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New Mexico Long-Term Services and Supports (LTSS)
Medicaid
Our New Mexico Long Term Services and Supports (LTSS) is a health coverage program for New Mexico residents who meet requirements and who are eligible for Medicaid. LTSS is designed to improve quality of life for members of any age who have functional limitations and/or chronic illnesses. LTSS helps support the member to live or work in the setting of their choice, which may include the person's home, a worksite, provider-owned or controlled residential setting, a nursing facility, or other institutional setting. LTSS provides in-home counseling sessions that focus on solving problems and becoming socially and physically active.
Qhov phiaj xwm kho mob no yog muaj muab kev pab nyob rau hauv cov nroog nram qab no:
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 Long-Term Services and Supports (LTSS)
Nrhiav Cov Kws Kho Mob thiab Kev Pab Them Nqi Duav Roos rau qhov Phiaj Xwm Kho Mob no.
Nrhiav cov kws kho mob, cov tsev kho mob, kho kev coj tus cwj pwm, thiab lwm cov kws kho mob txawj tshaj lij.
Nrhiav cov tshuaj uas raug pab them los ntawm qhov phiaj xwm kho mob no.
Nrhiav cov kws kho mob rau fab kev coj tus cwj pwm nyuaj siab mob hlwb thiab cov chaw muaj kev pab.
Nrhiav lub khw muag tshuaj nyob ze koj.
Nrhiav ib tus kws khoo hniav uas nyob ze koj.
Nrhiav ib lub chaw kho qhov muag.
Cov Kev Pab thiab Cov Yam Ntxwv
Kev Noj Qab Haus Huv Hauv Tsev (Home Health)
Muaj kev pab them nqi rau cov koom haum kho mob hauv tsev rau cov kev pab kho rau tus mob uas yuav tsum tau kho uas yog muab los ntawm ib tus kws tu neeg mob uas paub zoo txoj hauj lwm, thiab tus pab tus mob hauv tsev. Mus saib phau ntawv qhia tswv cuab kom paub meej.
Cuab Yeej thiab Cov Khoom Siv Kho Mob
Muaj qhov pab them tus nqi rau cov khoom siv kho mob, cov cuab yeej, thiab cov twj uas muab siv tau hauv tsev. Ib tus Neeg Khiav Hauj Lwm Saib Xyuas Kev Pab Tu yuav pab npaj cov cuab yeej thiab cov khoom siv uas yuav tau muaj.
Kev Saib Xyuas Pab Tu Hauv Tsev
Muaj kev saib xyuas pab tu hauv tsev. Cov tswv cuab thiab cov neeg uas pab lawv yuav tham tau nrog ib tus Neeg Khiav Hauj Lwm Saib Xyuas Kev Pab Tu kom paub txhua qhov kev xaiv ua muaj nyob ntawd. Peb yuav ua hauj lwm los teeb tsa cov hom phiaj kom mus raws li tus tswv cuab qhov kev xav tau. Txhua tus tswv cuab yuav tsum tau ua ib qho kev ntsuam xyuas thiab pom zoo rau qhov kev saib xyuas pab tu hauv tsev laus. Qhov no tuaj yeem pom zoo rau mus nyob hauv tsev laus rau lub sij hawm luv luv los sis nyob mus sij hawm ntev.
Tsev muag tshuaj
Cov tshuaj uas kws kho mob sau ntawv yuav los kuj them rau. All health plans follow the same rules about the medications that are covered as part of the New Mexico Long Term Services and Supports (LTSS). Nws siv tib daim ntawv teev cov npe tshuaj uas tau tso cai. Qhov no yog hu ua Daim Ntawv Teev Npe Tshuaj Uas Nyiam (Preferred Drug List) los sis PDL.
Kev Noj Qab Haus Huv Ntawm Tus Cwj Pwm
If you are currently receiving behavioral health services, please let your UnitedHealthcare Community Plan Care Coordinator know. It is important for them to be aware of all the services you are receiving or need.
Also, please let your behavioral health provider know that you are enrolled in UnitedHealthcare Community Plan’s LTSS program. They may have questions about the services you are receiving through LTSS and how we can work together to help you get the care you need.
