Presbyterian Senior Care (HMO) is an HMO plan with a Medicare contract. Presbyterian UltraFlex (HMO-POS) is a HMO-POS plan with a Medicare contract. Presbyterian MediCare PPO is a PPO plan with a Medicare contract. Enrollment in these plans depends on contract renewal.
Presbyterian Dual Plus is an HMO Special Needs Plan (HMO D-SNP) with a Medicare Contract and a contract with the State of New Mexico Human Services Department Medicaid program. Enrollment in this plan depends on contract renewal. Based on a Model of Care review, Presbyterian Dual Plus (HMO D-SNP) has been approved by the National Committee for Quality Assurance (NCQA) to operate a Special Needs Plan (SNP) through 2025.
Every year Medicare evaluates plans based on a 5-star rating system.
Out-of-network/non-contracted providers are under no obligation to treat Presbyterian Senior Care (HMO), Presbyterian UltraFlex (HMO-POS), Presbyterian MediCare PPO, or Presbyterian Dual Plus (HMO D-SNP) members except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.