Presbyterian Healthcare Services: Health Insurance
Presbyterian Healthcare Services additionally named its management center as the Rev. Hugh A Cooper Administration Center after its founder. This building placed near the Albuquerque International Balloon Fiesta Park, homes the executives of the business enterprise in addition to 2,500+ everlasting and gotten smaller personnel with a day by day visitation of up to a few,500+ employees, patients, contractors and clients at its management middle.
The Presbyterian Hospital Center grew through the Sixties and Seventies: Kaseman Hospital, a satellite facility in northeastern Albuquerque opened, the country’s first HMO health plan became hooked up, a statewide multi-medical institution machine became fashioned. The Presbyterian Hospital Center became renamed Southwestern Community Health Services, and in the end the present Presbyterian Hospital.
WHY CHOOSE PRESBYTERIAN?
We assist make it smooth to manipulate your care. Presbyterian Centennial Care is designed to hold you in proper health. We allow you to in case you are healthy or if you have special wishes or need complex healthcare services.
Presbyterian Healthcare Services has served New Mexicans for greater than 110 years. We have cared for New Mexico’s Medicaid individuals due to the fact that 1997.
You will get many fee-brought blessings in addition to the same old Centennial Care benefits if you pick out Presbyterian. These are:
Medisafe Medication Reminder – This is a remedy reminder that you could download for free on your phone. It assist you to manage the medicines for you and/or several participants of your own family on one phone. It also can music all the medicinal drugs for you and your family and tell you when it’s time to get one or more of them refilled. It works with iPhone or the ones telephones with Android.
Traditional Medicine Value Added Service – We know that Traditional Customs are a essential a part of fitness and wellbeing to Native American humans. We are seeking for to honor and help your lifestyle with the Traditional Medicine Value Added Service. This Value Added Service can help with $300 as soon as in keeping with calendar yr (January 1 to December 31). This carrier is simplest to be had to Native American Centennial Care members.
Baby benefit new discern application – Reward Gift cards. Prenatal participants participating in PHP Baby Benefits program and qualify for the prenatal go to necessities and Postpartum appointment will acquire a SKU-restrained present card to purchase toddler associated items such as diapers, journey crib, stroller or automobile seat.
Baby Bonuses software – Baby Bonuses is a no-fee application that gives rewards for taking your baby to their well-child checkups. When you whole the stairs within the program, you could earn gift card incentives. Presbyterian Baby Bonuses is most effective available to Presbyterian Centennial Care members.
Enhanced care coordination specialized services – Additional services for participants in care coordination best; ought to be authorized through a care coordinator. These services encompass caregiver help packages, domestic monitoring for excessive-risk contributors, and individualized offerings for participants who meet criteria.
School Based Health Clinic (SBHC) – This gain is to reimburse SBHC for interdisciplinary conferences conducted via the heath care body of workers of the SBHC. This service is for Centennial Care individuals and ABP members who’re non-dual participants.
School Sports Physicals – A physical exam to permit kids 12-18 years old to participate in carrying activities and crowning glory of the wished bureaucracy. This is a restrained bodily examination and is not similar to a routine nicely-toddler examination or normal bodily.
Tabtime Vibe Vibrating Pill Time Reminder – If you find it tough to take into account when to take your medication(s) as your physician prescribed, this contemporary version of the conventional plastic pill case might also assist. Tabtime is available for much less than $20, and it has 5 cubicles with exclusive alarms that vibrate while it’s time to take your remedy.
Wellness Classes – Wellness classes for adults with a diagnosis of diabetes or participants age five – 64 identified with Asthma.
LOSING YOUR INDIVIDUAL PLAN COVERAGE?
Presbyterian Health Plan offers plans to match both your fitness desires and your price range. From complete coverage to fundamental essential health care, our plans fall into three tiers, which fluctuate primarily based at the manner you and the health plan percentage your health care prices.
Basic Presbyterian Health plans
There are following Health Plans of Presbyterian Healthcare Services:
- Individual & Family Plans
- Medicare Advantage Plans
- Centennial Care Medicaid Plans
- Employer-Offered Plans
- Individual & Family Plans
Presbyterian Health Plan will maintain to provide Individual and Family Plans thru the New Mexico Health Insurance Exchange (additionally called beWellnm). Enrolling through beWellnm permits those who are eligible for a tax credit score to get medical health insurance at a lower value, which include month-to-month charges, deductibles, copayments, and coinsurance. To find out if you are eligible for a tax credit and save for eligible Presbyterian Health Plans
- Medicare Advantage Plans
Whether you lately became 65 or are looking for a loved one, we make getting Medicare coverage clean.
