Presbyterian MediCare PPO Plan 3 with Rx, a Union County, New Mexico Medicare Advantage plan from Presbyterian MediCare PPO, is a Preferred Provider Organization (PPO) option for people with Medicare. PPO health insurance allows you to choose your own primary care doctor, specialists and other healthcare providers. If you're on a budget you can lower your out-of-pocket costs by using the plan's provider network.
The monthly premium on this PPO plan is $160.00. Plus, co-payments and/or co-insurances also apply to most of the healthcare services you use. However, unlike original Medicare your out-of-pocket expenses are capped. As a result, you won't be vulnerable to excessive medical bills due to an accident or a critical illness.
After its first year on the market, the CMS (Centers for Medicare and Medicaid Services) gives each plan an overall one to five star rating. The unbiased quality assessment assists people when comparing plans. Medicare Advantage plans with five stars have the highest quality, whereas a one star plan has the lowest quality.
The CMS has awarded Presbyterian MediCare PPO Plan 3 with Rx Average as compared to all others (as of 15 October, 2014).out of 5 stars. That means Medicare deems this plan
Medicare Advantage plans are limited to a maximum out-of-pocket limit of $6,700 (annually). This out-of-pocket limit does not include your prescriptions or your monthly premiums. It only applies to your costs for healthcare services.
Although the mandatory limit is $6,700, the CMS allows plans to offer a lower limit that can be as low as $3,400. The out-of-pocket limit on this plan is $3,000. Be sure to take into consideration, along with the premium and the co-payments, when making your enrollment decision.
If you are comparing Presbyterian MediCare PPO Plan 3 with Rx with your original Medicare benefits, it's important to remember that there are no limits to your out-of-pocket expenses with Medicare Part A or Medicare Part B. If you keep your original Medicare benefits, the only way to avoid high medical bills is to purchase Medicare Supplement insurance to supplement your coverage.
Be a smart shopper. Compare Presbyterian MediCare PPO Plan 3 with Rx with these plans:
- HumanaChoice H6609-111
- HumanaChoice H6609-115
- Presbyterian MediCare PPO Plan 2 with Rx
- Presbyterian MediCare PPO Plan 1
Presbyterian MediCare PPO Plan 3 with Rx vs. Medigap Plan K
In addition to the plans above, we recommend evaluating Medicare Supplement Plan K. These plans have a $4,940 out of pocket limit (vs. $3,000 on Presbyterian MediCare PPO Plan 3 with Rx). Plus, you have the freedom to choose your doctors and other healthcare providers. Have a look at Medigap Plan K vs. Medicare Advantage before you make any decisions.
Who Can Join?
You can join Presbyterian MediCare PPO Plan 3 with Rx if you are entitled to Medicare Part A and enrolled in Medicare Part B and live in the service area. You must continue to pay your Medicare Part B premium. The service area includes: Amistad, Capulin, Clayton, Des Moines, Folsom, Gladstone, Grenville, Sedan, and all other areas of Union County, New Mexico.
CMS File Date: October 15, 2014.
This Medicare Advantage Plan catalog is maintained by 9/14/2015. For more information, download the Summary of Benefits (N/A), visit the Presbyterian MediCare PPO website, or call Presbyterian MediCare PPO at N/A.and was last updated on