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  • Insurance Plans Accepted at Presbyterian

    If you’re not covered by a Presbyterian Health Plan, rest assured that Presbyterian works with most major insurers. Learn more about how to confirm whether your insurance covers your care at one of our hospitals.

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  • Health Insurance Starter Guide

    Our Coverage Connector is a quick interactive tool that helps you determine where you should start looking for health insurance for you and your family's needs.

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  • Enroll Online for Your Presbyterian Health Plan

    From comprehensive to basic essential coverage, Presbyterian Individual and Family Health Plans fit just about any situation and any budget. Enroll now for coverage.

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Home|Insurance Plans|Our Plans|Individual & Family Plans Overview

Individual & Family Plans Overview

Presbyterian Health Plans fit just about any situation and any budget. From comprehensive to basic essential coverage, we've got you covered.

All plans cover the same benefits at varying levels and have a cap of $6,350 a year in out-of-pocket expenses for an individual, $12,700 for families. Regardless of which plan you select, you'll have no cost preventive care, prescription drug benefits, and access to more than 9,000 healthcare providers in more than 500 locations in New Mexico and border communities.

Learn more about plan benefits, rates, and how to enroll.

Individual and Family Health Plan Comparison Tool

To help you decide which level of coverage is best suited for your needs, select up to three plans to compare the benefits side-by-side. Select additional plans and the grid will remove your first selected choice and replace with your next choice.

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1Deductible is per person for up to 2 family members

3Limited to 20 visits per calendar year each service

4OOP maximums are per person for up to 2 family members. The OOP max includes deductible, copayments, coinsurance, and prescription drug costs.

5Includes all services & waived if admitted

 


Keep in mind:

  • Presbyterian's plans include a free fitness center membership for members ages 18 and up and access to Presbyterian's system of more than 600 doctors and 8 hospitals across New Mexico.
  • Bronze plans generally have the lowest premiums, but cover only 60% of medical costs on average. Gold plans have the highest premiums, but cover 80% of costs. Young adults up to age 30 can pick the "catastrophic" plan for very basic coverage.
  • The Silver B, Bronze A, Bronze B plans are Qualified High Deductible Health Plans (HDHP).
  • Copayments – Benefits with copayments ($) are not subject to deductible. Unless specifically noted, copayment covers office visit ONLY. All other services received are subject to deductible and coinsurance.
  • Coinsurances – Benefits with coinsurances (%) are subject to deductible first then you pay the applicable coinsurance % amount.

Learn More About New Mexico's New Health Insurance Exchange


Not Sure This Is Where You Need To Start?

Making a decision regarding your health insurance provider can be confusing. With the recent implementation of the Affordable Care Act, it's likely even more confusing than usual. Presbyterian Health Plan has created an interactive tool that helps you determine where you might begin your search for health insurance, whether through a commercial insurance plan provider, Medicaid or Medicare programs, or on New Mexico's new health insurance exchange.

Try Our Coverage Connector Now

Ready to sign up for coverage? Enroll Online Now



Fraud and Abuse

Our Special Investigative Unit is responsible for the detection, investigation and reporting of potential fraud and abuse activity. We are required to cooperate with regulatory and law enforcement agencies in reporting any activity that appears to be suspicious in nature. According to the law, any information that we have concerning such matters must be turned over to the appropriate governmental agencies.

Notices of Privacy Practices

The 'Notices of Privacy Practices' describe how Presbyterian safeguards your Protected Health Information, and your rights with regard to that information.​​​​​​​​​​​​​​​​​​​​