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Discover New Mexico Health Connections: A Community-Driven Health Plan for Affordable Care

New Mexico Health Connections (NMHC) is the state's only non-profit, consumer-operated health plan. As a Certified Qualified Health Plan, NMHC aims to improve healthcare quality with lower premiums and enhanced benefits. By reinvesting profits into the community, NMHC supports health infrastructure and preventive care. Governed by its members, NMHC focuses on coordinated care, addressing both physical and behavioral health needs. With a wide network of providers and an easy-to-navigate website, NMHC empowers members in their health journey.

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Discover New Mexico Health Connections: A Community-Driven Health Plan for Affordable Care

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  1. Health Care Guides Introducing New Mexico Health Connections New Mexico Health Connections

  2. New Mexico Health Connections • Affordable Care Act (ACA) – Section 1322 • Consumer Operated and Oriented Health Plan (CO-OP) • New Mexico’s only non-profit health plan • February 2013 - Licensed as Certified Qualified Health Plan by NM Office of the Superintendent of Insurance • Required to hold 2.5 times the normal financial reserves needed for health plans • All brought about by Nandini Kuehn, PhD and other concerned New Mexicans

  3. NMHC - What Makes Us Different Non-profit health plan • Mission-driven, not profit-driven • Profits will be reinvested back to New Mexicans to improve quality of health care • Lower Premiums • Improve Benefits • Collaboration with Community Organizations • Investing in the community health infrastructure • Serving as connector between members and community resources

  4. NMHC - What Makes Us Different • Consumer Operated and Oriented Health Plan (CO-OP) • Governed with consumer control • By 2016, majority of our Board of Directors will be NMHC members • Members will help drive health plan direction and decisions

  5. NMHC - What Makes Us Different • NMHC is committed to a model of coordinated care • Focused on keeping members and their families healthy • Closely partnering with Clinicians, Community Health Workers and Promotoras • Incentivizing prevention, health, and wellness

  6. Philosophy of Benefit Plans • Less is more • Fewer plans = Less confusion • Our benefit plans on the Exchange are the same as those off the Exchange • Choice to use co-pay model • The cost the member pays is defined and clear • Encourages use of preventive care and wellness services

  7. Generic Medications • $0 Co-pay for these Chronic Conditions: • Hypertension • Depression • Bipolar Disorder • Diabetes • Hypercholesterolemia • Chronic Obstructive Pulmonary Disease • Coronary Artery Disease • Congestive Heart Failure • Asthma

  8. Behavioral Health Services • Behavioral Health Services are a key focus for NMHC • Addressing Behavioral Health issues leads to better overall health • Behavioral Health Provider network • $0 co-pay for the first 3 outpatient visits • $0co-pay for most generic Behavioral Health medicines

  9. NMHC State-Wide Provider Network • Nearly 5,500 practitioners, hospitals, and facilities • Primary Care and Specialty • Close partnerships with FQHCs • Centers of Excellence • Out of State Network • Community Health Worker program • Please refer to website for a more detailed list of providers

  10. NMHC Website: Easy to Navigate

  11. NMHC Website: Getting Started

  12. NMHC Website: Quote and Compare

  13. NMHC Website: Quote Comparison

  14. NMHC Website: Provider Network

  15. NMHC Website: Rx Formulary

  16. Questions to help guide your clients • How often do you /your family go to the doctor • How many times did you visit the emergency room last year • What prescription medications are taken on a regular basis • Who are your doctors • Do you have any chronic conditions • Are you eligible for subsidies

  17. Things to Consider • How much did you spend last year • The least expensive plan is not always the most cost effective • Consider deductibles, co-pays and coinsurance as well as the monthly premium Example: The story of Mr. Sanchez and his health plan selection journey

  18. Mr. Sanchez & His Health Plan Selection

  19. NMHC Summary • NMHC adds value to the insurance market • Member Driven • Community Focused • Co-pays clarify member costs • Easy to use website • Profits reinvested in New Mexico • Built by New Mexicans, for New Mexicans

  20. New Mexico Health Connections www.mynmhc.org info@mynmhc.org 1-855-7MY-NMHC 2440 Louisiana Blvd., NE, Suite 601 Albuquerque, NM 87110

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