4

4 out of 5 stars* for plan year 2024

Plan ID: H3204-008

What You Need to Know:

  • Presbyterian Senior Care Plan 1 (HMO) is a Medicare Advantage Health Maintenance Organization Local HMO * plan.
  • It must provide all of the same hospital and medical benefits as Medicare Part A and Part B, however, costs may be different.
  • It has additional benefits not included in Medicare Part A and Part B, including prescription drug coverage.
  • The plan's monthly premium is $0, which does not include your monthly Medicare Part B premium.
  • The annual deductible for this health plan is no drug coverage.
  • The plan includes an out-of-pocket maximum of $4,000 per year (in-network).
  • Presbyterian Senior Care Plan 1 (HMO) includes a Part D prescription drug plan for prescription medication coverage. The annual deductible is no drug coverage.
  • This plan's Part D Initial Coverage Limit is .

* Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system.

$0

Monthly Premium

Medicare Plan Features
Monthly Premium: $0
Part C Premium: NULL
Monthly Premium: Part C Premium: Part D Drug Premium: Part D Supplemental Premium: Total Part D Premium: Drug Deductible: Tiers with No Deductible:
$0 NULL NULL NULL NULL NULL NULL
Gap Coverage: NULL
Benchmark: NULL
Type of Medicare Health: NULL
Health Plan Type: Local HMO *
Similar Plan: H3204-001
Special Needs Type: NULL
Chronic Condition: NULL
Additional Gap Coverage: NULL
Maximum Out-of-Pocket Limit for Parts A & B (Moop): $4,000
Annual Deductible: no drug coverage
Annual Initial Coverage Limit ICL: NULL
Number of Members enrolled in this plan in Valencia, New Mexico: Plans Summary Star Rating: Customer Service Rating: Drug Cost Rating:
146 members 3.5 out of 5 Stars. 4 out of 5 Stars. 3 out of 5 Stars.
Plan Offers Mail Order: NULL
Plan Health Benefits
Total # of Formulary Drugs: NULL
Number of Members Enrolled in this Plan in Valencia, New Mexico: 2,064 members
Number of Drugs Per Tier: NULL
Preferred Pharmacy Cost Sharing During Initial Coverage Phase: NULL
Special Needs Plan SNP Eligibility Requirement: NULL
Monthly Premium Split as Follows:
Part C Premium Part D Base Premium Part D Supplemental Premium Total Premium
NULL NULL NULL NULL
Monthly Premium with Extra Help Low Income Subsidy:
LIS100 Subsidy Total Monthly Premium with LIS Parts CD LIS25 Subsidy Monthly PartD Premium with LIS LIS25 Subsidy Total Monthly Premium with LIS Parts CD LIS50 Monthly PartD Premium with LIS LIS50 Subsidy Total Monthly Premium with LIS Parts CD LIS75 Monthly PartD Premium with LIS LIS75 Subsidy Total Monthly Premium with LIS Parts CD
NULL NULL NULL NULL NULL NULL NULL
Formulary Drug Details:
Tier 1 # of Drugs per Tier Tier 1 Preferred Pharmacy Cost Sharing (initial coverage phase) Tier 2 # of Drugs per Tier Tier 2 Preferred Pharmacy Cost Sharing (initial coverage phase) Tier 3 # of Drugs per Tier Tier 3 Preferred Pharmacy Cost Sharing (initial coverage phase) Tier 4 # of Drugs per Tier Tier 4 Preferred Pharmacy Cost Sharing (initial coverage phase) Tier 5 # of Drugs per Tier Tier 6 Preferred Pharmacy Cost Sharing (initial coverage phase)
NULL NULL NULL NULL NULL NULL NULL NULL NULL NULL

Other Medicare Advantage Plans in Valencia, New Mexico

Plan Name Type Premium MOOP Rx Deduct. Rating
Blue Cross Medicare Advantage Basic (HMO) (2023)Local HMO$5,100$250
5
HumanaChoice H5216-077 (PPO) (2023)Local PPO *$4,000$-
4
Lasso Healthcare Growth (MSA) (2023)MSA *$-$-
4
HumanaChoice H5216-196 (PPO) (2023)Local PPO$5,500$0
4
Lasso Healthcare Growth Plus (MSA) (2023)MSA *$-$-
4
Humana Value Plus H5216-199 (PPO) (2023)Local PPO$7,550$435
4
AARP Medicare Advantage Choice (PPO) (2023)Local PPO$3,800$150
5
AARP Medicare Advantage Patriot (PPO) (2023)Local PPO *$4,300$-
5
Presbyterian Senior Care Plan 2 with Rx (HMO) (2023)Local HMO$4,500$0
4
Presbyterian Senior Care Plan 3 with Rx (HMO) (2023)Local HMO$3,000$0
4
Humana Honor (PPO) (2023)Local PPO *$4,400$-
4
Amerivantage Plus (HMO) (2023)Local HMO$6,700$0
5
Amerivantage Care Access (HMO) (2023)Local HMO$7,550$445
5
AARP Medicare Advantage (HMO) (2023)Local HMO$4,300$150
5
Cigna True Choice Medicare (PPO) (2023)Local PPO$5,700$0
New plan - not yet rated.
Presbyterian MediCare PPO Plan 2 with Rx (PPO) (2023)Local PPO$6,700$335
4
Humana Gold Choice H8145-123 (PFFS) (2023)PFFS$-$300
4
Presbyterian MediCare PPO Plan 1 (PPO) (2023)Local PPO *$6,700$-
4
Blue Cross Medicare Advantage Choice Plus (PPO) (2023)Local PPO$6,700$350
4
Humana Gold Plus H0028-019 (HMO) (2023)Local HMO$4,000$0
4
Molina Medicare Choice Care (HMO) (2023)Local HMO$7,550$445
5
UnitedHealthcare Medicare Advantage Assure (PPO) (2023)Local PPO$7,550$445
5
Aetna Medicare Choice Plan (PPO) (2023)Local PPO$6,000$300
5
Cigna Preferred Medicare (HMO) (2023)Local HMO$4,600$0
New plan - not yet rated.
Blue Cross Medicare Advantage Select (HMO) (2023)Local HMO$4,500$150
5
Medicare Advantage Plans by Presbyterian Health Plan
Presbyterian Senior Care Plan 2 with Rx (HMO) (2023)Local HMO$4,500$0
4
Presbyterian Senior Care Plan 3 with Rx (HMO) (2023)Local HMO$3,000$0
4

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