Hla mus rau cov ntsiab lus xub thawj
Cov Ntsiab Lus Xub Thawj

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.

  • New Mexico Long-Term Services and Supports (LTSS) Steps to Enroll
  • Check Eligibility (opens modal window)

Cov Kev Pab thiab Cov Yam Ntxwv

Hearing & Vision care

Kev taug xyuas

Hearing Aid is limited to one aid per four-year period. Binaural aids are covered under specific circumstances. 

Hearing aid batteries, insurance and ear molds are also covered. 

If you are experiencing hearing loss or hearing aid difficulties, please contact Member Services at 1-877-236-0826, TTY 711. Certain services are available if you do have a hearing impairment and need a special telephone. Contact your Care Coordinator who will help you get special equipment if you need it.

Kho Qhov Muag Pom Kev

Cov kev mus tshuaj xyuas qhov muag tsis tu ncua yog ib qho tseem ceeb. Cov tswv cuab muaj feem tau txais cov kev kuaj qhov muag li ib txwm thiab cov tsom iav qhov muag raws li kws kho mob sau ntawv yuav. Hu rau koj tus kws kho mob teem sij hawm mus kuaj qhov muag li ib txwm. Koj tuaj yeem teem tau sij hawm mus ntsib ib tus kws kho qhov muag uas koom nrog peb. 

Cov kev kuaj qhov muag nram qab no yog them rau rau cov tswv cuab uas hnub nyoog qis dua 21 xyoo: 

  • Kuaj qhov muag li ib txwm kuaj ib zaug tauj ib xyoos — tsis tas muaj ntawv xa mus 
  • Ib daim tsom iav qhov muag uas kws kho mob sau ntawv txhua kaum ob lub hlis 

Cov kev kuaj qhov muag nram qab no yog them rau rau cov tswv cuab uas hnub nyoog 21 xyoo thiab siab dua: 

  • Kev kuaj qhov muag li ib txwm kuaj ib zaug txhua txhua ob lub xyoos — tsis tas muaj ntawv xa mus 
  • Ib daim tsom iav qhov muag uas kws kho mob sau ntawv yuav txhua txhua 5 lub xyoos 

Yog tias koj xav caij tsheb, koj cov kev pab suav nrog kev muab tsheb thauj mus los. Peb pab them cov kev taug kev mus rau:

  • Cov sij hawm teem mus ntsib kws kho mob
  • Chaw rau khoom noj
  • Tsev muag tshuaj
  • Cov kev teem caij kev muaj cai tsim nyog tau txais Medicaid

Kev ua raws li cov cai yoj yim nod yuav pab rau koj tau caij tsheb: 

  • Call 3+ business days ahead of time 
  • Call 1-877-236-0826, TTY 711 to set up your ride 
  • Yog tias koj thim koj qhov kev mus ntsib kws kho mob, hu rau 1-877-236-0826 kom thim koj qhov kev teem caij tsheb 
  • Npaj kom muaj koj daim npav ID ua tswv cuab 
  • Kev caij tsheb tsuas yog rau cov laj thawj uas tau txais kev pom zoo nkaus xwb 
  • Paub txog qhov chaw nyob ntawm koj tus kws kho mob thiab hnub tim thiab lub sij hawm teem caij mus ntsib 
  • Qhia meej txog qhov chaw uas koj xav caij tsheb mus rau 
  • Tom qab koj mus ntsib kws kho mob, hu xov tooj txhawm rau caij tsheb rov qab mus tsev 
  • Yog tias koj tus kws kho mob muab ib daim ntawv sau yuav tshuaj rau koj, koj tuaj yeem nres ntawm lub tsev muag tshuaj txhawm rau yuav tshuaj tso mam mus tsev 
  • Qhia rau peb paub yog hais tias koj muaj cov kev xav tau tshwj xeeb xws li ib lub laub zaum muaj log 
  • Kev muab tsheb thauj mus los tej zaum yuav raug txwv rau ib tus kws kho mob uas nyob ze koj

Tej zaum koj kuj tseem tsim nyog tau txais daim npav them nqi caij tsheb npav los sis cov phooj ywg thiab tsev neeg cov nyiaj them rov qab. Hu xov tooj rau Lub Chaw Pab Cuam Tswv Cuab txhawm rau teem lub sij hawm caij tsheb los sis nug cov nqe lus nug txog cov kev pab muab tsheb thauj mus los.

Qhov kev pab cuam no yog rau cov kev caij tsheb uas tau npaj tseg ua ntej. Yog tias koj muaj xwm txheej ceev uas yuav txo txoj sia, ces hu rau 911. Lub tsheb thauj neeg mob yuav tau muab yog tias koj xav kom xa mus rau tom tsev kho mob.

Reimbursement to member or healer for Traditional Healing services performed are covered. Benefits include:

$300 per year for Traditional healing services. This benefit includes but is not limited to:

  • Native American Healing and Ceremonies
  • Curandismo Healing

Your provider will need to submit a form to get a reimbursement. Forms can be requested by calling Member Services at 1-877-236-0826. For hearing impaired: TTY 711.

Home-delivered, medically tailored, culturally appropriate meals to promote better health and support health care. Meals can be tailored for members with regular and specialty dietary needs, and can support puréed, gluten free and vegetarian. This program promotes healthy nutrition and addresses food insecurity or malnutrition. Focus supporting members through transitions of care, including:

  • Post-delivery, for member and up to four household members
  • Post-release meals for justice- involved members
  • Skilled nursing facility (SNF) transition, focused on LTSS members

Muaj kev pab tu mus sij hawm ntev. 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 qhov kev tshuaj ntsuam thiab raug pom zoo rau qhov kev pab tu mus sij hawm ntev.

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.

New Mexico Preferred Drug List

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.

Cov Ntaub Ntawv Qhia Txog Tswv Cuab

Cov Chaw Muaj Kev Pab Rau Cov Tswv Cuab (opens modal window)
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