UNM Team Health Network (Tier 1)
You pay lower co-pays and coinsurance amounts when you access the UNM Team Health Network.
- UNM Health System providers and facilities including UNM Hospital and Sandoval Regional Medical Center and associated clinics, and UNM Medical Group clinics
- DaVita
- First Choice Community Health Providers and Facilities
- Presbyterian Medical Services (PMS)
- After Hours Pediatrics
- Langford Physical Therapy
Extended Network (Tier 2)
Our extended network is provided by BCBSNM. Access to the Extended Network within New Mexico:
- Requires a Benefit Determination from UNM Team Health for non-urgent/non-emergent care prior to receiving care.
- Failure to obtain Benefit Determination before accessing Extended Network providers and facilities will result in services being covered at the Out-of-Network level of benefit.
- Please call UNM Team Health Customer Care at 505 925-2432 or toll free at (844) 866-2224 to request a Benefit Determination.
Out-of-Network (Tier 3)
Services are considered out-of-network if providers and facilities are not contracted with UNM Team Health and a Benefit Determination for the Extended-Tier 2 network is not obtained.
Only usual and customary charges are covered, and some preventive services are not covered for Out-of-Network providers.
Please refer to your Schedule of Benefits or contact UNM Team Health Customer Care.
Out-of-State
Emergency room and urgent care visits for all members, and regular appointments for dependents who live out of state, are covered at the Tier 2 benefit level when you use UNM Team Health's BCBS extended network.
Notify UNM Team Health Customer Care of dependents living out of state.
