ALBUQUERQUE, NM – Presbyterian Health Plan (PHP) is
launching new HMO Individual Plan products for adults and children, which will
replace all existing Individual Plan products available through Presbyterian
Insurance Company, Inc. beginning January 1, 2013.
As the future of how healthcare will be delivered and
offered to individuals continues to change, Presbyterian decided to modernize
its individual plans in anticipation for healthcare exchanges. These plans will
allow for better coordination of our members’ care through the use of
Presbyterian’s integrated system and at the lowest rates possible. Our premium
increases would have been much higher if we had stayed with the old individual
PHP is committed to working with members enrolled in one of
our current Individual Plans to offer them an affordable HMO alternative with
comprehensive benefits. For most members, monthly premium rates will not change
much, and in many cases, members will see reduced rates. The main change is
that out-of-network care will not be covered in the new HMO plans.
PHP is offering an “open enrollment period” for current
members to enroll in this new plan. Members currently enrolled in an Individual
Plan will all have until December 31, 2012 to switch to one of the new HMO plans
and PHP will guarantee their acceptance.
If the member waits until after December 31, they will be
subject to standard medical underwriting and may be denied coverage, or if the
member opts to stay on their current plan, they will have until May 31, 2013
before their current plan terminates.
Members enrolled in the Individual Plans will receive a
letter in the next few days explaining in more detail the changes and actions
that need to be taken. PHP has also expanded our call center representatives to
field questions from customers. Individual Plan members can call the
Presbyterian Customer Service Center at 505-923-5947 or 855-206-7737, Monday
through Friday, 8 a.m. to 6 p.m. for more information or assistance.
Health Plan and Presbyterian Insurance Company Inc. serve more than 400,000 New
Mexicans, and are part of the Presbyterian Healthcare Services family.
Presbyterian Healthcare Services exists to improve the health of patients,
members and the communities we serve. Presbyterian was founded in New Mexico in
1908, and is the state’s only private, not-for-profit healthcare system.
Presbyterian offers eight hospitals, a statewide health plan, and a growing
multi-specialty medical group. Presbyterian is the second largest private
employer in New Mexico with more than 9,000 respected employees and growing.