2018 Presbyterian MediCare PPO Plan 1 (PPO) H3206-3-0 in NM from Presbyterian | HealthPocket

Presbyterian MediCare PPO 1 (PPO)

Medicare Advantage Plan for New Mexico

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PARTC

Plan Summary

Insurance TypeMedicare Advantage Plan (Part C)
Insurance ProviderPresbyterian
Plan IDH3206-3-0
CMS Rating1
Plan TypePPO
Annual Deductible$0.00

What To Know About This Plan

  • This is a health coverage only plan with no drug coverage

Why We Like This Plan

  • gives you freedom to choose which doctors, specialist and hospitals you visit

Plan Details

Costs and Other Important Information

Plan Year:2018
Prescription Drugs Covered?Yes
Health Plan Deductible$0
Monthly Drug Plan Premium$0
Monthly Health Plan Premium$95

Coverage Area for Presbyterian MediCare PPO 1 (PPO)

StateNew Mexico
CountyBernalillo

CMS Ratings

Staying healthy - screenings, tests and vaccines

Breast cancer screening
Colorectal cancer screening
Annual flu vaccine
Improving or maintaining physical health
Improving or maintaining mental health
Monitoring physical ability
Adult BMI assessment

Managing Chronic Conditions

Special needs plan care management
Not Rated
Care for older adults – medication review
Not Rated
Care for older adults – functional status assessment
Not Rated
Care for older adults – Pain screening
Not Rated
Osteoporosis management in women who had a fracture
Diabetes care – eye exam
Diabetes care – kidney disease monitoring
Diabetes care – blood sugar controlled
Controlling blood pressure
Rheumatoid arthritis management
Reducing the risk of falling
Plan all-cause readmissions

Member Experience with Health Plan

Getting needed care
Getting appointments and care quickly
Customer service
Overall rating of health care quality
Overall rating of plan
Care Coordination

Member Complaints, and Changes in Health Plan's Performance

Complaints about the health plan
Members choosing to leave the health plan
Beneficiary access and performance problems
Health plan quality improvement

Health Plan Customer Service

Plan makes timely decision about appeals
Reviewing appeals decisions
Call center – foreign language interpreter and TTY/TDD availability - Medical

Drug Plan Customer Service

Call center – foreign language interpreter and TTY/TDD availability - Drugs
Appeals auto-forward
Appeals upheld

Member Complaints, and Changes in Drug Plan's Performance

Complaints about the drug plan
Members choosing to leave the drug plan
Not Rated
Beneficiary access and performance problems
Drug plan quality improvement

Member Experience with Drug Plan

Rating of drug plan
Getting needed prescription drugs

Drug Pricing and Patient Safety

MPF Price Accuracy
High risk medication
Part D medication adherence for diabetes
Part D medication adherence for hypertension
Part D medication adherence for cholesterol
Medication Therapy Management program completion rate

Physician Finder

Physicians that accept Presbyterian MediCare PPO 1 (PPO) for New Mexico

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DOZEMAN, LYNN
6900 GONZALES RD SW
ALBUQUERQUE, NM 87121
BUXTON, BENJAMIN
6900 GONZALES RD SW
ALBUQUERQUE, NM 87121
TAM, ADELA
6900 GONZALES RD SW
ALBUQUERQUE, NM 87121
CANDELARIA, DELFINO
6900 GONZALES RD SW
ALBUQUERQUE, NM 87121
PEACHEY, MARILYN
10000 KING RANCH LN SW
ALBUQUERQUE, NM 87121
FETNER, JEAN
8901 BLUEWATER RD NW
ALBUQUERQUE, NM 87121
MONTOYA, ANDREA
2200 GUN CLUB RD SW
ALBUQUERQUE, NM 87105
MILLER, FREDERICK
2001 EL CENTRO FAMILIAR BLVD SW
ALBUQUERQUE, NM 87105
SHELLEY, BRIAN
2001 EL CENTRO FAMILIAR BLVD SW
ALBUQUERQUE, NM 87105
PONCE, LIANA
2001 EL CENTRO FAMILIAR BLVD SW
ALBUQUERQUE, NM 87105
JACOBSOHN, VANESSA COOK
2001 EL CENTRO FAMILIAR BLVD SW
ALBUQUERQUE, NM 87105
JANSEN, SHARI
2701 DON FELIPE RD SW
ALBUQUERQUE, NM 87105
GURULE, MONICA
5309 DON MARIANO RD SW
ALBUQUERQUE, NM 87105
BUCKELS, WENDY
2410 VENETIAN WAY SW
ALBUQUERQUE, NM 87105
Details
LYNN DOZEMAN, MD
Phone Number
(505) 831-2534
Office Locations
6900 GONZALES RD SW
ALBUQUERQUE, NM 87121
6900 GONZALES RD SW ALBUQUERQUE NM, 87121

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