Presbyterian MA Plans End Dec. 31: Your Clients Need a New Plan

Coverage holds through 2026. Clients who don't choose a new plan this AEP start 2027 without drug coverage.

If you have Presbyterian Medicare Advantage clients in New Mexico, every one of them on the plans below needs a new plan for 2027. Clients who don't choose one before January 1, 2027 will be moved to Original Medicare (Parts A and B) automatically, and Original Medicare does not include Part D drug coverage.

Presbyterian Health Plan has announced that its Presbyterian Medicare Advantage Senior Care Plans (HMO/HMO-POS) will end on December 31, 2026. The good news for your clients is that their current coverage stays in place through December 31, 2026, so they can keep seeing in-network providers and getting their medications as they do today while you help them choose what comes next.

The Plans That Are Ending

These Presbyterian Medicare Advantage plans end on December 31, 2026:

• Presbyterian Senior Care Plan 1 (HMO)

• Presbyterian Senior Care Plan 2 w/Rx (HMO)

• Presbyterian Senior Care Plan 3 w/Rx (HMO)

• Presbyterian Senior Care Extra Health Plan w/Rx (HMO)

• Presbyterian Employer Group 4 Plan (HMO-POS)

• Presbyterian Senior Care (HMO-POS) NMRHCA Group Medicare Advantage Plan

• Presbyterian Senior Care (HMO-POS) The University of New Mexico (UNM) Premier and Select Plan

Presbyterian will not offer general enrollment Medicare Advantage plans after December 31, 2026, so these clients will need a plan from another carrier. If a client isn't sure which plan they have, it's on their member ID card.

Who Isn't Affected

Clients on a Presbyterian Dual Plus (D-SNP) plan are not affected by this change. Presbyterian notes that D-SNP eligibility in 2027 requires enrollment in its Turquoise Care Medicaid plan. Clients on Original Medicare only, or on Medicaid/Turquoise Care, are also not affected.

When Clients Can Make a Change

Clients cannot change their plan until October 15, 2026. Presbyterian is directing members to choose a new plan during the Annual Enrollment Period, October 15 through December 7, 2026. Presbyterian also notes that some members may have additional time during Open Enrollment (January 1 through March 31) and a Special Enrollment Period (January 1 through February 28), but it recommends making the change during AEP so there is no gap in coverage.

What to Cover in the Conversation

Before you recommend a new plan, check which Medicare plans your client's primary care provider and specialists accept, since that may decide where they land. Clients with a prior authorization for surgery or other services scheduled in 2027 will need to work with their new plan to keep that care on track. Clients can also keep using myPRES and MyChart to access their claims information and Presbyterian Medical Group records after the change.

Where Your Clients Can Get Help from Presbyterian

Presbyterian has set up a dedicated Medicare Advantage helpline at (505) 923-2000, TTY 711, open seven days a week from 8 a.m. to 8 p.m. through March.

Presbyterian is also holding a resource day at its Health Plan Place Winrock location on October 22, 2026, from 10 a.m. to 2 p.m., at 2100 Louisiana Blvd NE, Suite 408, Albuquerque, NM 87110.