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I
t can be difficult to know what to do
when you feel ill or have an injury.
Urgent care centers provide fast medical
help for situations that are not life-
threatening.
When it’s urgent
Urgent care centers are places where you can
walk in without an appointment and be seen
by a medical professional without having to
wait very long. Urgent care offers a convenient
alternative when your doctor’s office is closed
or when you can’t get an appointment as
quickly as you need one.
According to the National Institutes of
Health and other experts, urgent care is
Source: Centers for Disease Control and Prevention
Flu viruses
CHANGE
from year to year. To stay
protected, you need a flu vaccine
EVERY YEAR
.
BUST THAT MYTH!
The flu shot can’t give you the flu.
It has no infectious germs.
*
*Mild side effects from the shot may occur, but serious
reactions are very rare.
Take your best
shot at staying well
Flu shots are a
covered
benefit on your plan
.
Call your doctor or visit your
local in-network pharmacy.
!
FLU SEASON ALERT
Influenza can be
MISERABLE & DEADLY
. Nearly
EVERYONE
6 months or older should get a yearly flu vaccine.
Vaccinate!
Don’t wait.
Don’t hesitate.
It takes
2 WEEKS
for the flu vaccine
to be fully effective.
Safe,
convenient
flu shots
Did you know that many NMHC-
contracted pharmacies throughout
New Mexico can prescribe
and give the flu vaccine to our
members? Pharmacists who are
prescribing and giving flu shots
must receive additional training
and become certified immunizers.
You may find it handy to get
your vaccine when picking up
your routine prescription refills.
Ask your pharmacist about
this option and if there are any
restrictions.
vomiting or diarrhea, severe pain, and uncon-
trolled bleeding.
Neither urgent nor emergency care should
be used in place of a primary care doctor.
Not sure your need is urgent or an emer-
gency? If you are an NMHC member, you
can call our 24-hour nurse advice line at
877-725-2552
. A registered nurse can help
you decide when you should seek urgent care
or emergent care, answer general questions,
and offer resources.
When you seek care from a provider in the
NMHC network, you’ll save money on out-
of-pocket costs. Find an urgent care center
on our website,
www.mynmhc.org/find_a_
doctor.aspx.
appropriate for minor illnesses and injuries, like:
•
Cuts and lacerations.
•
Sprains and strains.
•
Colds, fevers and the flu.
•
Earaches.
•
Rashes.
•
Stomachaches, vomiting and diarrhea.
•
Back pain.
When it’s an emergency
Urgent care is not emergency care—it shouldn’t
be used for life-threatening problems.
If you think you or someone else has a true
emergency, call 911 or go to an emergency
department. Signs of an emergency include
difficulty breathing, chest pain, fainting, severe
Is it urgent—or an emergency?
Specialty drugs
and your cost-share
responsibility
What are specialty
pharmacy drugs?
In general, specialty pharmacy drugs are
relatively high-cost medications used to treat
complex medical conditions. They often require
special handling or monitoring. Specialty drugs
cost more, in part because they need extensive
research, development and testing before they
can be used on humans.
Specialty drugs may treat conditions for
which there are limited treatment options and
may even be considered clinical breakthroughs.
For example, newer drugs may provide clinical
“cures” or greatly slow down the progression of
disease.
If I receive a specialty
drug from my doctor, will
I have to pay more?
Specialty pharmacy has its own cost-share
amount (copayment or coinsurance) that is
separate from your office visit cost-share
amount. You can find the specialty pharmacy
copayment for your health plan on our website:
www.mynmhc.org/shop-plans-on-exchange
.aspx
. Click on the link for your plan, and a
Summary of Benefits and Coverage will appear
in a new window.
If you see your doctor and receive a specialty
pharmacy drug during your visit, you will be
charged your office visit cost-share amount,
plus
the specialty pharmacy cost-share amount.
Find out if your prescription falls under the
specialty pharmacy benefit by reviewing our
formulary (list of covered drugs). Find it online
at
www.mynmhc.org/Formulary.aspx.
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