The Online Provider Directory Our Provider Directory lists the contracted providers, pharmacies and other health care providers in this area who are part of the Lovelace network. Members can use this directory to select a Primary Care Provider (PCP) for themselves and each covered member of their family. It can also be used to locate participate participating specialists, hospitals and other health care providers. Visit the Provider Directory here

	Member Rights As a Medicare beneficiary and as a member of a Lovelace, you have certain rights to help protect you. Along with your rights you also have certain responsibilities as a member of a Lovelace. This document (PDF format) provides you information on your rights and responsibilities: Member Rights and Responsibilities

	Appeals and Grievances You have the right to make a complaint if you have concerns or problems related to your coverage or care.  “Appeals” and “Grievances” are two different types of complaints you can make... read more

	Quality Matters At Lovelace, improving quality is a constant effort. Those efforts include keeping you informed about our progress and our shortcomings. This page provides extensive information on every aspect of quality management at Lovelace.

	New Online Member Options Our NEW interactive Web site is a valuable source of information. As a member enrolled with a Lovelace, including LSP or Premier Choice, you can verify eligibility, check status of claims, send secure message to Lovelace Customer Center or search for a participating provider and much more. Log in now!

The Lovelace Senior Plan (LSP) 2008

The Lovelace Senior Plan is a Medicare Advantage HMO plan that gives you complete healthcare coverage in place of your Medicare coverage. You pay no deductibles and only low copayments for medical services and prescription drugs. LSP offers two plans with different levels of prescription drug coverage. In addition you’ll receive worldwide emergency and urgent care benefits.

For 2008, LSP also offers a medical-only plan for individuals who may have other pharmacy coverage, such as VA or TriCare.

Under the Lovelace Senior Plan, you become a member of our award-winning HMO. As of August 2006, Lovelace Senior Plan retained its “Excellent” status by the National Committee for Quality Assurance (NCQA).

LSP is offered into service areas including the following New Mexico counties: Bernalillo, Sandoval, Valencia, Torrance and Santa Fe.

Find out more about eligibility

Low Income Subsidy (LIS):

LIS for Bernalillo, Sandoval, Torrance, Valencia or Santa Fe Counties

Summary of Benefits:

What you get
You enjoy increased benefits with virtually no claim forms or paperwork, and no unexpected out-of-pocket costs. You just present your Lovelace Senior Plan Member Identification Card (not your Medicare card) and make your copayment.
No more worry about Medicare deductibles and coinsurance. (See your Summary of Benefits for more information.)

Plan Options
Both our Standard and Enhanced Plans offer prescription coverage equal to or better than the Medicare Part D Prescription Drug benefit.  Plus enrollment on LSP includes your Medicare Part D premium. Our medical-only $0 premium plan does not offer prescription coverage.

Worldwide Emergency Coverage…
No one "plans" to get sick. Emergency care is covered 24 hours a day regardless of where you are… even outside the U.S.! A $50 copay applies (waived if admitted).

Vision Benefits…
Routine vision exams every two years (or when medically necessary) cost you a reasonable copay at a Lovelace Senior Plan contracted provider. Every two years you are covered up to $150 for lenses, frames or contact lenses.

These documents provides a summary of benefits available under standard and enhanced plans and your out-of-pocket copayments or co-insurance.

Summary of Benefits for MA-PD plans for Bernalillo, Sandoval, Valencia, Santa-Fe, and Torrance Counties, 2008

Summary of Benefits for Medical Only plan for Bernalillo, Sandoval, Valencia, Santa-Fe, and Torrance Counties, 2008

Enrollment Forms:

Lovelace Senior Plan MA-PD Plans Enrollment Form

Lovelace Senior Plan Medical Only Plan Enrollment Form

Instructions:

To Enroll with a Lovelace Medicare Advantage Plan,

1. Print enrollment form.
2. Complete all 3 pages of enrollment form. Please be sure to selection a primary care provider. If you don’t know any, a representative will assist you or you may reference our website.
3. Please sign and date page 3 of the application.
4. After signed and complete, fax back to 505-262-7757
5. If you have any questions, please call 800-262-3757
6. A representative from Lovelace will contact you within 72 hours to review benefits and confirm receipt of application.

Evidence of Coverage:

These documents explains how to get Medicare services, including Part D pharmacy services, through Lovelace Senior Plan. It explains your benefits, rights and responsibilities as a member of Lovelace Senior Plan and our responsibilities to you.

Lovelace Senior Plan Evidence of Coverage for MA-PD plans for Bernalillo, Sandoval, Santa Fe, Valencia and Torrance Counties, 2008

Lovelace Senior Plan Evidence of Coverage for Medical Only plan for Bernalillo, Sandoval, Santa Fe, Valencia and Torrance Counties, 2008

	Lovelace Senior Plan Comprehensive Formulary, 2008
	Prior Authorization, Step Therapy and Non Formulary Drug Exception Form
Information and forms for coverage determinations, appointment of representatives, appeals and grievances

Existing LSP members needing additional information should contact our Customer Care Center at 505-232-1883 or 800-808-7363, Monday through Friday 8:00 a.m. to 5:00 p.m. Staff will be available to accept Part D calls Monday through Sunday from 8:00 a.m. to 8:00 p.m.  The speech and hearing impaired may use 1-800-659-8331. TTY service provided by New Mexico Relay.

Mailing address:

Lovelace
4101 Indian School Rd, NE, Suite 110
Albuquerque, NM 87110

Prospective members wishing to obtain more information on the Lovelace Senior Plan may call 505-262-3757 or 800-262-3757 or e-mail Suellen.Sullivan@lovelacesandia.com.

Fraud and Abuse Program Policy Statement:
The Lovelace (LHP) Fraud & Abuse Program is dedicated to detecting, investigating, and preventing all forms of suspicious activities related to possible health insurance fraud or abuse, including any reasonable belief that insurance fraud will be, is being, or has been committed. Click here for more information.

HIPAA Privacy Notice :: HIPAA Privacy Notice Spanish

Lovelace Senior Plan and Premier Choice are Medicare Advantage Plans offering a Part D benefit, with a Medicare contract and are open to all individuals entitled to Medicare including the disabled.