Presbyterian Health Plan, Inc. is pleased to provide the Presbyterian MediCare PPO New Mexico Retiree Health Care Authority (NMRHCA) Plans I and II. Enrollment in these plans must be made directly through NMRHCA. To enroll, call NMRHCA at 505-222-6400 or visit their website.
Presbyterian MediCare PPO NMRHCA Plans I and II are available only to individuals who live in our plan service area. To remain a member of our plan, you must keep living in this service area. The service area includes the entire state of New Mexico.
The Presbyterian MediCare PPO NMRHCA Plan I and II Member Handbook provides a detailed overview of the coverage and payments required at each specific deductible level. Important information to check out includes:
- Copayments required for the types of care visits you usually make.
- Whether the plan covers your specific conditions or circumstances.
- Prescription coverage, especially if you are on an unusual drug.
Presbyterian MediCare PPO NMRHCA Plan I and II Member Handbook
The Provider Directory lists the doctors available to you in-network as part of your Presbyterian MediCare PPO NMRHCA plan. Check to make sure your doctor is covered to receive the highest level of coverage.
Summary of Benefits
A summary of this plan is included in the detailed plan information in the following document.
Summary of Benefits
Prescription Drug Coverage
The Presbyterian MediCare (PPO) NMRHCA health plans include prescription drug coverage. A list of the drugs covered can be found in the Formulary lists.
2014 Medicare Formularies
Presbyterian MediCare PPO Formulary
Presbyterian MediCare PPO Formulary - En Español
2014 Formulary Changes (Coming Soon)
Prior Authorization Criteria for 2014 Formulary
Prior Authorization Criteria for 2014 Formulary - En Español
Step Criteria for 2014 Formulary
Step Criteria for 2014 Formulary - En Español
Quantity Limits for 2014 Formulary
Quantity Limits for 2014 Formulary - En Español
Supplement Formulary Information
Drug Coverage Determination Request Form
Medicare Part D Transition Process Policy
Pharmacy Prior Authorization Form
Specialty Pharmaceuticals/Medical Drugs List
2014 Presbyterian MediCare PPO Provider Directory
2014 Presbyterian MediCare PPO Provider Directory - En Español
For more information on prescription drug benefits, see Understanding Formularies and Formulary Terms.
Mail Service Pharmacy Benefit
Presbyterian is pleased to offer mail-order prescriptions in partnership with Walgreens. Order up to a 90-day supply of maintenance drugs (as prescribed by your physician) and get free delivery to your home with the Walgreens Mail Service Pharmacy.
Walgreens Mail Service Tips and Forms
Walgreens En Español
Contact Presbyterian's friendly Customer Service Center
Weekdays, 7:00 a.m. - 6:00 p.m.