Presbyterian Medicare Advantage Plans New Mexico 2025

Looking for Presbyterian Medicare Advantage plans in New Mexico for 2025? Our guide breaks down the options available, including HMO, HMO POS, and HMO D-SNP plans, highlighting the key benefits, cost-saving features like $0 premiums, and the necessary steps to enroll in Presbyterian Medicare Advantage Plans New Mexico.

Stay informed about your Medicare choices with our focused analysis, tailored for New Mexico residents.

 

Key Takeaways

 

  • These Advantage Plans include numerous $0 benefits like primary care visits, generic drugs, preventive services, and telehealth appointments, which enhance affordability and convenience in healthcare access.

 


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Understanding Presbyterian Medicare Advantage Plans in New Mexico

 

Presbyterian Medicare Advantage Plans New Mexico 2025, Understanding Presbyterian Medicare Advantage Plans in New Mexico

 

Presbyterian Medicare Advantage plans in Santa Fe, New Mexico offer a wide range of options to cater to different healthcare needs. These plans include:

  • HMO (Health Maintenance Organization)

 

  • HMO POS (Health Maintenance Organization Point of Service)

 

  • HMO D SNP (Health Maintenance Organization Dual Eligible Special Needs Plan)

 

These health plan-designed plans provide comprehensive healthcare solutions that are affordable and of high quality.

HMO plans are an attractive option for those seeking cost-effective solutions. They offer a network of healthcare providers and may even come with a $0 monthly premium. For those eligible for both Medicare and Medicaid, there are special HMO D-SNP plans like Presbyterian Dual Plus.

 

HMO Plans

Presbyterian HMO plans are designed to provide members with access to a wide network of Presbyterian doctors and specialists, ensuring that you have the care you need, when you need it.

This extensive network is a testament to the commitment of Presbyterian to deliver quality healthcare that is convenient and accessible.

What makes these HMO plans even more appealing is their affordability. With options that offer a $0 monthly premium, these plans are designed to be budget-friendly while providing comprehensive health coverage.

 

HMO POS Plans

The UltraFlex HMO-POS plan offered by Presbyterian is an innovative solution designed to offer members flexibility and convenience. One of its key features is the flex spending card, which is valued at $860 annually. This card can be utilized for health-related expenses such as over-the-counter medications.

But the benefits of the UltraFlex HMO-POS plan do not stop there. The plan also offers an expanded service network, providing members with a wider choice of healthcare providers.

Moreover, it includes out-of-network benefits, allowing members to access services outside the Presbyterian network with a flat copay, offering you the flexibility you need in your healthcare.

 

HMO D SNP Plans

HMO D-SNP plans like Presbyterian Dual Plus offer specialized services catering to specific needs. These plans are designed for individuals who are eligible for both Medicare and Medicaid, providing them with coordinated care and additional benefits.

Eligibility for these HMO D-SNP plans requires residency in certain New Mexico counties and pertains to various Medicaid status categories.

The Presbyterian Dual Plus is an example of how these plans provide targeted services to meet the unique needs of eligible individuals in New Mexico, ensuring that everyone has access to quality healthcare, regardless of their circumstances.

Key Features and Benefits of Presbyterian Medicare Advantage Plans

 

Presbyterian Medicare Advantage Plans New Mexico 2025, Key Features and Benefits of Presbyterian Medicare Advantage Plans

 

Presbyterian Medicare Advantage plans stand out for their comprehensive benefits, which go beyond just medical coverage. These plans offer a plethora of $0 benefits, including:

  • Basic dental services

 

  • Hearing exams

 

  • Lab services

 

  • Outpatient behavioral health visits

 

  • No-cost primary care visits

 

  • Diabetic test supplies

 

  • Diagnostic tests

 

Members can enjoy these additional $0 benefits, making Presbyterian Medicare Advantage plans a great choice with even more benefits.

In terms of prescription medications, HMO Plans 2 and 3 offer significant cost savings with $0 preferred generic drugs and no prescription drug deductible. Additionally, telehealth services are available at $0 copay, ensuring you have convenient access to healthcare services, no matter where you are.

Coverage also extends to diabetic supplies at no extra cost, routine acupuncture and chiropractic care, and emergency and urgent care worldwide.

 

$0 In-Network Copays

Presbyterian Medicare Advantage plans are designed with your financial well-being in mind. These plans offer $0 in-network copays for essential services, significantly reducing your out-of-pocket costs for healthcare. This ensures that you do not have to compromise on your health due to financial constraints.