Get the blessings and savings you’ve earned with a Presbyterian Medicare Advantage Plan. Presbyterian gives you the value that incorporates our system of physicians, hospitals, and a fitness plan – all working collectively to hold you healthy.
Our Presbyterian Medicare Advantage plans provide extra methods to securely get the care you want from home and they offer extra blessings than unique Medicare, including:
- An $860 flex card to help pay for over-the-counter tablets and extra with the UltraFlex plan
- No-cost number one care visits
- $zero for telehealth visits through video, on line, or telephone with in-community number one care vendors, experts, and pressing care.
- More $0 advantages such as fundamental dental offerings, a listening to examination, lab services, diabetic check supplies, outpatient behavioral health visits and diagnostic checks
- No prescription drug deductible and $zero favored established capsules for HMO Plans 2 and 3
- Coverage for emergency and pressing care anywhere inside the world
- Routine acupuncture and chiropractic care
- Gym memberships blanketed through SilverSneakers
- Centennial Care Medicaid Plans
Are you looking for a Medicaid plan on the way to assist to maintain you healthy and satisfied? The Presbyterian Centennial Care plan can do this. Presbyterian Centennial Care offers you the fundamental benefits you need, plus greater value-delivered benefits. It is funded in part under a agreement with the State of New Mexico. The plan includes bodily fitness, behavioral fitness, and lengthy-term care services.
Apply for Centennial Care Medicaid
A LIST OF THINGS YOU NEED TO APPLY FOR CENTENNIAL CARE:
- Proof of your earnings
- Proof that you are a U.S. Citizen or a lawful everlasting resident (only the character applying wishes to expose this proof)
- Proof that you live in New Mexico
Centennial reward
Centennial Care will reward you for doing something top in your health. You can earn factors for making certain healthful picks. If you get certain clinical assessments or fill positive prescriptions (drugs) that assist preserve you healthy, you will earn reward factors. Spend your rewards factors on health, wellbeing and fitness gadgets
Transportation Benefits
Presbyterian Centennial Care affords non-emergency transportation to blanketed clinical and behavioral health offerings. Our transportation accomplice has different kinds of transportation available. The kind you qualify for is primarily based for your clinical want, your pickup vicinity, and where you are going.
Our transportation accomplice gives:
- Ambulatory cars for members who are in a position to stroll around without help
- Public, fixed-route bus (as an example, ABQ City Bus Transportation)
- Through-the-door-shared-transportation vehicle
- Wheelchair equipped motors
Our transportation accomplice will ask inquiries to discover what form of trip you want. They will even ask you questions on the visit to ensure that they recognise the place you are requesting to visit.
Emergency Transportation
If you need emergency transportation for a existence-threatening state of affairs, call 911 or the emergency smartphone quantity on your region. We cover emergency transportation by using ambulance, air ambulance, or specially-prepared van. You should bring your Presbyterian Centennial Care member ID card with you at all times.
Same-day Transportation
You can get identical-day transportation most effective in case you want pressing healthcare offerings and don’t have a experience. You can’t get identical-day transportation if you forgot to arrange a journey for a scheduled appointment.
If you are unwell and experience like you want to see your number one care issuer (PCP) that identical day, call your PCP. He or she will be able to assist making a decision if you should are available in that day. The PCP may ship you to an urgent care center rather.
Presbyterian Baby Benefits
Baby Benefits is a free program that offers rewards for attending prenatal and publish-natal appointments. We need that will help you revel in and recognize your pregnancy. We provide:
- Gift card incentives for going on your prenatal physician visits
- Care coordination services when you have a excessive-hazard being pregnant
- A 24/7 PresRN phone line for help any time of the day or night time
- Transportation services to and out of your physician visits
- Help with making your physician’s appointments
When you entire steps within the software, you could earn present card incentives. Presbyterian Baby Benefits is best available to Presbyterian Centennial Care members.
Such offerings are funded in part with the State of New Mexico.
Centennial Care for Native Americans
Presbyterian has been part of New Mexico’s records for over a hundred years. We are the only fitness plan that has been serving Medicaid individuals since New Mexico commenced providing Medicaid plans over 20 years in the past. We are proud to remain your accomplice in fitness.
