You have a wide range of Medicare and other senior health insurance options available to you in Bernalillo County. To make shopping easier, use the navigation links below to show specific plan types. If you're not ready to make a decision click here to discover your options.
To speak with a Medicare adviser, call us toll-free at 877-549-1452 (TTY 411). Our telephone hours are 6AM to 5PM PST, Monday through Friday.
Bernalillo County Medicare Insurance Options
Original Medicare (Part A and Part B) is the only Medicare insurance that's standard in New Mexico. All private Medicare insurance is regulated by the federal government, but plan and policy availability is regional (e.g., within all parts of Bernalillo County or throughout the state).
As if all of the various health insurance options aren’t confusing enough, you also need to make sure your doctor accepts the insurance you want, or find a doctor that does. Some doctors only work through insurance networks, while others treat patients with Original Medicare (and Medicaid). Some doctors do both.
The purpose of the MedicareWire.com website is to help guide you through the process of choosing your health insurance. It's all about providing you with the information you need so you can get on the phone with a licensed adviser and finalize your Medicare elections for the year.
Medicare Advantage Insurance in Bernalillo County
If you're concerned that Original Medicare might be too expensive (you pay 20% of all costs), then a Bernalillo County Medicare Advantage plan is the first option you need to explore. It's the private health insurance alternative that replaces your Medicare Part A and Part B benefits with a managed care plan (HMO or PPO), or a private fee-for-service plan (available in limited areas).
For most Bernalillo County seniors cost is a factor, so let's talk about it. You have plans as low as $0.00 per month and some as high as $132.00 per month. It's not always true that the higher the premium the more benefits and coverage you get. Be a good shopper and compare. Be sure to compare prescription drug benefits. There are 18 plans that give you prescription drug coverage and 3 that don't include it.
There are several different type of plans, including Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Private Fee-for-Service (PFFS), and Medical Savings Account (MSA). HMO and PPO plans are the most common. We identify the plan type and its benefits on each plan page.
In many areas you will find one or more $0 plans. This simply means that there's no additional monthly premium cost to you above and beyond your monthly Part B premium. In all cases you are required to continue to pay your monthly Part B premium in addition to the Medicare Advantage plan premium.
Are you aware that Medicare Advantage has an annual out-of-pocket spending limit? This feature, called the Maximum Out-of-Pocket (MOOP) expense, is what safeguards you from the threat of high medical bills. Each year the Centers for Medicare and Medicaid Services (CMS) sets the maximum and an alternative minimum MOOP that plans may offer, so be sure to look for it when comparing your health insurance options.
About one-third of all seniors on Medicare enroll in a Medicare Advantage plan. You can learn more about this private health insurance option on our Medicare Advantage Frequently Asked Questions page and our Medicare Advantage Coverage page.
Medicare Supplement Insurance in Bernalillo County
If you like the flexibility of being able to see any doctor you choose, but you're concerned about paying 20% of all your medical bills, the solution is Medicare Supplement insurance. Commonly called Medigap, supplemental Medicare insurance helps pay your share of the Medicare costs.
Medigap insurance is available in New Mexico in ten standardized letter plans, A, B, C, D, F, G, K, L, M and N. There's also a high deductible version of Plan F. Plan A is the most basic and Plan F offers the most coverage possible.
It's critical that you understand how Medigap works. It does not give you extra healthcare benefits. If Medicare does not cover a healthcare expense, Medigap does not cover it. That includes your prescriptions, hearing aids, eye glasses, dental exams and other items that Medicare does not cover. Medigap works with everything covered under Medicare Part A and Part B.
Medicare Prescription Drug Plans in Bernalillo County
One of the most important healthcare benefits needed by most New Mexico seniors is prescription medication coverage, and it's not included in Original Medicare. If you want assistance paying for your prescriptions you must enroll in a Medicare Advantage plan that includes it, or join a Medicare Part D plan (PDP).
You have a variety of options available to you throughout New Mexico. This year there are a total of 31 prescription drug plans available, each with its own formulary. Monthly premiums start at just $12.60 and go up to $125.40 per month for the most inclusive extended plan. While shopping and comparing, don't forget to look at the annual deductible. This is what you will pay at the pharmacy before assistance begins.
Don't make the mistake of enrolling in a Medicare Part D plan because it's cheap. Your prescription drug insurance is important. Learn more about it by reading Medicare Part D Frequently Asked Questions and Medicare Part D Coverage.
How-To Find a Medicare Doctor in Bernalillo County, New Mexico
We've recently added all Bernalillo County Medicare doctors (primary care physicians for now) to MedicareWire.com. Doctors who treat Medicare patients are listed by city or town. We have school information, years of experience, hospital affiliations and insurances for doctors in Albuquerque, Cedar Crest, Isleta, Sandia Park, Tijeras, and surrounding areas.