In HMO Plans 2 and 3, members have access to $0 preferred generic drugs and benefit from having no prescription drug deductible. This enhances medication affordability, making it easier to manage your health.

The $0 copay framework extends to a wide range of services, including dental cleanings, routine eye exams, hearing exams, lab services, and annual physical exams, offering a full spectrum of preventive care and everyday health needs.

 

Telehealth Services

Telehealth is revolutionizing healthcare delivery, and Presbyterian Medicare Advantage plans are at the forefront of this transformation. These plans offer comprehensive telehealth services, including:

  • Primary care

 

  • Urgent care

 

  • Specialty care

 

  • Therapy services

 

Telehealth appointments with in-network providers are available at no additional charge, ensuring that members can access care when needed without added financial stress. From primary care visits and specialist consultations to urgent care and outpatient rehabilitation services, you can access a wide range of healthcare services without leaving your home.

There are no out-of-pocket costs for most in-network providers, which includes video visits, messaging through MyChart, and urgent care video consultations, making healthcare more accessible than ever.

 

Dental Coverage Options

Dental health is an integral part of overall health, and Presbyterian Medicare Advantage plans understand this. These plans provide basic dental coverage, which includes:

  • Oral exams

 

  • Cleanings

 

  • Fluoride treatments

 

  • Dental x-rays

 

  • Periodontal maintenance

 

For members seeking more comprehensive dental coverage, the Presbyterian Medicare PPO offers an optional Comprehensive Dental Plan for an additional monthly premium. This plan provides higher coverage limits and includes services such as:

  • implants

 

  • cosmetic procedures

 

  • bone grafts

 

  • tissue regeneration

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Enhancing Your Health with Additional Benefits

 

Presbyterian Medicare Advantage Plans New Mexico 2025, Enhancing Your Health with Additional Benefits

 

Presbyterian Medicare Advantage plans go beyond just medical coverage. They also offer a range of additional benefits designed to enhance your health and wellness. From gym memberships through SilverSneakers to emergency travel assistance services provided by Assist America, these plans offer more than just healthcare.

 

SilverSneakers Memberships

Staying active is crucial for maintaining good health, and the SilverSneakers program is designed to help you do just that. As a member of a Presbyterian Medicare Advantage plan, you have free access to over 15,000 fitness locations nationwide through SilverSneakers.

The SilverSneakers Fitness program offers a variety of fitness classes, all designed to improve your:

  • Stamina

 

  • Strength

 

  • Flexibility

 

  • Balance

 

Whether you wish to attend classes at a gym or prefer to work out at home, SilverSneakers has something for everyone. With additional digital offerings like SilverSneakers LIVE classes and On-Demand video content, staying active has never been more convenient.

 

Assist America Travel Assistance

Traveling can be a rewarding experience, but it can also bring unexpected health emergencies. With Assist America’s global emergency travel assistance services, you can travel with peace of mind knowing that you are covered in case of a medical emergency.

Assist America provides around-the-clock support, offering emergency and urgent care assistance anywhere in the world. In the event of a medical travel emergency, Assist America facilitates medical transport, ensuring you receive the necessary care without delay.

This service is available not only to members but also their spouse and dependent children, making it a comprehensive solution for your travel needs.

 

Hearing Aid Coverage

Hearing health is a vital aspect of overall wellness, and Presbyterian Medicare Advantage Plans recognize this. These plans offer comprehensive hearing aid coverage that includes routine annual hearing exams and up to two hearing aids per year with no copay.

In partnership with TruHearing, Presbyterian members enjoy significant cost savings on hearing aids. The coverage also includes benefits such as:

  • a 3-year manufacturer warranty

 

  • a 60-day no-risk trial period

 

  • one year of follow-up visits for fitting and adjustments

 

  • 80 free batteries for non-rechargeable aids

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Comparing Presbyterian Medicare PPO and Original Medicare

 

Presbyterian Medicare Advantage Plans New Mexico 2025, Comparing Presbyterian Medicare PPO and Original Medicare

 

The Presbyterian Medicare PPO plans offer several advantages over Original Medicare. One of the key benefits is the freedom to choose any provider that accepts Medicare without being restricted to a network.

This gives you the flexibility to choose the healthcare providers that best suit your needs.

Presbyterian Medicare PPO plans offer the following benefits:

  • $0 copays for primary care visits

 

  • Coverage for emergency and urgent care services around the world

 

  • Coverage for routine acupuncture and chiropractic care

 

These plans provide a more comprehensive healthcare solution than Original Medicare.

