people who are trained on Native American culture and traditions who can talk to you about your specific concerns. Whenever possible, the MCOs will have people who speak your language.