Presbyterian Senior Care Plan 1 (HMO) in Valencia 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 Plan 1 (HMO) (H3204-008) is a $0-premium Medicare Advantage HMO from Presbyterian Healthcare Services available in Valencia County, New Mexico in 2026, with a 3.0-star overall rating, a $4,250 in-network out-of-pocket maximum, and a $0 annual Part D drug deductible.

Plan facts (CMS CY2026 Landscape file)

OrganizationPresbyterian Healthcare Services
Plan namePresbyterian Senior Care Plan 1 (HMO)
Contract IDH3204
Plan ID008
Segment ID0
Contract year2026
Contract categoryMA
Plan typeHMO
SNPNo
Monthly consolidated premium
Part C premium$0.00
Part D basic premium
Part D total premium
Annual Part D deductible
Maximum out-of-pocket (in-network)$4250.00
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.
  • $4,250 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 = Valencia 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 Valencia County

The CMS CY2026 Landscape file lists 37 Medicare Advantage plans in Valencia County, New Mexico, of which 0 carry a 5.0-star overall rating and 28 have a $0 consolidated monthly premium. Consolidated premiums range from $0.00 to $114.00 per month, and in-network out-of-pocket maximums range from $3250.00 to $9250.00.

For the full county plan directory, see all Medicare plans in Valencia 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 — H3204-008.
  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 H3204-008 means

CMS assigns every Medicare Advantage and Part D offering a plan identifier made of three parts. In H3204-008, 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 008 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 Plan 1 (HMO) an HMO or PPO?

Presbyterian Senior Care Plan 1 (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 Plan 1 (HMO) include prescription drug coverage?

Presbyterian Senior Care Plan 1 (HMO) does not include Part D prescription drug coverage in its consolidated benefits.

What is the maximum out-of-pocket cost for Presbyterian Senior Care Plan 1 (HMO)?

The 2026 in-network maximum out-of-pocket limit for Presbyterian Senior Care Plan 1 (HMO) is $4250.00, per the CMS CY2026 Landscape file.

What counties offer Presbyterian Senior Care Plan 1 (HMO) (H3204-008)?

Presbyterian Senior Care Plan 1 (HMO) (H3204-008) 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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