Presbyterian Medicare 2012
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 2012 Presbyterian Medicare Advantage Plans
Visit the following links to learn more about:
Presbyterian Senior Care (HMO) En Español 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 Español 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
Presbyterian Medicare Part D Transition Policy En Español
2012 Plan Rating Presbyterian Senior Care, En Español
2012 Plan Rating Presbyterian MediCare PPO, En Español
Contact Us
Mail Correspondence to:
Presbyterian Medicare
P.O. Box 27489
Albuquerque, NM 87125-7489
Presbyterian Customer Service Center:
Hours of Operation:
October 15 through February 14 – The Presbyterian Customer Service Center has representatives available to assist you Monday through Sunday, including holidays, 8:00 a.m. to 8:00 p.m.
February 15 through October 14 - The Presbyterian Customer Service Center has representatives available to assist you Monday through Friday 8:00 a.m. to 8:00 p.m. The Presbyterian Service Center uses a voice response system to assist you Saturday, Sunday and holidays from 8:00 a.m. to 8:00 p.m. All Messages left will be responded to within one business day. Please call (505) 923-6060 or 1-800-797-5343 or the Hearing-impaired Access Line at 1-888-625-8818. You can also e-mail us: info@phs.org.
You may also use our Contact Form that is available online 24 hours a day at info@phs.org
You are now able to submit feedback about your Medicare health plan or prescription drug plan directly to Medicare using the link to the form below.
| [MPC081173] | W111006PSCPPO 11/11/2011 |
Pres Online Login
New User? Register now to view and pay your medical bills, visit your doctor, view claims, get insurance quotes, and more.
