Presbyterian Medicare Advantage Plans 2025

Are you looking for a Medicare Advantage plan that offers comprehensive benefits, tailored dental and vision coverage, and a seamless enrollment process?

Look no further than Presbyterian Medicare Advantage Plans.

In this article, we’ll discuss the variety of plans available, including HMO, HMO-POS, and PPO options, and explore the numerous benefits that make Presbyterian Medicare Advantage Plans stand out from the competition.

 

Key Takeaways

  • Discover Presbyterian Medicare Advantage Plans for no or low-cost quality care.

 

  • Benefit from tailored dental and vision coverage, generous allowances, hearing health exams & aids including SilverSneakers® membership, and Assist America® global emergency assistance.

 

  • Check plan availability in your area before selecting a plan with the convenient online enrollment process offered by Presbyterian Healthcare Services.

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Discovering Presbyterian Medicare Advantage Plans

Presbyterian Medicare Advantage Plans provide secure access to care from home and an extensive system of physicians and hospitals, with numerous $0 and low-cost options.

These plans offer a variety of benefits at no additional cost, such as:

  • primary care visits,
  • telehealth visits,
  • basic dental services,
  • and more, ensuring that you receive the value you need.

 

 

Presbyterian Medicare Advantage Plans 2025 Discovering Presbyterian Medicare Advantage Plans

 

 

HMO: Zero Dollar Premiums, Quality Care

Presbyterian HMO plans offer the following benefits:

  • $0 monthly premium options
  • Access to Presbyterian physicians and specialists
  • Benefits that extend beyond Original Medicare
  • $0 Telehealth Benefit, which enables members to access virtual visits with their network providers at no cost

 

Our health plan offers you the value that comes with the necessary resources to keep you healthy.

Presbyterian Senior Care (HMO) plans offer:

  • Basic dental coverage
  • Option of comprehensive coverage for an additional monthly cost
  • $0 copay Primary Care Provider visits
  • Dental cleanings
  • X-rays
  • Exams

 

These benefits ensure your behavioral health and overall well-being are well-rounded.

Presbyterian Medicare Advantage Plans 2025 HMO-POS: Flexibility and FreedomHMO-POS: Flexibility and Freedom

The Presbyterian Medicare Advantage HMO-POS plan provides a broad service network, including a system of physicians and hospitals, network primary care, benefits beyond the network, and a flexible spending card for increased adaptability.

With more benefits than original Medicare, the expanded service network allows you to access care outside the HMO network, giving you greater freedom in choosing your providers. However, be aware that additional cost-sharing or copayments may apply for services received from out-of-network providers.

The HMO-POS plan provides an out-of-network benefit with a flat copay and a flex spending card preloaded with $215 per quarter for approved out-of-pocket expenses, such as dental, vision, hearing, and over-the-counter products. Simply activate the card before shopping and use it to cover your expenses.

 

PPO: Provider Choice and Coverage

Presbyterian PPO plans offer the following benefits:

  • Freedom to choose providers within or beyond the network for all-encompassing coverage
  • Certain services for no copayment To be eligible for Presbyterian MediCare PPO, you must:
  • Be entitled to Medicare Part A and enrolled in Medicare Part B
  • Reside in New Mexico

 

Presbyterian MediCare PPO plans offer basic dental coverage through a contracted provider, with a comprehensive option available for an additional monthly cost. This ensures your dental needs are met, no matter your preference.

Tailored Dental and Vision Benefits

Presbyterian Medicare Advantage Plans provide bespoke dental and vision benefits to meet your unique needs. With basic dental coverage through a contracted provider at no additional cost and an optional comprehensive dental plan, you can choose the level of coverage that suits you best.

Vision benefits are also a priority, with an annual allowance for vision hardware included in the plans.

 

Enhanced Dental CoveragePresbyterian Medicare Advantage Plans 2025 Enhanced Dental Coverage

Presbyterian Medicare Advantage Plans offer improved dental coverage which includes:

  • Basic dental services from a contracted provider without additional charges
  • Oral exams
  • Cleanings
  • Other basic dental services to maintain your oral health.

 

For those seeking more comprehensive dental coverage, Presbyterian Medicare Advantage Plans offer an additional option with a $4,000 calendar-year benefit maximum. This ensures that you have access to the dental care you need, whether you prefer basic or comprehensive coverage.

 

Generous Vision Allowance

Presbyterian Medicare Advantage Plans include vision benefits with an annual allowance of up to $265 for eyewear, encompassing:

  • Frames
  • Lenses
  • Contacts
  • Prescription sunglasses

 

This generous allowance allows you to choose the eyewear that best fits your needs, style, and budget.

The vision allowance covers:

  • Frames
  • Lenses
  • Contacts
  • Contact lens fittings

 

You can use this allowance with any Medicare-approved vision provider that accepts VISA®. With this flexibility, maintaining your vision health is easy and convenient.

 

Hearing Health: Exams and Aids Included

 

Presbyterian Medicare Advantage Plans 2025 Hearing Health: Exams and Aids Included

 

Presbyterian plans acknowledge the importance of hearing health as a key element of overall well-being.

