Hmm … it looks like your browser is out of date.
Let’s update your browser so you can enjoy a faster, more secure site experience.
New Mexico Turquoise Care
Medicaid
Turquoise Care is the name of New Mexico's Medicaid Managed Care program offered by UnitedHealthcare Community Plan. It's for children, families, pregnant women and adults who meet income and other eligibility requirements.
This plan is available in the following counties:
Bernalillo, Catron, Chaves, Cibola, Colfax, Curry, De Baca, Dona Ana, Eddy, Grant, Guadalupe, Harding, Hidalgo, Lea, Lincoln, Los Alamos, Luna, Mckinley, Mora, Otero, Quay, Rio Arriba, Roosevelt, San Juan, San Miguel, Sandoval, Santa Fe, Sierra, Socorro, Taos, Torrance, Union, and Valencia.
- New Mexico Turquoise Care
Find Providers and Coverage for this Plan.
Find doctors, hospitals, behavioral health, and other specialists.
Find medications covered by this plan.
Search for behavioral health providers and resources.
Find a dentist near you.
Find a pharmacy near you.
Find a vision center.
Benefits & features
Behavioral health
Our online behavioral health resources connect members to information and resources for overall health and wellness, including specific behavioral health tools, resources and information. For example, our health and wellness library feature 60 centers and over 220 videos focused on topics such as:
- Physical health,
- Mental health,
- Substance use,
- Recovery tools,
- Resiliency skills development,
- Caregiving,
- Parenting,
- Supports for Native Americans,
- School and education,
- Suicide prevention,
- Mindfulness,
- Disaster planning and recovery that combine resources (e.g., articles, videos, training programs, screeners).
SUD Helpline
SUD Helpline is an anonymous, confidential, payer- agnostic helpline where community members and their families or friends can call and speak with a licensed behavioral health expert for information on SUD treatment. Members can work with a licensed clinician to plan the next step in their care should they choose to pursue treatment. Avalilable to all members.
Care coordination
If you have a chronic health condition, like asthma or diabetes, you may benefit from our Care Coordinator program.
We can help with a number of things, like scheduling doctor appointments and keeping your providers informed about the care you get. To learn more, call 1-877-236-0826, TTY 711.
Community benefit
What is the Community Benefit?
The Community Benefit (CB) is Turquoise Care’s name for the home and community-based services (HCBS) benefit package.
- The Personal Care Services benefit is also part of CB
- Community Benefits are services that allow eligible members to receive care in their home or community as an alternative to being placed in a long-term care facility
- Community Benefits are intended to supplement natural supports and support community living
Goals of Community Benefits.
- Allow New Mexicans who require long-term care to remain in their homes and in their communities
- Reduce the number of unnecessary nursing home admissions
Community Benefit eligibility.
- All members must have a full Medicaid category or have Waiver category of eligibility
- All members must meet the nursing facility level-of-care criteria
- All members must be a resident of New Mexico
Dental care
Getting a yearly dental check-up is important to your health. Your coverage includes:
- ACC/Flouride Varnishing Treatment (one per lifetime)
- Flouride Treatment (treatment every 6 months).
Early and periodic screening diagnostic and treatment (EPSDT)
What are EPSDT services?
The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit provides comprehensive and preventive health care services for children younger than age 21 who are enrolled in Medicaid. Follow the EPSDT schedule for all eligible UnitedHealthcare Community Plan members up to age 21, including pregnant members. EPSDT screening including the following:
- Immunizations
- Hearing and vision screening
- Medical history
- Measurements of height, weight and BMI
- Unclothed physical examination
- Nutrition screening
- Developmental/Behavioral assessment
- Hematocrit/Hemoglobin at 9 months and 13 years
- Lead screening at 12 months and 24 months
- Standardized developmental screening
- Additional screening necessary according to risk factors
- Anticipatory guidance
These exams may include vaccinations or shots. If your child has not had his or her checkup this year, call the doctor and schedule one. We may send you a reminder letter to get your child checked.
Lead testing — The doctor will need to do a blood test to make sure your child does not have too much lead. Your child should be checked at 12 months and 24 months of age or if they have never been checked.
Dental exam — Your child should have their teeth cleaned and receive fluoride treatments every six months.
Private duty nursing — When your child’s doctor wants a nurse to provide care at home or at school.
Personal care services — When your child’s doctor wants a caregiver to help your child with eating, bathing, dressing and toileting.
EPSDT also provides hearing services, vision services, school-based services and more. If you have questions, please contact your Care Coordinator.
Health problems should be identified and treated as early as possible. If your child needs special services like Private Duty Nursing or Personal Care Services, they will be provided under EPSDT through UnitedHealthcare Community Plan.
Please speak with your doctor about any shots your child may need.
Emissar Youth
Provides a method of digitally delivered peer support between youth peer support specialists and transition aged youth/foster-adoptive members. This platform is designed for youth peer support specialists to provide one (1) hour in-person or virtual weekly meetings and bridge the gap between regular meetings by providing text message peer support via the mobile application.
Available for justice-involved individuals (youth). Requires access to smartphone and access to broadband resource.
Emergency care
Hospital emergency rooms are there to offer emergency treatment for trauma, serious injury and life-threatening symptoms. Some reasons to go to the ER include:
- Serious illness
- Broken bones
- Heart attack
- Poisoning
- Severe cuts or burns
UnitedHealthcare Community Plan covers any emergency care you need throughout the United States and its territories. Within 24 hours after your visit, call Member Services at 1-877-236-0826, TTY 711.
