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2012 Presbyterian Medicare Advantage Plans

Presbyterian Medicare Plans

Presbyterian Health Plan and Presbyterian Insurance Company, Inc are Medicare Advantage organizations with contracts with the Centers for Medicare and Medicaid Services (CMS). The benefit information provided herein is a brief summary, but not a comprehensive description of available benefits. Additional information about benefits is available to assist you in making a decision about your coverage.

Welcome to 2012 Presbyterian Medicare Advantage Plans    

 
 
 
  ENROLL NOW
 
Visit the following links to learn more about:
 

Presbyterian Senior Care (HMO) En Español  is Presbyterian's Medicare Advantage Health Maintenance Organization with plan choices that include healthcare coverage and healthcare coverage with prescription drugs Presbyterian Senior Care (HMO) is available in; Bernalillo, Valencia, Sandoval, Torrance counties, and the following ZIP codes in Cibola County (87007, 87014, 87020, 87026, 87038), Socorro County (87062, 87831) and Santa Fe County (87010, 87015, 87056, 87540).    

Presbyterian MediCare PPO En Español is Presbyterian's Preferred Provider Organization with plan choices that include healthcare coverage and healthcare coverage with prescription drugs.  Presbyterian MediCare PPO is available in all counties in New Mexico.

 

Best Available Evidence policy  Presbyterian Medicare Part D Transition Policy En Español

If you believe you have qualified for Extra Help and you believe that you are paying an incorrect cost-sharing amount when you get your prescription at a pharmacy, our plan has established a process that allows you to either request assistance in obtaining evidence of your proper co-payment level, or, if you already have the evidence, to provide this evidence to us. 
Presbyterian MediCare PPO Plan is ready to help you. Please call Customer Service at 1-800-797-5343 (TTY 1-888-625-8818) within 10 days of paying the copayment or coinsurance that you believe is not correct.  We may ask you to provide us with proof of your extra help eligibility as well as your receipt from the pharmacy.  Customer Service will work with you, Medicare and the pharmacy to determine if you have paid the wrong copayment or coinsurance.
  • Our plan also assists newly enrolled Medicare beneficiaries through an arrangement with Social Services Coordinators, Inc., an organization that assists beneficiaries in determining if they qualify for Extra Help from various agencies, such as, CMS/Medicare and other assistance programs. Social Services Coordinators, Inc. can be contacted at 1-866-851-0324.

Please use the link below to look through the downloads that relate to the CMS BAE policy.

2012 Plan Rating Presbyterian Senior Care, En Español

2012 Plan Rating Presbyterian MediCare PPO, En Español

New Benefits Covered by Medicare
If new Medicare benefits take effect mid-year, this information will be posted here.
 

Contact Us
Mail Correspondence to:
Presbyterian Medicare
P.O. Box 27489
Albuquerque, NM 87125-7489

Presbyterian Customer Service Center:

Hours of Operation:

October 15 through February 14 – The Presbyterian Customer Service Center has representatives available to assist you Monday through Sunday, including holidays, 8:00 a.m. to 8:00 p.m.

February 15 through October 14 - The Presbyterian Customer Service Center has representatives available to assist you Monday through Friday 8:00 a.m. to 8:00 p.m. The Presbyterian Service Center uses a voice response system to assist you Saturday, Sunday and holidays from 8:00 a.m. to 8:00 p.m. All Messages left will be responded to within one business day. Please call (505) 923-6060 or 1-800-797-5343 or the Hearing-impaired Access Line at 1-888-625-8818. You can also e-mail us: info@phs.org.

You may also use our Contact Form that is available online 24 hours a day at

 You are now able to submit feedback about your Medicare health plan or prescription drug plan directly to Medicare using the link to the form below.

Connect to Medicare.Gov. website

Medicare Complaint Form

Sales: Toll Free 1-800-347-4766 or (505)923-8548
TTY Users: 1-888-625-6429
  
 [MPC081173]
 
Y0055_W111008PSCPPO  CMS Approved11/11/2011
Updated 12/07/2012