New Mexico Health Connections | my connection | Summer 2016

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{ SUMMER 2016 | FOR MEMBERS OF NEW MEXICO HEALTH CONNECTIONS }
A copayment (or
copay) is a fixed
amount of money you
pay for a healthcare
service that is covered by your plan.
For example, if you visit your pri-
mary care provider, you will pay a
primary care copay. Different types
of services usually have different
copays. Many prescription drugs
have copays as well. You usually
have to pay your copay up front. A
copay does not apply to preventive
care visits, such as an annual exam.
An annual deductible is the
amount that you pay for covered
healthcare services before your
insurance begins to pay. After
you pay all of your deductible,
you usually will pay only a copay
or coinsurance amount for ser-
vices covered by your plan. You do
not have to pay a deductible for
preventive care visits or for services
for which a copay is listed in your
summary of benefits and coverage.
Coinsurance is a percentage
of the cost of a covered healthcare
service that you usually pay after
you have paid your deductible. For
example, if you have a preferred
provider organization plan with a
$500 deductible and a 30 percent
coinsurance, you will have to pay
all $500 of your deductible before
your insurance starts to pay. After
that point, you will be respon-
sible for 30 percent of the allowed
amount on covered healthcare
services.
COPAYMENT, DEDUCTIBLE, COINSURANCE
Health insurance terms
you should know
So what does this mean for you?
Learn the details of your health plan so you will be prepared to pay out-of-pocket costs. To find the summary of
benefits and coverage for your plan, visit . Click on the link for your plan.
You also can call Customer Service toll-free at 877-775-0287.
NURSEADVICESM NEW MEXICO
Health guidance at
your fingertips
If you have questions about a health prob-
lem and need expert guidance, you can
call NurseAdvice New Mexico (NANM)
around the clock, 365 days a year.
NANM’s staff of experienced registered nurses
can answer your health-related questions. In
addition, you can email your health questions
to NANM if they are not urgent.
When should I call NANM?
If you or a family member is having symptoms
or feeling sick, call NANM at 877-725-2552.
You can speak to a nurse who will assess your
symptoms and offer you appropriate care
advice. This type of personalized service is best
accomplished by speaking with a person “live.”
When should I email NANM?
If you are not sick or injured and are seeking
general health information, then you can send a
nurse your question via the NANM website.
1. Go to and select “Ask
for Health Information.”
2. Click the “Submit Your Question” button.
You will be taken to a secure web page.
3. Complete the online form and click “Submit”
at the bottom of the page.
4. A registered nurse will respond to your health
question via email within 24 hours.
What kinds of information may
I send online?
• Questions about a lab test your doctor ordered
or a medication you are taking.
• Questions about a particular health problem
or diagnosis.
• Questions about a certain diet—for example,
to help treat diabetes.
• Questions about when your sick child should
return to school.