Presbyterian Senior Care: Focused on Your Needs

 

Presbyterian Medicare Advantage Plans New Mexico 2025, Presbyterian Senior Care: Focused on Your Needs

 

Presbyterian Senior Care offers a continuum of care and service options for seniors, including:

  • At-home services

 

  • Personal care

 

  • Skilled nursing communities

 

  • Affordable housing

 

  • Premier retirement communities

 

This comprehensive approach ensures that all your needs are met, no matter how they evolve over time.

Presbyterian Senior Care is dedicated to making aging easier through person-centered care and services. With a reputation as a Dementia Care Center of Excellence and a Rehabilitation Center of Excellence, you can trust that your care is in good hands. The organization provides:

  • Personalized care plans

 

  • Flexible living choices

 

  • An environment of dignity and respect

 

  • Compassionate and supportive setting

How to Enroll in a Presbyterian Medicare Advantage Plan

Enrolling in a Presbyterian Medicare Advantage plan is a straightforward process. To be eligible, you must be entitled to Medicare Part A, enrolled in Medicare Part B, and a resident of New Mexico.

In addition to seniors aged 65 or older, younger individuals with disabilities or those with End-Stage Renal Disease (ESRD) may also be eligible for enrollment.

After selecting the most suitable plan, you can initiate the enrollment process through several convenient methods. The goal is to make the enrollment process as seamless as possible, so you can start benefiting from your new healthcare plan without delay.

Navigating the Presbyterian Healthcare Services Website

 

Presbyterian Medicare Advantage Plans New Mexico 2025

 

The ‘Plans and Premiums’ section on the Presbyterian Healthcare Services website is a valuable resource for individuals looking to learn more about the Medicare Advantage plans available in their area.

This user-friendly interface provides comprehensive information about the various plans, including:

  • Plan options

 

  • Premiums

 

  • Coverage details

 

  • Prescription drug coverage

 

  • Provider networks

 

This information makes it easier for you to make an informed decision about your healthcare.

Contacting Presbyterian Medicare for Support

Presbyterian Medicare offers personalized support to its members through various methods. Whether you prefer to make a phone call or visit a physical location, you have numerous avenues to get the assistance you need.

For questions about out-of-state coverage and other inquiries, you can contact the Presbyterian Customer Service Center at the number provided on the back of your ID card.

Alternatively, you can visit the main administrative center located in Albuquerque, New Mexico, for in-person support. These multiple contact methods ensure that you have the support you need when you need it.

Summary

Presbyterian Medicare Advantage plans offer diverse healthcare solutions tailored to the unique needs of New Mexico residents. From comprehensive HMO plans to specialized HMO D-SNP plans, these offerings ensure that every individual can find a plan that fits their healthcare needs and financial situation.

With additional benefits like $0 in-network copays, comprehensive telehealth services, and dental coverage, these plans go beyond just healthcare coverage. They offer a lifestyle of wellness, backed by the support of a trusted healthcare provider.

It’s time to explore the advantages of Presbyterian Medicare Advantage plans and embark on a journey toward better health and well-being.

 

Frequently Asked Questions

 

Does New Mexico have Medicare Advantage plans?

Yes, New Mexico does have Medicare Advantage plans, with nearly 49% of Medicare beneficiaries in the state enrolled in these plans. The availability of Medicare Advantage plans varies by county.

 

Who is the largest provider of Medicare Advantage plans?

The largest provider of Medicare Advantage plans is UnitedHealth Group, serving 7.6 million people in its plans and generating $257 billion in premium revenues in 2022.

 

How much are most Medicare Advantage plans?

Most Medicare Advantage plans have an estimated average monthly premium of $18.50, but this cost can vary based on the insurer and level of coverage. Premiums can range from $0 to $200 or more.

Enter your zip code on this page to compare plans and rates in your area.

 

What types of plans are offered by Presbyterian Medicare Advantage in New Mexico?

Presbyterian Medicare Advantage in New Mexico offers HMO, HMO POS, and HMO D SNP plans, catering to the diverse healthcare needs of residents.

 

What are some of the key benefits of Presbyterian Medicare Advantage plans?

Presbyterian Medicare Advantage plans may offer $0 in-network copays for essential services, comprehensive telehealth services, dental coverage, and additional benefits like SilverSneakers fitness program, Assist America travel assistance, and hearing aid coverage.

Compare Medicare Plans

Find a plan to fit your needs

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Speak with a licensed insurance agent

1-844-350-0776
TTY 711

Mon-Fri : 8am-9pm ET