Presbyterian Insurance Company, Inc. is pleased to provide the Presbyterian MediCare PPO Sandia Plan. Enrollment into this plan must be made directly with Extend Health (the administrator for Sandia). To enroll, contact Extend Health at 1-888-598-7809 or visit their website.
Presbyterian MediCare PPO Sandia Plan is 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 is described below.
Our service area includes these states: New Mexico.
The Presbyterian MediCare PPO Sandia Plan Member Handbook provides a detailed overview of the coverage and copayments 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.
2014 Presbyterian MediCare PPO Sandia Plan Member Handbook
The Provider Directory lists the doctors available to you in-Network as part of your MediCare Sandia 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 Sandia National Laboratories health plan includes prescription drug coverage. A list of the drugs covered can be found in the Formulary lists.
2014 Medicare Formularies
2014 Medicare Advantage Formulary List
2014 Formulario de medicamentos
What if my drug is not covered?
2014 Formulary Changes (Coming Soon)
Prior Authorization Criteria for 2014 Formulary
Los criterios de las autorizaciones previas 2014
Step Criteria for 2014 Formulary
Criterios de la terapia en pasos 2014
Quantity Limits for 2014 Formulary
Límites de las cantidades 2014
Supplement Formulary Information
Drug Coverage Determination Request Form
Medicare Part D Transition Process Policy
Pharmacy Prior Authorization Form
Example Medicare Part D Transition Letter
Example Medicare Part D Transition Letter (en Español)
Specialty Pharmaceuticals/Medical Drugs List
Specialty Pharmacy Drug Request Form
Suboxone/Subutex Pharmacy Drug Request Form
Get free delivery to your home with Walgreens Mail Service
Get free delivery to your home with Walgreens Mail Service (en Español)
U.S. Food and Drug Administration (FDA) Safety Alerts
U.S. Food and Drug Administration (FDA) Drug Recalls
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 Walgreens Mail Service.
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.