Presbyterian Senior Care Plan 1 (HMO) Medicare Advantage Plan H3204-008 • 2026 • Santa Fe County, NM

Presbyterian Senior Care Plan 1 Overview

Plan Details for Presbyterian Senior Care Plan 1

This Medicare Advantage HMO plan provides Medicare Part A and Part B coverage through a network of participating providers. The monthly premium is $0.00, and services are generally covered when received from in-network providers, except in emergency situations.

Primary care visits have a $0 copay, specialist visits come with a $30 copay, urgent care services carry a $20-$50 copay, and ambulance transportation is $350 copay. These costs apply toward the annual out-of-pocket maximum (MOOP) of $4250.00. Once this limit is reached, in-network services are fully covered for the remainder of the year.

This plan is listed by CMS under Plan ID H3204-008. Cost-sharing details are provided below.

Cost-Sharing Overview

Cost-sharing for Presbyterian Senior Care Plan 1 includes out-of-pocket expenses for covered healthcare services. The table below provides a summary of typical in-network out-of-pocket costs for plan H3204-008.

Certain preventive services are covered 100% by Presbyterian Senior Care Plan 1 as a Part B benefit.

Prescription Drug Coverage

This plan does not include a Medicare Part D plan for prescriptions.

Medicare Plan Star Ratings

Medicare Advantage (Part C) and Part D plans are rated each year by CMS on a 5-star scale. Ratings summarize plan performance across clinical care and member experience measures.