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Last Updated: 1/1/2024

Presbyterian MediCare PPO Members

Learn more about your plan benefits, managing your plan and how to access care.

Your Plan Documents

Find important plan information related to your 2024 Presbyterian MediCare PPO plan.

Didn't find what you are looking for?

View all plan documents

Manage Your Care

Accessing Care

Get Care

You have many options for getting care through your health plan. Visit the Get Care webpage for help finding the best care option for your situation.

View Get Care Options

Need to find a provider?

Check out the Provider Directory for a list of in-network providers and pharmacies.

Find a Provider in my plan’s Network

Dental Coverage & Providers

Your plan includes basic dental coverage through a contracted provider* at no additional cost to you. Services include:

  • Oral exams, cleanings, and fluoride treatments (two every 12 months)

  • Dental x-rays (frequency varies by type)

  • Periodontal maintenance (four every 12 months)

  • Emergency treatment of minor pain (as needed)

*MediCare PPO members may use non-contracted providers but may pay higher out-of-pocket costs.

Start using your preventive dental benefits today!

Find a DentaQuest provider

Manage Your Plan

Interested in changing your plan?

Open Enrollment Period is from October 15 - December 7. You can switch your Presbyterian Medicare Advantage plan. The coverage start date is January 1 of the next year.

Medicare Advantage Open Enrollment Period is from January 1 – March 31. You can switch your Presbyterian Medicare Advantage plan. The coverage start date is the first of the month after we get your request.

Special Enrollment Period is available year-round but is only for certain situations that happen in your life, like moving to a new address, getting Medicaid, or getting Extra Help. The coverage start date varies but generally is the first of the month after we get your request.

To get started, please have your 11-digit member ID number and date of birth.

Online Plan Change Form

Add Additional Dental Coverage

A Comprehensive Dental Plan is available for an additional monthly premium. You may enroll online anytime. Already enrolled? You don’t need to do anything.

Enroll to receive these extra benefits.

  • Includes all the coverage of the basic dental plan

  • Use services right away. No deductible or waiting period required!

  • $4,000 calendar-year benefit maximum (Unused portion does not carry forward to next year's benefit)

  • No Prior Authorization needed for covered services

  • Services not covered include implants, cosmetic procedures, bone grafts and tissue regeneration

Enroll in Comprehensive Dental Coverage

Have Questions?

Call your local Presbyterian Customer Service Center at:

 or  (TTY ) Hours: 8 a.m. to 8 p.m., Sunday - Saturday