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PHP Member Coverage & Resources

We appreciate the opportunity to be your partner in health, especially during this trying time when the COVID-19 crisis is so deeply impacting many of you throughout our community. Here are some resources to help you get through this pandemic and stay well.

Testing is a critical part of our fight against COVID-19. How do you know if you should get a test?

  • Do I have any symptoms of COVID-19?
    (Symptoms may include a fever with a temperature over 100.0 F, chills or shivering, muscle aches, headache, sore throat, cough, difficulty breathing, a changed or reduced sense of smell or taste, congestion or runny nose, nausea or vomiting, and/or diarrhea.)
  • Have I had close contact (within 6 feet for a total of 15 minutes or more over a 24-hour period) with someone who has been confirmed to have COVID-19?

If you answered yes to either you should be tested as soon as possible. Please see below for more information on testing options and costs.

All New Mexicans can access multiple options to mail order or pick up free at-home COVID-19 tests through FindaTestNM.org.


Employer-provided, individual and family plans

Free for symptomatic or recently exposed

Free

Free, except for employment requirement

Free, except for testing required for employment purposes such as weekly testing due to a vaccine exemption. PHP will cover up to eight individual tests per member per month. Reimbursement will be limited to up to $12 per test, including taxes.

Members can visit a Wal-Mart or Sam’s Club pharmacy to pick up an at-home test with no co-pay at the point of sale. For all other network pharmacies, a member will need to pay for the test and then file a claim for reimbursement online or with the At-Home Over-the-Counter (OTC) Test Kits Reimbursement Form

We’ll be updating guidance frequently so please check here for the latest information.


COVID-19 coverage

As a Presbyterian health plan member, there will be no cost to you for anything related to COVID-19 medical treatment. You won’t pay copays, deductibles or coinsurance with in-network providers for visits related to COVID-19, whether at a clinic, hospital or using remote care. If you are on a high deductible health plan (HDHP), you will also have no cost for these services. Note: Members insured through PNM or TriCore should contact their employer about costs for COVID treatment.


Getting healthcare services

You may be concerned about upcoming appointments and getting healthcare services not related to COVID-19.

Most healthcare facilities remain open and many providers, including Presbyterian facilities, are adding remote care options for their patients. If you feel you cannot wait to get care, do not hesitate to seek the care you need. You can learn more about what is going on at our Presbyterian facilities during this time by reading our Frequently Asked Questions (FAQs)

As a Presbyterian plan member, you already have access to no cost, 24/7 care options.
Learn more about all of your Telehealth options


Getting prescriptions

We are here to help if you have trouble getting your medications. If you are without access to your ongoing prescription medications due to the COVID-19 pandemic, please contact your pharmacy for refills. If you encounter any barriers, please call the Presbyterian Customer Service Center using the phone number on the back of your member ID card and choose the pharmacy option to reach one of our pharmacy specialists.

There are also options for medication delivery:

  • Many pharmacies, including Walmart, CVS and Walgreens, are offering medication delivery services. Contact your pharmacy to learn more.
  • You can also sign up for mail-order delivery of your ongoing medications by going to myPRES and select Prescriptions. You may also call OptumRx (our mail-order partner) at 1-866-528-5829. Using mail order saves you money and allows you to get a 90-day supply of your medication.

Therapy and counseling options

If you are already seeing a behavioral health provider, we encourage you to check with them on what options they are offering you right now.

We also offer these confidential, no cost remote care therapy options.

  • Talkspace

    Text therapy via secure mobile app, also with audio and video options
    Note: This service is not currently available to our Centennial Care and Medicare members.
    Talkspace

  • On to Better Health

    Online access to guided therapy programs and self-help tools
    On to Better Health

  • New Mexico Crisis and Access Line

    This service lets New Mexicans call and text counselors and peer support workers and access mental health resources.
    New Mexico Crisis and Access Line


Financial hardship resources

If you have lost your job or health insurance coverage, need childcare or food, or have questions about housing and bills, visit newmexico.gov for helpful information.