Healthy First Steps
Healthy First Steps® (HFS) is a specialized case management program designed to provide assistance to all pregnant members and those experiencing an uncomplicated pregnancy. It also helps manage medical, behavioral and social risks. The goal is improving birth outcomes and lowering NICU admissions by managing prenatal and postpartum care needs of pregnant members.
To enroll
Members self-enroll on a smartphone or computer at uhchealthyfirststeps. com and click on “Register” or call 1-800-599-5985.
Hospitalization (Hospital care)
This plan pays for all hospital expenses related to a hospital stay, so you can focus on resting and healing.
Our plan covers:
- Inpatient care
- Outpatient care
- Labs, X-rays and other tests
And after you leave the hospital, you are not alone. We are here to help you get any needed follow-up care to continue healing at home.
Language help
If you speak a language other than English, we can provide translated printed materials. Or we can provide an interpreter who can help you understand these materials. You’ll find more information about Interpretive Services and Language Assistance in the section called Other Plan Details. Or call Member Services at 1-877-236-0826, TTY 711.
Si usted habla un idioma que no sea inglés, podemos proporcionar materiales impresos traducidos. O podemos proporcionar un intérprete que puede ayudar a entender estos materiales. Encontrará más información acerca de servicios de interpretación y asistencia lingüística en la sección Otros detalles del plan. O llame a Servicios para Miembros al 1-877-236-0826, TTY 711.
Medicines
Your plan covers prescription drugs for members of all ages. Also covered: insulin, needles and syringes, birth control, coated aspirin for arthritis, iron pills and chewable vitamins.
Out-of-plan benefits
What services are NOT included in the Turquoise Care benefit package?
- Cosmetic services
- In vitro services
- Inpatient facility room and board — leave of absence
- Routine podiatry services
- Services to intermediate care facilities for the intellectual disability
Preferred Drug List
UnitedHealthcare Community Plan covers hundreds of prescription drugs from hundreds of pharmacies. The full list of covered drugs is included in the Preferred Drug List. You can fill your prescription at any in-network pharmacy. All you have to do is show your member ID card.
Click the link below to download the complete list, or download online at myuhc.com/communityplan/nm.
Pregnancy and infant support
At UnitedHealthcare Community Plan, we want you to have a healthy pregnancy and a healthy baby. We want you and your baby to get all the care you both need. That’s why we have a special program for you — and your baby.
Our maternal child health team will help you learn what to expect when you see your doctor and how to take care of your changing body. Here are some of the things we will help you learn about:
- Local resources
- Nutrition, weight, and well-being
- Fitness
- Sexual health
- Substance abuse
- Domestic violence
When you think you are pregnant, call your local Department of Human Services (DHS) office and Member Services at 1-877-236-0826, TTY 711. This will help ensure you get all the services available to you.
Primary care services
You are covered for all visits to your Primary Care Provider (PCP). Your PCP is the main doctor you will see for most of your health care. This includes checkups, treatment for colds and flu, health concerns and health screenings. Well Visits. Annual checkups to help keep you and your family healthy.
Seeing Safety
Seeking Safety is designed to help people who have experienced trauma or substance problems develop and sustain recovery goals. Seeking Safety encourages ones who have suffered trauma to find a safe environment to engage with their peers, respect themselves and develop and use healthy coping techniques to achieve their recovery goals. We are the only managed care entity approved by Seeking Safety’s creator to train and use certified provider-based peers to render this program.
SelfCare digital app
SelfCare is a self-help digital application that uses cognitive behavioral therapy- based tools and techniques to improve overall mental well-being and behavioral health tracking, supporting members before they are in crisis. Self Care is designed to enable resilience by helping members build new skills and daily habits.
Features include selfpaced digital programs available on demand, any time; industry-recognized clinical depression, anxiety and well- being surveys; and evidenceinformed mental health support through trackers, mental health skills and tools collections and communities, all offered in both English and Spanish. With a 97% member satisfaction rating, Self Care provides digital support for members who may not be ready for traditional treatment.
Available to all members.
Specialist services
Your coverage includes services from specialists. Specialists are doctors or nurses who are highly trained to treat certain conditions. You may need a referral from your PCP first.
Urgent care
Urgent care clinics are there for you when you need to see a doctor for a non-life-threatening condition but your PCP isn’t available or it’s after clinic hours. Common health issues ideal for urgent care include:
- Sore throat
- Ear infection
- Minor cuts or burns
- Flu
- Low-grade fever
- Sprains
If you or your children have an urgent problem, call your PCP first. Your doctor can help you get the right kind of care. Your doctor may tell you to go to urgent care or the emergency room.
Vision care
Regular eye exams are important. Members are eligible for routine eye exams and prescription eyeglasses. Call your doctor to schedule a routine eye exam. You can schedule an appointment with any participating vision care provider.
Refractive Eye exam available to all members once every 24 months.
Wellhop
Wellhop is a virtual support group for members who are pregnant. The program includes the following:
- Group video conversations with a trained facilitator and members at the same stage in Pregnancy
- Evidence- based information on pregnancy and postpartum, educational articles, videos, podcasts and more
- Convenient access from mobile devices
Access to online community 24 hours a day, seven days a week.
Wellness programs
UnitedHealthcare Community Plan has many programs and tools to help keep you and your family healthy, including:
- Classes to help you quit smoking. If you are pregnant or under the age of 21, coaching and medications are available to help you quit smoking.
- Pregnancy care and parenting classes
- Nutrition classes
- Well-care reminders
Your provider may suggest one of these programs for you. If you want to know more, or to find a program near you, talk to your PCP or call Member Services at 1-877-236-0826, TTY 711.