Hmm … it looks like your browser is out of date.
Let’s update your browser so you can enjoy a faster, more secure site experience.
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.
This plan is available in the following counties:
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)
Find Providers and Coverage for this Plan.
Find doctors, hospitals, behavioral health, and other specialists.
Find medications covered by this plan.
Search for behavioral health providers and resources.
Find a pharmacy near you.
Find a dentist near you.
Find a vision center.
Benefits & Features
Home Health
Coverage is available to home health agencies for medically necessary skilled nursing services provided by a qualified nurse, as well as home health aide services. See the member handbook for details.
Medical Equipment and Supplies
Coverage is available for medical supplies, equipment, and devices that can be used in the home. A Care Coordinator can help arrange for needed equipment and supplies.
Nursing Home Care
Nursing home care is available. Members and those who support them can talk to a Care Coordinator to understand all available options. We will work to set goals that match up with the member’s desired outcome. All members must be screened and approved for nursing home care. This can be approved for a short-term or a long-term stay.
Pharmacy
Prescribed medications are covered. 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). The same list of approved medications is used. This is called the Preferred Drug List, or PDL.
Behavioral Health
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. We cover:
Behavioral Health Services
- Individual, group, and family therapy
- Outpatient behavioral health services
- Inpatient behavioral health services
- Specialized behavioral health services for children with autism
Substance Use Disorder Services
- Outpatient opioid (pain medication) treatment
- Residential treatment
- Targeted case management
Additional health resources can be found at myuhc.com/CommunityPlan. Find the balance, support, and care you need to live the healthiest life possible.
If you believe you need access to behavioral health services, talk with your PMP or call Member Services for help.
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
Language help
If you speak a language other than English, 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.
Chiropractic Care
Chiropractic care is covered with some limits. See the member handbook for details.
Dental care
Getting a yearly dental check-up is important to your health. Your coverage includes:
- Two exams and cleanings per year
- Bitewing X-ray once every 12 months and one complete set of X-rays every three years
- Minor restorations such as filling
- Major restorations such as crowns and root canals (one of each per 12 months)
- Deep cleanings and surgical treatment for gum disease
- Partial or full dentures, and repairs to partials or full dentures
- Sedation and nitrous oxide (known as laughing gas) if medically necessary
Emergency care
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.
Foot Care (podiatry)
Up to 6 routine foot care visits are covered each year. Some services need prior approval. Please see the member handbook for details.
Housing Stability
We want members and their families to enjoy safe and affordable housing. We can help with a plan to improve a current home or plan a move to a different home. A Care Coordinator will work to collect goals and share options that address the needs of our members.
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.
Medical Equipment and Supplies
Coverage is available for medical supplies, equipment, and devices that can be used in the home. A Care Coordinator can help arrange for needed equipment and supplies.
Substance Abuse Treatment
Members can get residential treatment if they are getting help due to alcohol or drug use. This includes overnight stays in a facility. The member’s Care Coordinator can help answer questions or explain any limits or prior approval needed.