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NMSU Retirees –NMSU Preferred Provider Option PPO Plan Non-Medicare Eligible Retirees –NMSU Carveout Plan Medicare Eligible Retirees Two Plans are available:

Nationwide coverage when traveling or living outside of home state Worldwide ® coverage when traveling in more than 195 countries more than 5,300 hospitals nationwide network Nationwide, more than 95% of hospitals and 85% of doctors Over 20,000 contracted providers in New Mexico more than 896,000 providers Preferred Providers

PPO Network Providers…. In-network You receive the highest level of benefits: –Pay less for services received –No balance billing No claim forms –Providers file claims for you Out of Network: You pay more of the cost Higher deductibles, coinsurance You may need to file your own claim You could be balance billed for amounts over allowed amount Always verify provider network status

Call BlueCard Access 24/ BLUE (2583) Call Customer Service NMSU (6678) Log on: bcbsnm.com Click on ‘Find A Doctor” bcbsnm.com How to Find a PPO Provider OR Contact your physician and ask if they belong to the BCBS PPO Network

Benefits Member Share Preferred Provider Non-Preferred Provider Deductible –Individual $ 500 $ 700 –Family $1,500 $ 2,100 Out-of-Pocket Maximum –Individual $2,000 $ 4,000 –Family $5,000 $ 10,000 Primary Provider Office Visit$25 (deductible waived) 40%* Specialist Visit$3540%* Preventive Care / Well VisitsNo ChargeNot Covered Inpatient Admission25%*40%* Emergency Room25%* Urgent Care25%*40%* Pet Scans, CT Scans, MRIs, Lab Tests, X-rays, including EKGs 25%40%* *After deductible

Retail Pharmacy Program 7

Self Service: Blue Access ® for Members Log on to bcbsnm.com and click the “Log In” tab to get started bcbsnm.com

BlueExtras SM Discounts Weight Management – Discounts at Jenny Craig ®´ on membership and food Vision Care and Eyewear – Discounts on eyewear, contact lenses and laser vision correction surgery Nutrition – Discounts on Seattle Sutton’s Healthy Eating ®´ meal plans; national home delivery program Hearing Aids – Discounts on hearing aids for members, parents, and grandparents Just for being BCBSNM Members! Complementary Alternative Medicine – Discounts on acupuncture, health clubs, chiropractic, naturopaths, spas, massage therapy, vitamins and supplements, and more

24/7 Nurseline24/7 Nurseline Our 24/7 Nurseline is here to help Nurses provide health advice and information AudioHealth Library ® includes topics such as kicking the smoking habit Available in English and Spanish 10 Advice anytime – Round-the-clock health and wellness advice from licensed professionals

 Well OnTarget – A New Way to Experience Wellness! Personalized tools and resources to help all members on the path to health and wellness. These will be replacing the current wellness tools. LiveOn Member Wellness Portal OnMyTime Self-directed Courses Health & Wellness Content Tools & Trackers OnMyTeam Wellness Coaching Improved and user friendly Health Assessment Life Points Program will be replacing the Blue Points program Fitness program that offers membership to a national network of leading national, regional and local fitness centers for one low monthly price of $25 and no contract. Premiering January 2013!

The New and Improved National Provider Finder on bcbsnm.com: National View provider profiles Ability to compare 3 providers/facilities side by side Rate a Provider Google map feature Premiering 2 nd Quarter 2013!

NMSU Medicare Carveout Plan – No changes Low or no out-of-pocket costs Freedom to choose your providers No referrals required No claims to file Worldwide Coverage for Emergency Many non-Medicare covered services provided 13

NMSU Medicare Carveout Plan 14 When a Provider Accepts Medicare Assignment:

Medicare Carveout Plan When provider does NOT accept Medicare assignment When services are NOT covered by Medicare, but ARE plan benefits 15 OR Example: Acupuncture is not covered by Medicare. $100 Calendar year deductible 20% Coinsurance $1500 Annual out-of-pocket maximum Prior Authorization from BCBS applies

What if I Have Questions? Claim questions/status Network provider information Membership and eligibility Medical coverage questions Inquiries (telephone and ) Transition of Care information ID card requests Help with online tools NMSU (6678) Toll-free Customer Service Personalized Service Call your customer service team for:

Medicare Blue RX (Medicare Part D Prescription Drug Plan)

Eligibility – Medicare NMSU eligible retiree Entitled to Part A and Enrolled in Part B. Under your NMSU employer sponsored program you must be enrolled in Medicare Part A and Part B in order to be eligible for the Medicare Carveout plan. Not enrolled in any other Medicare Prescription Drug Plan (PDP). If you elect to not be enrolled in NMSU’s Blue MedicareRX Plan, you will not be eligible for NMSU’s Medicare Carveout plan.

Enhanced Plus Blue MedicareRX BenefitEnhanced Plus Plan Individual Deductible$0 Annual Drug Cost up to $2,510$5 Generic $30 Preferred Brand $60 Brand 33% Specialty Annual Drug Costs exceeding $2,930 (up to a total of $4,750 out of pocket costs) $5 Generic $30 Preferred Brand $60 Brand 33% Specialty After your total out-of-pocket costs exceed $4,750 You pay the greater of: $2.65 copay for Generic/NonPreferred Generic and $6.60 copay for all other drugs, or 5% coinsurance, whichever is greater. ** Copayments shown are per 30-day supply at an in-network pharmacy. For more detailed information on this benefit plan, please refer to your Summary of Benefit.

Non-Medicare Retirees – Aging in NMSU will mail you a packet containing the Medicare Part D information at least forty-five days prior to your birthday month. NMSU will automatically enroll you in Blue Medicare Rx and Medicare Carveout program once they have received confirmation of Medicare Part A and Medicare Part B enrollment from you. NMSU sends a letter 2 months prior to the 65 th birthday to obtain this information.

NMSU If your dependent child loses Medicaid eligibility as secondary coverage (Dependent has Medicare as the primary coverage) you may add them to the NMSU medical and Blue MedicareRX within 31 days of the loss of coverage. You must provide proof of loss to NMSU’s Benefits Office Mentally or Physically impaired Dependents

Termination NMSU allows you to terminate your Blue MedicareRX group plan at any time during the year with proof of enrollment in another plan. Remember if you disenroll from NMSU’s Blue MedicareRX or enroll in another Medicare Part D plan you will not be eligible for the NMSU medical plan.

Pharmacy (continued) For a complete list of our retail, network and preferred network pharmacies Mail order option What pharmacy can I use? -Call , 7 days a week, 7 a.m. – 7 p.m., Local time. For the hearing or speech impaired, please call Or visit - You can also save on copayments with our convenient mail-order program administered by Prime Therapeutics^.

Resources Medicare Blue RX Medicare -Call , 7 days a week, 7 a.m. – 7 p.m., CST -For the hearing or speech impaired, please call days a week, 7 a.m. – 7 p.m., CST -Visit -Call MEDICARE ( ) 24 hours a day -TTY/TDD Users: , 24 hours a day -Visit

Resources (continued) Social Security -Call , 7 a.m. – 7 p.m. Monday- Friday -TTY/TDD Users: , 7 a.m. – 7 p.m. Monday-Friday -Visit

Nearly 100 million Americans choose the Blues … including over 400,000 New Mexicans. Administered by: Blue Cross and Blue Shield of New Mexico, a Administered by: Blue Cross and Blue Shield of New Mexico, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association