Individual & Family Plans
Choose the Plan that is New Mexico
Thank you for your interest in an Individual and Family Plan. Presbyterian Health Plan, Inc. has offered Individual and Family Plans to New Mexicans for more than two decades. Finding affordable and comprehensive health coverage is so important, and we are here to help.
If you are notified that you are no longer eligible for Medicaid, low or no-cost coverage is available. Contact our representatives for assistance with a quote and enrollment.
Enroll Online Now
Use our fast and convenient online enrollment tool to get a quote, quickly compare plans, and enroll in the Presbyterian Off Exchange Individual and Family Plans.
Contact Us
Please contact our Individual Plan call Center Monday through Friday, 8:00 a.m. to 5:00 p.m.
Local
, option 4 Toll Free 1-866-8MY-PRES , option 4 TTY
Hablamos Español
Presbyterian Individual & Family Plans on beWellnm
Find out if you are eligible for a tax credit. Enrolling on a Presbyterian plan through beWellnm allows individuals who are eligible for a tax credit to get health insurance at a lower cost, including monthly premiums, deductibles, copayments, and coinsurance.
Contact our representatives for assistance with a quote and enrollment.
Learn about Individual and Family medical plan options, premiums, provider networks, gym memberships, vision coverage, and much more. We are looking forward to being your partner in health.
Health Plan Categories
Gold plans often have the highest monthly premiums and lower out-of-pocket costs for care.
Silver plans often have lower monthly premiums and higher out-of-pocket costs than Gold.
Bronze plans often have the lowest monthly premiums and highest out-of-pocket costs for care.
Presbyterian Health Plan is offering Gold+ with TytoHome and GYM – Limited Service Area off exchange plan that includes a Medical Exam kit (value of $299). This device allows you to go beyond video visits and provides clinicians with clinical-level, real-time remote exam data to deliver top-quality diagnoses and treatment with maximum convenience.
Gym/Fitness Center Membership*
You and your enrolled dependents (ages 18 and up) have access to more than 10,000 national, regional and local fitness, recreation, and community centers. These facilities include all Defined Fitness locations in Albuquerque, Rio Rancho, and Farmington, as well as the nationwide Prime® Fitness network, which includes select YMCA locations, Snap Fitness, Chuze, Curves, and more. Discounted rates are also available from Sports and Wellness. Not included with Clear Cost Plans.
Participating Gym/Fitness Center Locations
Clear Cost Plan members can access our Fitness Pass Program for only $22.50 per member per month. After you enroll in a clear cost plan, sign up for the Fitness Pass program online at www.phs.org/wellness.
*Some gyms may charge a registration or annual fee.
Vision Coverage
Presbyterian Health Plan is pleased to provide you with vision coverage options for your entire family. Vision for Children and Vision Basic plans are included with your medical plan. Not included with Clear Cost Plans.
Learn More About Vision Coverage Options
$0 Telehealth Benefit
Any telehealth service (video, telephone or online) with an in-network provider is $0, including Primary Care, Specialist, Urgent Care or Behavioral Health visits.
Learn More About This Telehealth Benefit
Access to Presbyterian’s Integrated Health System
Presbyterian health plan members have access to our integrated health system. Nine hospitals, a large medical group, and a health plan network of more than 22,000 providers and facilities all over New Mexico.
Assist America - 24/7 Emergency Travel Assistance*
You have the protection of Assist America’s global emergency travel assistance services 24 hours a day, 365 days a year. This unique program immediately connects you to services when experiencing a medical emergency while traveling 100 miles or more away from a permanent residence or in another country. Not included with Clear Cost Plans.
Improve Your Health with Wellness at Work*
Wellness at Work helps you create personalized health improvement plans and features a powerful Personal Health Assessment (PHA) tool to help identify personal health risks and provide recommendations for improving those risks.
Support for Your Mental Health
With the Employee Assistance Program (EAP) this program provides support for complex personal challenges. Learning how to cope with stress at work and at home can improve overall well-being. Members and families living in the same household can get up to three complimentary assistance visits per situation. Services are short-term, confidential counseling sessions conducted by local licensed providers. Not included with Clear Cost Plans.
Plan and Network Choices
With new plans and networks to choose from, create a provider directory for providers who are close to work or home, find specific providers (including primary and specialty care providers), narrow the search to match preferences (such as a male or female provider), and find facilities and pharmacies.
*Value added products and services are not insurance benefits and may be discontinued at any time.
Ready to Enroll?
Special Enrollment is available year round
Applications are being accepted if you have experienced a major life event within the past 60 days – such as a loss of healthcare coverage or had a baby – you may qualify for a special enrollment.
Complete your application online.
Enroll by Phone
To apply with one of our representatives by phone, call:
Local
, option 4 Toll Free , option 4 TTY
Hablamos Español
Important: These plans are “Off Exchange” plans, this means you will not get any financial help lowering your monthly premium or out-of-pocket costs like deductibles, copayments, and coinsurance.
Enroll by Mail or Fax
Send your completed form by mail or fax:
Presbyterian Health Plan P.O. Box 27489 Albuquerque, NM 87125 FAX: 505-923-8252
Important: These plans are “Off Exchange” plans, this means you will not get any financial help lowering your monthly premium or out-of-pocket costs like deductibles, copayments, and coinsurance.