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Health Insurance Counseling and Advocacy

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Programs that offer information and guidance for people who need assistance in selecting appropriate health insurance coverage. May also answer questions about health insurance benefits and help people complete insurance forms. (AIRS LH-3500) Organizations that dedicated to protecting and improving the quality and affordability of health and long-term care for all individuals and advocating for changes in the health care system that will achieve these goals; or which advocate more broadly for legislation and other measures. (AIRS TD-1600.2570)

Service Legend
Local Service
Statewide Service: Provides online resources, telehealth, or service at a satellite office.
Nationwide Service: Provides online resources, telehealth or services at a regional/national headquarters location.
Western Sky Community Care View on Map
Statewide Provider
5300 Homestead Rd NE
Albuquerque, NM 87110
Statewide Provider
Address:
5300 Homestead Rd NE
Albuquerque, NM 87110
Toll Free Phone: 844-543-8996
Service Categories:
Health Insurance Counseling and Advocacy
Medicaid
URL: https://www.westernskycommunitycare.com/
Services Provided:

Established to deliver quality healthcare in the state of New Mexico through local, regional and community-based resources, Western Sky Community Care is a Managed Care Organization and subsidiary of Centene Corporation (Centene). Western Sky sets up and administers Medicaid, Medicare, and Marketplace healthcare plans for consumers in partnership with the New Mexico Human Services Department. Western Sky provides coordinated healthcare, long term services and supports, pharmacy, vision and transportation services.
Source: University of New Mexico, Center for Development and Disability
Last Updated: 10/3/2022
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Presbyterian Centennial Care View on Map
Statewide Provider
9521 San Mateo Blvd, NE
Albuquerque, NM 87113
Statewide Provider
Address:
9521 San Mateo Blvd, NE
Albuquerque, NM 87113
Toll Free Phone: 888-977-2333
Service Categories:
Health Insurance Counseling and Advocacy
Medical Care Expense Assistance
Email: info@phs.org
URL: https://www.phs.org/health-plans/centennial-care-medicaid/Pages/default.aspx
Services Provided:

Presbyterian Centennial Care provides basic benefits, plus extra value-added benefits. It is funded in part under a contract with the State of New Mexico. The plan includes physical health, behavioral health, and long-term care services. Benefits can include Medisafe Medication Reminder, Traditional Medicine Value Added Service, baby benefit new mother program, and more.
Source: University of New Mexico, Center for Development and Disability
Last Updated: 9/27/2022
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Aging and Disability Resource Center View on Map
Statewide Provider
2550 Cerrillos Road
Santa Fe, NM 87505
Statewide Provider
Address:
2550 Cerrillos Road
Santa Fe, NM 87505
Toll Free Phone: 800-432-2080
Service Categories:
Health Insurance Counseling and Advocacy
Information & Referral Resources
Medicaid Waiver Programs
Prescription Drug Patient Assistance Programs
URL: http://www.nmaging.state.nm.us/adrc.aspx
Services Provided:

The ADRC is here to assist elders, persons with disabilities and caregivers to find services and resources to help them live well and independently. Programs include Information & Assistance (I&A), Long-Term Options Counseling, Benefits Counseling, Healthcare Options, and Centennial Care Medicaid Waiver for Home & Community-Based Services (Our ADRC handles registry for the state Medicaid waiver). ADRC also provides Health Care Fraud Prevention, Prescription Drug Assistance (PDA), Community Information & Educational Presentation and New Mexico Social Services Resource Directory.
Source: University of New Mexico, Center for Development and Disability
Last Updated: 8/25/2022
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Ombudsman Specialist Blue Cross Blue Shield Centennial, BlueCross Blue Shield of New Mexico View on Map
Statewide Provider
225 North Michigan Avenue
Chicago, IL 60601
Statewide Provider
Organization Name: BlueCross Blue Shield of New Mexico
(Show others in Organization)
Address:
225 North Michigan Avenue
Chicago, IL 60601
Toll Free Phone: 888-243-1134
Service Categories:
Health Insurance Counseling and Advocacy
Email: nmcentennialcareombudsman@bcbs.com
URL: https://www.bcbsnm.com/pdf/benefits/cc-omsbudsman-nm.pdf
Services Provided:

The Ombudsman Specialist advocates for your rights by using Medicaid guidelines and BCBSNM resources to help you with the following:

Reviewing and addressing your concerns regarding services
Addressing your concerns about benefits you feel should be covered but were denied
Helping you understand or clarifying your rights and responsibilities
Helping understand covered services that are available to you
Helping you reach appropriate BCBSNM personnel
Helping you understand the pros and cons of your possible options
Helping you understand BCBSNM policies and procedures
Helping research claims issues
Helping you with the appeals and grievance process
Source: University of New Mexico, Center for Development and Disability
Last Updated: 9/27/2022
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Health Insurance Marketplace, Centers for Medicare and Medicaid Services View on Map
Nationwide Provider
465 Industrial Boulevard
London, KY 40750-0001
 Phone: 800-318-2596
Nationwide Provider
Organization Name: Centers for Medicare and Medicaid Services
(Show others in Organization)
Address:
465 Industrial Boulevard
London, KY 40750-0001
Phone: 800-318-2596
TDD: 855-889-4325
Toll Free Phone: 800-318-2596
Service Categories:
Health Insurance Counseling and Advocacy
Specialized Information Resources
URL: https://www.healthcare.gov/
Eligibility:

Anyone looking for health insurance under the Affordable Care Act (ACA). Specifically for those who currently don't have health coverage or looking to change plans.
Services Provided: The Marketplace is a new way to find health coverage that fits the individual's budget and needs. With one application, the individual can see all options and enroll. Open enrollment runs from November to December; please see the website for specific dates.COVID-19 UPDATE: Check with health insurance company for specific benefits and coverage for COVID-19. Login to update marketplace application if COVID-19 impacts income or household. May be able to change plan if certain situations apply.

  • General Health Insurance Information/Counseling
Source: Nationwide Suggest Providers Queue
Last Updated: 4/7/2022
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