Behavioral Health screenings are performed as medically necessary for diagnosis and treatment. Peb them rau:
Cov Kev Pab Cuam Fab Kev Noj Qab Haus Huv Ntawm Kev Coj Tus Cwj Pwm
- Kev kho ib tus neeg kheej, pab pawg, thiab tsev neeg
- Cov kev pab rau fab kev noj qab haus huv ntawm kev coj tus cwj pwm rau tus neeg mob uas tsis pw kho mob
- Cov kev pab rau fab kev noj qab haus huv ntawm kev coj tus cwj pwm rau tus neeg mob uas pw kho mob
- Cov kev pab cuam kev fab kev noj qab haus huv ntawm kev coj tus cwj pwm tshwj xeeb rau cov me nyuam yaus uas hlwb tsis zoo los yog hlwb tsis puv
Cov Kev Pab Fab Kev Siv Tshuaj Tsis Haum
- Kev kho quav tshuaj opioid (tshuaj daws mob)
- Kev kho mob nyob hauv vaj tsev
- Kev tswj xyuas tus neeg mob uas nyob hauv hom phiaj
Additional health resources can be found at myuhc.com/CommunityPlan. Nrhiav tus pab nyiaj, pab txhawb nqa, thiab kev saib xyuas uas koj xav tau kom ua lub neej zoo tshaj plaws.
Yog koj ntseeg tias koj xav tau cov kev pab rau tus mob ntawm kev coj tus cwj pwm, tham nrog koj tus PMP los sis hu rau Lub Chaw Muab Kev Pab Tswv Cuab kom lawv pab.
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
Kev pab txhais lus
If you speak a language other than Lus Askiv, 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.
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.
Kev Kho Mob Tus Txha Nqaj Qaum
Peb them rau qhov kev kho mob rau tus txha nqaj qaum tab sis muaj qee cov kev txwv. Mus saib phau ntawv qhia tswv cuab kom paub meej.
Kev kho hniav
Kev mus kuaj hniav txhua xyoo yog ib qho tseem ceeb rau koj kev noj qab haus huv. Qhov kev pab them nqi rau koj muaj xws li:
- Kuaj thiab ntxuav tu hniav ob zaug tauj xyoos
- Xoos fais fab X-ray ib zaug txhua txhua 12 hlis thiab ib zaug xoos fais fab X-rays ib zaug txhua nrho txhua txhua peb xyoos
- Cov kev kho me xws li ntsaws hniav
- Cov kev kho loj xws li looj hniav thiab kho cag hniav (ib zaug ib qho tauj 12 hlis)
- Cov kev ntxuav tu tob heev thiab phais rau tus mob pos hniav
- Hniav cuav ib lo hniav tas nrho los yog ib sab, thiab kev kho rau ib sab los yog ib lo hniav tas nrho
- Tso tshuaj loog thiab tshuaj nitrous oxide (raws li paub yog laughing gas) yog yuav tau ua
Kev saib xyuas kho mob thaum xwm txheej ceev
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.
Kev Kho Txhais Ko Taw (podiatry)
Peb them rau cov kev mus kho ko taw ntau txog 6 zaus txhua xyoo. Muaj ib cov kev pab cuam yuav tau thov ntawv tso cai ua ntej. Thov mus saib tswv cuab phau ntawv kom paub meej.
Vaj Tse Nyob Ruaj Khov
Peb xav kom cov tswv cuab thiab lawv tsev neeg tau lub vaj tse nyob uas muaj kev kaj huv thiab them taus tus nqi. Peb tuaj yeem pab tau ib txoj kev npaj los ua kom lub tsev nyob tam sim no zoo dua qub los yog npaj rhais mus rau ib lub tsev txawv. Ib Tus Neeg Khiav Hauj Lwm Saib Xyuas Kev Pab Tu yuav ua hauj lwm los mus muab kom tau cov hom phiaj thiab qhia cov kev xaiv uas yuav kho tau cov kev xav tau ntawm peb cov tswv cuab.
Large provider network
You can choose any PCP from our large network of providers. Our network also includes specialists, hospitals and pharmacies — giving you many options for your health care. Find a complete list of network providers at myuhc.com/communityplan/nm.
Cuab Yeej thiab Cov Khoom Siv Kho Mob
Muaj qhov pab them tus nqi rau cov khoom siv kho mob, cov cuab yeej, thiab cov twj uas muab siv tau hauv tsev. Ib tus Neeg Khiav Hauj Lwm Saib Xyuas Kev Pab Tu yuav pab npaj cov cuab yeej thiab cov khoom siv uas yuav tau muaj.
Kev Kho Kev Siv Dej Cawv Yeeb Tshuaj
Cov tswv cuab yuav tau txais kev kho rau kev quav dej cawv los sis yeeb tshuaj yog tias lawv tau txais kev pab rau qhov no. Qhov no suav nrog cov kev mus pw kho hauv ib qhov chaw tu mob. Tus tswv cuab tus Neeg Khiav Hauj Lwm Saib Xyuas Kev Pab Tu yuav teb tau cov lus nug los sis piav seb puas muaj cov kev txwv los yog puas yuav tsum tau kev tso cai ua ntej.