Presbyterian is pleased to be a health partner with TriCore Reference Laboratories.
As a Presbyterian Health Plan, Inc. or Presbyterian Insurance Company, Inc. member, you get superior coverage, access to excellent healthcare facilities all over New Mexico, and the quality care you expect to get and stay healthy.
- Annual preventive screening reminders and periodic wellness newsletters sent directly to you
- Help with managing chronic conditions through Presbyterian Healthy Solutions, an innovative disease management program
- Direct access to medical advice 24 hours a day, 365 days a year through NurseAdvicesm New Mexico
- Discounts from select providers for acupuncture, massage therapy, chiropractic care, vision services, and more
- Convenient Web-based services available through myPRES any time, day or night
- Our friendly, locally based Presbyterian Customer Service Center is completely dedicated to you and available to answer your benefit questions
Schedule of Benefits
Specific information on each of the two plans is included in the detailed plan information in the following documents. TriCore employees may select from an HMO or PPO plan. The HMO plan covers in-state contracted providers only (with the exception of urgent and emergent services). The PPO plan covers contracted providers nationwide and also includes an out-of-network benefit. 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.
Prescription Drug Coverage
TriCore Reference Laboratories’ Presbyterian Plans include prescription drug coverage. Details on the coverage can be found in the Prescription Schedule of Benefits.
HMO Prescription Drug Rider
PPO Prescription Drug Rider
Formulary List - Therapeutic Class
Drugs Requiring Prior Authorization
Specialty Pharmaceuticals/ Medical Drug List
Pharmacy Prior Authorization Form
Fax completed Prior Authorization forms to Presbyterian Pharmacy Services at (505) 923-5540 or 1-800-724-6953.
Suboxone/Subutex Prior Authorization Form for Commercial and Medicare Plans
What if my drug is not covered?
Presbyterian Pharmacy Network Listing
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 Walgreens Mail Service.
Walgreens Mail Service Tips and Forms
Walgreens En Español
Contact TriCore Human Resources Department at 505-938-8925 or
Presbyterian’s friendly Customer Service Center
Weekdays, 7:00 a.m. - 6:00 p.m.