Presbyterian is devoted to improving the health of Native American members, patients and communities we serve.
- People First: Members, Patients, Employees and Clinician Partners
- Wholeness: Body, Mind, Spirit and Community
- High Performance: Excellence, Innovation, Teamwork and Trust
CHOOSE PRESBYTERIAN AS YOUR PARTNER IN HEALTH
Presbyterian Centennial Care is designed to preserve you in true health. Along with the standard Centennial Care blessings, we give you value brought offerings and the equipment that will help you attain your high-quality health. Presbyterian Health Plan also has a devoted Native American team to help you with your healthcare wishes.
We are a Managed Care Organization (MCO) Medicaid plan that helps manipulate your healthcare desires. We assist you get entry to healthcare offerings while you are healthful and when you aren’t. We additionally help if you have unique wishes or want complex healthcare offerings. Also, Native American Centennial Care participants do now not pay copays when receiving scientific offerings.
You can pick out Presbyterian Centennial Care when you entire the Medicaid application.
PRESBYTERIAN CENTENNIAL CARE PROVIDES YOU WITH ALL THE CARE YOU NEED
Benefits include Preventative care, Care for pregnant mothers, Dental and vision offerings, Disease control, Urgent or emergency care, Long-term services and assist, Prescription drug coverage, Behavioral fitness services and lots greater.
Native Americans can acquire healthcare provider at Indian Health Service, Tribal Healthcare Facilities, Urban Indian Health Centers (I/T/Us) in addition to the Presbyterian Health Plan network of providers
- Employer-Offered Plans
Working together with your organization to get you and your family covered is very important to us. Presbyterian Health Plan, Inc. And Presbyterian Insurance Company, Inc. Are pleased to associate with New Mexico’s main corporations to offer coverage plans to keep their employees healthy. Presbyterian’s fitness plans offer an expansion of coverage, a couple of deductibles and premium options, and masses of extras to assist preserve you and your family healthy.
Presbyterian Health Plan also partners with region businesses to provide organization-subsidized Medicare, helping to inspire persevering with adventure and enjoyment.
Understanding Health Insurance
Insurance can be one of the maximum perplexing parts of healthcare. We need you to feel confident on your choice for insurance and to recognize how to excellent use your plan advantages. That’s why Presbyterian Health Plan presents resources that will help you make the maximum informed selections for you and your circle of relatives.
WHY CHOOSE A PRESBYTERIAN HEALTH PLAN?
Presbyterian Health Plan offers you a choice of many sorts of health insurance with specific advantages and services, in addition to a wide community of vendors.
HOW TO SHOP FOR INSURANCE
Are you equipped to enroll in a health plan but aren’t certain where to begin? Our simple guide allows you recognize primary terms, expenses and other healthcare subjects, so that you can pick the plan that high-quality suits your scenario and budget.
TYPES OF INSURANCE
We are right here to help you recognize the one-of-a-kind types of insurance (each personal and public), so you could make the maximum knowledgeable desire.
UNDERSTANDING HEALTHCARE COSTS
Healthcare fees don’t stop when you pay your monthly plan top class—there can be copays, coinsurance and deductibles to consider. Presbyterian desires to help you avoid the annoying marvel of surprising healthcare prices by means of supporting you to recognize the fundamentals of healthcare prices.
UNDERSTANDING FORMULARIES
Formularies are lists of pharmaceuticals (each brand name and ordinary) that your plan covers. The drugs fall into one-of-a-kind classes and might cost unique quantities. Here, we assist you apprehend how those lists paintings.
DOES THE AFFORDABLE CARE ACT (ACA) AFFECT ME?
Also known as Obamacare, the Affordable Care Act modified a variety of the regulations approximately health insurance—from the eligibility of plans to the elimination of lifetime maximums. Learn how these new legal guidelines ought to have an effect on you and your coverage.
GLOSSARY OF TERMS
Not positive what a sure phrase method? Look it up in our word list, filled with helpful phrases and meanings.
FRAUD & ABUSE
Report an incident right here by way of contacting our Special Investigative Unit, available 24 hours an afternoon. If you’re unsure approximately what fraud and abuse incidents entail, we provide described examples of every man or woman case.
APPEALS, GRIEVANCES & EXCEPTION PROCESS
If you have got worries or complaints concerning your coverage or care, file an professional grievance the usage of those easy steps. Not positive what type of complaint applies on your scenario? We can help with that, too.
