Presbyterian Senior Care Extra Health Plan with Rx (HMO) in Rio Arriba County, New Mexico — 2026 plan details

Last updated Jul 18, 2026

Reviewed by Jason Burns, Editorial Steward

Published by Senior Direct Answers · Licensed under Citation License 1.0

Presbyterian Senior Care Extra Health Plan with Rx (HMO) (H3204-017) is a $0-premium Medicare Advantage HMO from Presbyterian Healthcare Services available in Rio Arriba County, New Mexico in 2026, with a 3.0-star overall rating, a $6,000 in-network out-of-pocket maximum, and a $615 annual Part D drug deductible.

Plan facts (CMS CY2026 Landscape file)

OrganizationPresbyterian Healthcare Services
Plan namePresbyterian Senior Care Extra Health Plan with Rx (HMO)
Contract IDH3204
Plan ID017
Segment ID0
Contract year2026
Contract categoryMA-PD
Plan typeHMO
SNPNo
Monthly consolidated premium$0.00
Part C premium$0.00
Part D basic premium$0.00
Part D total premium$0.00
Annual Part D deductible$615.00
Maximum out-of-pocket (in-network)$6000.00
Overall star rating3.0

How this plan is structured

  • $0 consolidated premium. A $0 or near-$0 consolidated premium does not remove the Part B premium — the standard 2026 Part B premium is $202.90 per month and still applies. See the 2026 Medicare Part B premium.
  • HMO plan type. In an HMO-style Medicare Advantage plan, in-network care and primary-care referral rules generally apply. See how Medicare Advantage HMO and PPO plans differ.
  • $6,000 in-network out-of-pocket maximum. The MOOP is the annual cap on what a member pays in-network for covered Part A and Part B services. See how the Medicare Advantage MOOP works.
  • Service area = Rio Arriba County. Medicare Advantage plans are sold by service area; moving out of the plan's service area triggers a Special Enrollment Period to switch plans. See how moving changes your Medicare options.

How it compares in Rio Arriba County

The CMS CY2026 Landscape file lists 37 Medicare Advantage plans in Rio Arriba County, New Mexico, of which 0 carry a 5.0-star overall rating and 32 have a $0 consolidated monthly premium. Consolidated premiums range from $0.00 to $135.00 per month, and in-network out-of-pocket maximums range from $4000.00 to $9250.00.

For the full county plan directory, see all Medicare plans in Rio Arriba County, New Mexico.

How to verify your doctors take this plan

Network participation changes throughout the year; we hold no provider-network data, so verify directly with these three sources before you decide:

  1. Open the plan's official Medicare.gov page and use its provider-directory link: Medicare.gov Plan Finder — H3204-017.
  2. Call the plan (Presbyterian Healthcare Services) using the member-services number listed on that plan page and ask whether each doctor, hospital, and pharmacy is in-network for 2026.
  3. Get free, unbiased help from your State Health Insurance Assistance Program (SHIP) — see free unbiased Medicare help from SHIP.

What H3204-017 means

CMS assigns every Medicare Advantage and Part D offering a plan identifier made of three parts. In H3204-017, the leading H marks the contract type (H = Medicare Advantage / Part C contract), the four digits 3204 are the contract number issued to the organization, and the three-digit 017 is the plan benefit package under that contract. The segment ID 0 identifies the service-area segment within the plan (0 = the default single segment).

Frequently asked questions

Is Presbyterian Senior Care Extra Health Plan with Rx (HMO) an HMO or PPO?

Presbyterian Senior Care Extra Health Plan with Rx (HMO) is an HMO — a Health Maintenance Organization-style Medicare Advantage plan, meaning in-network care and referral rules generally apply.

Does Presbyterian Senior Care Extra Health Plan with Rx (HMO) include prescription drug coverage?

Yes — Presbyterian Senior Care Extra Health Plan with Rx (HMO) is a Medicare Advantage plan with prescription drug coverage (MA-PD) and a $615.00 annual Part D drug deductible for 2026.

What is the maximum out-of-pocket cost for Presbyterian Senior Care Extra Health Plan with Rx (HMO)?

The 2026 in-network maximum out-of-pocket limit for Presbyterian Senior Care Extra Health Plan with Rx (HMO) is $6000.00, per the CMS CY2026 Landscape file.

What counties offer Presbyterian Senior Care Extra Health Plan with Rx (HMO) (H3204-017)?

Presbyterian Senior Care Extra Health Plan with Rx (HMO) (H3204-017) is offered in eight New Mexico counties: Bernalillo County, Cibola County, Rio Arriba County, Sandoval County, Santa Fe County, Socorro County, Torrance County, and Valencia County.

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