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Presbyterian Medicare 2010

Presbyterian Health Plan and Presbyterian Insurance Company, Inc are Medicare Advantage Organizations with contracts with the Centers for Medicare and Medicaid Services (CMS). The benefit information provided herein is a brief summary, but not a comprehensive description of available benefits. Additional information about benefits is available to assist you in making a decision about your coverage.

 

Welcome to 2010 Presbyterian Medicare Advantage Plans

Visit the following links to learn more about:

Presbyterian Senior Care (HMO)  En Espanol  is Presbyterian's Medicare Advantage Health Maintenance Organization with plan choices that include healthcare coverage and healthcare coverage with prescription drugs.Presbyterian Senior Care (HMO) is available in; Bernalillo, Valencia, Sandoval, Torrance counties, and the following ZIP codes in Cibola County (87007, 87014, 87020, 87026, 87038), Socorro County (87062, 87831) and Santa Fe County (87010, 87015, 87056, 87540).

Presbyterian MediCare PPO  En Espanol  is Presbyterian's Preferred Provider Organization with plan choices that include healthcare coverage and healthcare coverage with prescription drugs.

Presbyterian MediCare PPO is available in all counties in New Mexico.
 

Best Available Evidence (BAE) Federal regulations at 42 CFR § 423.800 specify the requirements of Part D sponsors in the administration of the Low-Income Subsidy program, including the reduction of cost sharing for subsidy-eligible individuals. In certain cases, CMS systems do not reflect a beneficiary's correct Low-Income Subsidy (LIS) status at a particular point in time. As a result, the most up-to-date and accurate subsidy information may not have been communicated to the Part D Plan.
To address these situations, CMS created the Best Available Evidence (BAE) policy. This policy requires sponsors to establish the appropriate cost-sharing for low-income beneficiaries when presented with evidence that the beneficiary's information is not accurate.


Please use the link below to look through the downloads that relate to the CMS BAE policy.
 

Best Available Evidence Policy

 

Presbyterian Medicare Part D Transition Policy (Draft)

Contact Us
Mail Correspondence to:
Presbyterian Medicare
P.O. Box 27489
Albuquerque, NM 87125-7489


Or contact our Medicare Sales Department at (505) 923-8458 or toll-free at 1-800-347-4766, TTYusers: 1-888-625-6429
or the Presbyterian Customer Service Center at (505) 923-6060 or toll-free at 1-800-797-5343, TTY users: 1-888-625-8818
 

E-mail: jdecker@phs.org
 

Presbyterian Customer Service Center
E-mail: info@phs.org


Presbyterian Medicare Health Plan Consultants and Customer Service Representatives are available to assist you by phone, Monday through Sunday from 8:00 a.m. to 8:00 p.m. You may also use our Contact Form that is available online 24 hours a day at info@phs.org

 

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