Plan year 2026 · coverage ends Dec. 31, 2026CMS crosswalk of Oct. 1, 2026
Presbyterian Senior Care Extra Health Plan with Rx is not offered under this ID in 2027
H3204Contract017Plan
HMO · served 8 counties in New Mexico in 2026
Run by Presbyterian Health Plan (contract H3204), sold as Presbyterian Health Plan, owned by Presbyterian Healthcare Services
CMS crosswalk: members move into H3204-013
Presbyterian Senior Care Extra Health Plan with Rx (H3204-017) is not offered under this ID in 2027: the CMS plan crosswalk of October 1, 2026 moves its members into Presbyterian Dual Plus (H3204-013), which is sold in every county it served. 936 people were enrolled in it in September 2026; they can also choose another plan during open enrollment, October 15 to December 7, 2026. The crosswalk also lists part of the plan as terminated without saying which members; your Annual Notice of Change says whether you move to a new plan or your coverage ends.
What changes for its members in Presbyterian Dual Plus?
| What you pay or get | 2026 | 2027 | Change |
|---|---|---|---|
| Plan name | Presbyterian Senior Care Extra Health Plan with Rx | Presbyterian Dual Plus | renamed |
| In-network out-of-pocket limit | $6,000 | $9,850 | ▲up $3,850 |
| Drug deductible | $615 | $700 | ▲up $85 |
| Part B premium reduction, monthly (best in its area) | $1 | none | ▼dropped |
| Primary care visit (best in its area) | $0 copay | 20% of the cost | changed |
| Specialist visit (best in its area) | $40 copay | 20% of the cost | changed |
| Emergency room (best in its area) | $130 copay | 20% of the cost | changed |
| Hospital stay, in network (best in its area) | $400 a day for days 1–5, then $0 a day for days 6–90 | not filed | changed |
| Skilled nursing facility, in network (best in its area) | $0 a day for days 1–20, then $195 a day for days 21–100 | not filed | changed |
| Ground ambulance, in network (best in its area) | $350 copay | 20% of the cost | changed |
| Eyewear, yearly limit (best in its area) | $265 a year | $275 a year | ▲up $10 |
| Hearing aids, yearly limit for both ears (best in its area) | not offered | $1,000 a year | ▲added |
| Over-the-counter items, yearly (best in its area) | $180 a year | $660 a year | ▲up $480 |
| Counties served | 8 | 33 | ▲up 25 |
| 3 lines do not change | |||
| Monthly premium | $0 | $0 | no change |
| Medical deductible, in network (best in its area) | none | none | no change |
| Comprehensive dental, yearly limit (best in its area) | not offered | not offered | no change |
Source: CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026); CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS plan benefit package files, 2027 and 2026. Your plan's Annual Notice of Change is the letter that confirms your 2027 plan; confirm on Medicare Plan Finder.
What can members do, and by when?
If your notice says you move to a new plan
- If you do nothing
- You are moved into Presbyterian Dual Plus on January 1, 2027.
- October 15 to December 7, 2026
- Open enrollment: choose another Medicare Advantage plan, or Original Medicare with a drug plan, instead.
If your notice says your plan is ending
- Your coverage
- Ends December 31, 2026.
- October 15 to December 7, 2026
- Open enrollment: join another Medicare Advantage plan, or Original Medicare with a drug plan. Coverage starts January 1, 2027.
- December 8, 2026 to the end of February 2027
- A special enrollment period because the plan is leaving: you can still join a plan, but coverage starts the first day of the month after you join, so choose by December 31 to have no gap.
- If you do nothing
- You are enrolled in Original Medicare when the plan ends, without a drug plan unless you join one; with Extra Help or full Medicaid, Medicare enrolls you in one.
- If you have Medicaid or Extra Help
- You can switch to a different drug plan, or leave a Medicare Advantage plan for Original Medicare with a drug plan, once a calendar month; the change starts the first day of the next month.
Source: Medicare.gov, “Special enrollment periods” and “Joining a plan” (read Oct. 7, 2026).
Where did its members live?
Where its members lived in September 2026; each county and state page lists the 2027 plans sold there.
| County | Members, Sept. 2026 | For 2027 |
|---|---|---|
| Bernalillo, NM | 511 | moves into H3204-013 |
| Sandoval, NM | 129 | moves into H3204-013 |
| Socorro, NM | 99 | moves into H3204-013 |
| Valencia, NM | 95 | moves into H3204-013 |
| Santa Fe, NM | 48 | moves into H3204-013 |
| Torrance, NM | 24 | moves into H3204-013 |
| Cibola, NM | 15 | moves into H3204-013 |
| Rio Arriba, NM | 11 | moves into H3204-013 |
Source: CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11).
What else should you check?
- 2027 plans in Bernalillo, NMThe plans you can join instead
- Presbyterian Health Plan plans for 2027Plans the same company still offers
- Every plan not offered in 2027764 Medicare Advantage and drug plans