Presbyterian MediCare PPO Plan 2 with Rx (PPO) in Cibola, New Mexico (2023)
Presbyterian MediCare PPO Plan 2 with Rx (PPO) in Cibola County, New Mexico costs $188/mo. This affordable Regional PPO plan (H3206-001) is a top choice for those living in Cibola County with a $335 prescription deductible and out-of-pocket limits at $6,700. Learn more about Medicare Part C by AARP in Cibola County, New Mexico below.
Read moreUPDATED: Sep 21, 2023
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UPDATED: Sep 21, 2023Fact Checked
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4 out of 5 stars* for plan year 2024
Plan ID: H3206-001
What You Need to Know:
- Presbyterian MediCare PPO Plan 2 with Rx (PPO) is a Medicare Advantage Health Maintenance Organization Local PPO 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 $188, which does not include your monthly Medicare Part B premium.
- The annual deductible for this health plan is .
- The plan includes an out-of-pocket maximum of $6,700 per year (in-network).
- Presbyterian MediCare PPO Plan 2 with Rx (PPO) includes a Part D prescription drug plan for prescription medication coverage. The annual deductible is .
- This plan's Part D Initial Coverage Limit is $57.
* Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system.
$188
Monthly Premium
| Medicare Plan Features | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Monthly Premium: | $188.00 | ||||||||
| Part C Premium: | $131.1 | ||||||||
| Monthly Premium: | Part C Premium: | Part D Drug Premium: | Part D Supplemental Premium: | Total Part D Premium: | Drug Deductible: | Tiers with No Deductible: | |||
| $188.00 | $131.1 | $56.90 | $0 | $56.90 | $335.0 | 0.0 | |||
| Gap Coverage: | No | ||||||||
| Benchmark: | not below the regional benchmark | ||||||||
| Type of Medicare Health: | Basic Alternative | ||||||||
| Health Plan Type: | Local PPO | ||||||||
| Similar Plan: | H3206-003 | ||||||||
| Special Needs Type: | NULL | ||||||||
| Chronic Condition: | NULL | ||||||||
| Additional Gap Coverage: | No additional gap coverage, only the Donut Hole Discount | ||||||||
| Maximum Out-of-Pocket Limit for Parts A & B (Moop): | $6,700 | ||||||||
| Annual Deductible: | NULL | ||||||||
| Annual Initial Coverage Limit ICL: | $4,130 | ||||||||
| Number of Members enrolled in this plan in Cibola, New Mexico: | Plans Summary Star Rating: | Customer Service Rating: | Drug Cost Rating: | ||||||
| 28 members | 3 out of 5 Stars. | 4 out of 5 Stars. | 3 out of 5 Stars. | ||||||
| Plan Offers Mail Order: | Yes | ||||||||
| Plan Health Benefits | |||||||||
| Total # of Formulary Drugs: | 3,198 drugs | ||||||||
| Number of Members Enrolled in this Plan in Cibola, New Mexico: | 1,807 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 | ||||||
| $131.10 | $56.90 | $0.00 | $188.00 | ||||||
| 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 | |||
| $159.80 | $49.90 | $181.00 | $42.80 | $173.90 | $35.80 | $166.90 | |||
| 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) |
| 197 | $4.00 | 1229 | $10.00 | 527 | $45.00 | 577 | $95.00 | 668 | 25% |
Other Medicare Advantage Plans in Cibola, New Mexico
| Plan Name | Type | Premium MOOP | Rx Deduct. | Rating |
|---|---|---|---|---|
| Lasso Healthcare Growth (MSA) (2023) | MSA * | $- | $- | |
| HumanaChoice H5216-077 (PPO) (2023) | Local PPO * | $4,000 | $- | |
| Lasso Healthcare Growth Plus (MSA) (2023) | MSA * | $- | $- | |
| HumanaChoice H5216-196 (PPO) (2023) | Local PPO | $5,500 | $0 | |
| Humana Value Plus H5216-199 (PPO) (2023) | Local PPO | $7,550 | $435 | |
| Presbyterian Senior Care Plan 2 with Rx (HMO) (2023) | Local HMO | $4,500 | $0 | |
| Presbyterian Senior Care Plan 3 with Rx (HMO) (2023) | Local HMO | $3,000 | $0 | |
| Humana Honor (PPO) (2023) | Local PPO * | $4,400 | $- | |
| Presbyterian Senior Care Plan 1 (HMO) (2023) | Local HMO * | $4,000 | $- | |
| Presbyterian MediCare PPO Plan 1 (PPO) (2023) | Local PPO * | $6,700 | $- | |
| Molina Medicare Choice Care (HMO) (2023) | Local HMO | $7,550 | $445 | |
| UnitedHealthcare Medicare Advantage Assure (PPO) (2023) | Local PPO | $7,550 | $445 | |
| Medicare Advantage Plans by Presbyterian Insurance Company, Inc | ||||
| Presbyterian MediCare PPO Plan 1 (PPO) (2023) | Local PPO * | $6,700 | $- | |