Skip to Content

Disclaimers

This information is available for free in other languages. Please call 505-923-5420 or 1-855-592-7737 (TTY 711).

Presbyterian Senior Care (HMO) is an HMO plan with a Medicare contract. Presbyterian MediCare PPO is a PPO plan with a Medicare contract. Enrollment in Presbyterian Senior Care (HMO) and Presbyterian MediCare PPO depends on contract renewal.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or copayments/coinsurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium. The Formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.

Medicare evaluates plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next.

Medicare beneficiaries may also enroll in Presbyterian Senior Care (HMO) or Presbyterian MediCare PPO through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov.

Out-of-network/non-contracted providers are under no obligation to treat Presbyterian Senior Care (HMO) and Presbyterian MediCare PPO members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. 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.

Medicare Advantage Dual Plus (HMO SNP)

Presbyterian Dual Plus is an HMO Special Needs Plan (SNP) with a Medicare Contract and a contract with the New Mexico State Department of Human Services Department Medicaid program. Enrollment in Presbyterian Dual Plus (HMO SNP) depends on contract renewal.

This plan is available to anyone who has full Medical Assistance from the State and Medicare. Premium, co-pays, coinsurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.

Y0055_MPC081749_Approved_10162017
Last Updated: 09/30/2017