They provide coverage for routine hearing exams and up to two hearing aids per year to promote better hearing health.

The annual hearing exam comes with no copay, and the $0 cost-share for up to two hearing aids per year ensures that you have access to the necessary devices for improved hearing.

While the specific brands and types of hearing aids covered may vary, Presbyterian Medicare Advantage Plans are committed to offering comprehensive hearing health benefits to their members.

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Embrace Wellness With Silversneakers®

Membership in a Presbyterian Medicare Advantage Plan comes with a complimentary SilverSneakers® membership, giving you access to more than 15,000 fitness locations across the country.

The SilverSneakers® fitness program is specifically tailored for adults aged 65 and over, offering a range of activities such as:

  • Yoga
  • Flexibility exercises
  • Balance training
  • Cardio workouts
  • Strength training
  • And more

 

With the SilverSneakers® program included at no additional cost in Presbyterian Senior Care (HMO) plans, staying active and embracing wellness has never been easier.

 

Global Emergency Assistance With Assist America®

While traveling is an exhilarating experience, having a safety net for potential emergencies is beneficial.

Assist America® provides global emergency assistance for up to 90 days per emergency when traveling 100 miles or more away from home.

 

Presbyterian Medicare Advantage Plans 2025 Global Emergency Assistance With Assist America®

 

This comprehensive network of medical providers, medical evacuations, and repatriations ensures that you receive assistance when you need it most, with 24/7 multilingual support available.

To utilize Assist America® services while traveling, simply contact their 24/7 Operations Center at the toll-free number provided on your membership card or travel assistance app.

They are available to assist in accessing the necessary services, including medical referrals, emergency medical evacuation, and repatriation.

 

Seamless Enrollment Process

The enrollment process for a Presbyterian Medicare Advantage Plan is straightforward, with eligibility reliant on enrollment in Medicare Parts A and B and residency in New Mexico.

The online enrollment form provided by Presbyterian Healthcare Services makes it easy to apply during the Open Enrollment Period or your Medicare Initial Election Period.

To enroll, you may need specific documents such as:

  • 2024 Forms, Plan Information, and Policies
  • Summary of Benefits
  • Evidence of Coverage (EOC)
  • Annual Notice of Change (ANOC)
  • Provider Directory

 

These documents and additional information can be accessed on the Presbyterian Medicare website.

 

Member Support and ServicesPresbyterian Medicare Advantage Plans 2025 Member Support and Services

Presbyterian provides dedicated support and services for members, guaranteeing necessary assistance. Their customer support services include:

  • Phone support at 505-923-8458 or 1-800-347-4766 from 8 a.m. to 8 p.m., Sunday to Saturday
  • Fax support through designated fax numbers
  • The toll-free number for additional assistance

 

In addition to standard support, Presbyterian provides free qualified interpretation and translation services to ensure effective communication with non-English speaking members.

Details on accessing these services can be found in the Presbyterian Volunteer Services Handbook.

 

Plan Availability Based On Location

The availability of plans differs by location, with certain Presbyterian Medicare Advantage Plans available in specific New Mexico counties like Bernalillo and Cibola.

To view the plans available in your area, you can visit the Presbyterian website and enter your zip code. This ensures that you find the plan that best meets your needs based on your location.

The availability of Presbyterian Medicare Advantage Plans depends on your residential location, a factor to keep in mind when choosing the appropriate plan for you.

 

Summary

In conclusion, Presbyterian Medicare Advantage Plans offer a variety of comprehensive benefits, tailored dental and vision coverage, and seamless enrollment processes.

With plans designed to meet the unique needs of each individual, it’s clear why so many people are choosing Presbyterian for their Medicare Advantage needs.

Explore the available plans and benefits today to find the perfect fit for your healthcare journey.

 

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Frequently Asked Questions

 

→ What are the pitfalls of a Medicare Advantage plan?

Medicare Advantage plans may offer a $0 premium, but they can be expensive with hidden out-of-pocket costs.

Furthermore, they limit the choice of doctors and medical offices available to you and could end up costing more for complex or expensive healthcare needs compared to Original Medicare and a Medigap plan.

 

→  What are four types of Medicare Advantage plans that Presbyterian offers?

Medicare Advantage plans come in 4 types: HMOs, PPOs, PFFSs, and SNPs. Each type of plan offers its unique features and services, so be sure to check out the details for each before deciding which is right for you.

 

→ What does Medicare pay for in an Advantage plan?

Medicare Advantage plans provide coverage for all Medicare Part A and Part B services, except hospice care. In addition, these plans may also include prescription drug coverage and additional benefits such as vision and dental coverage at lower out-of-pocket costs.

 

→  What types of plans are offered by Presbyterian Medicare Advantage?

Presbyterian Medicare Advantage offers HMO, HMO-POS, and PPO plans to suit different needs and budgets.

 

→ Are dental and vision benefits included in the plans?

Yes, Presbyterian Medicare Advantage Plans include dental and vision benefits, offering basic and comprehensive dental coverage options as well as an annual vision allowance.

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Presbyterian Medicare Advantage Plans by State

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Speak with a licensed insurance agent

1-844-350-0776
TTY 711

Mon-Fri : 8am-9pm ET