Presbyterian Health Plan is New Mexico’s largest health care provider. They have been providing health insurance since 1985, giving them over 24 years of experience. They operate throughout New Mexico from their headquarters in Albuquerque. They have over 6,000 participating physicians and healthcare providers in their network to serve the more than 450,000 enrolled members. They also operate seven hospitals throughout New Mexico. They believe in offering a high quality of care to their members, for which they received national recognition from the National Committee for Quality Assurance (NCQA). They offer New Mexico a number of healthcare options. They offer plans to individuals who qualify for Medicaid, Medicare, individuals, and to employers looking to offer employee coverage.

 

Presbyterian is a Medicare Advantage Organization that contracts with the Centers for Medicare and Medicaid Services to offer HMO, PPO and prescription drug plans that all provide more benefits to seniors than Original Medicare. They currently have more than 17,000 seniors in New Mexico covered with their HMO plan. Their statewide PPO plan offers preventive care benefits and allows the choice of any doctor or hospital that accepts Medicare. Presbyterian MediCare PPO provides reimbursement for covered benefits regardless of whether they are received in-network, with the exception of emergency or urgent care. However, your out-of-pocket costs may be higher if you use choose to use out-of-network doctors, specialists, or hospitals.  The Presbyterian Prescription Drug plan allows Medicare beneficiaries to gain prescription drug coverage while keeping their Original Medicare for health coverage.

 

If you are a resident of New Mexico and qualify for Part A and Part B of Medicare, these Medicare options are available to you.  You also qualify if you are under 65 and receive social Security Disability benefits. If you opt to enroll in a Presbyterian Health plan, you still have to pay any of your Medicare premiums.

 

The 2010 Presbyterian Senior Care (HMO) offers more benefits than Original Medicare and in most cases does not require referrals to see specialists. The exceptions are for podiatry, otolaryngology (ENT), and occupational, physical and speech/language therapies. Presbyterian offers three HMO plans for seniors,  and two of these offer prescription coverage. These are: Senior Care (HMO) Plan 1,  Senior Care (HMO) Plan 2 with Rx, and  Senior Care (HMO) Plan 3 with Rx.

 

The 2010 Presbyterian MediCare PPO (Preferred Provider Organization) offers more benefits than Original Medicare and allows you to be seen by any Medicare-approved practitioner or provider, anywhere. It also requires no referrals and offers no-charge preventive services including annual physical, vision, and hearing exams. The three plans offered are MediCare PPO Plan 1,  MediCare PPO Plan 2 with Rx, and MediCare PPO Plan 3 with Rx.

 

If you are interested in getting a Medicare Supplemental Plan from Presbyterian Health Plan, please contact the Medicare experts at eAmeriFamily Insurance.  They are industry veterans and will guide you through the process of getting the right Medicare, Medicare Advantage, MediGap, or Medicare Supplement Plan for you.