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The 2020 Medicare Advantage Plans in Valencia County NM.

2018 Medicare Advantage Plans in Valencia County New Mexico

There are 18 Medicare Advantage Plans available in Valencia County NM from 10 different health insurance providers. 8 of these Medicare Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $3000 and the highest out of pocket is $6700. The highest rated plan available in Valencia County received a 4 overall star rating from CMS and the lowest rated plan is 3 stars. Valencia County New Mexico residents can also pick from 4 Medicare Special Needs Plans.

(Click the Plan Name for More Details)

Name Premium
Part D
 Gap  MOOP Overall Rating Formulary Sign Up
AARP MedicareComplete (HMO)
$0.00 $300.00 No $5,000 FormularyEnroll
AARP MedicareComplete Choice (PPO)
$14.00 $300.00 No $3,500 FormularyEnroll
Amerivantage Classic (HMO)
$24.60 $405.00 Yes $6,700 FormularyEnroll
Blue Cross Medicare Advantage Basic (HMO)
$0.00 $0.00 Yes $4,200 FormularyEnroll
Blue Cross Medicare Advantage Choice Plus (PPO)
$40.00 $405.00 Yes $6,700 FormularyEnroll
Blue Cross Medicare Advantage Flex (HMO-POS)
$151.00 $405.00 Yes $6,700 FormularyEnroll
Blue Cross Medicare Advantage Premier (HMO)
$60.00 $0.00 Yes $3,900 FormularyEnroll
Blue Cross Medicare Advantage Select (HMO)
$0.00 $405.00 Yes $6,400 FormularyEnroll
Humana Gold Choice H8145-123 (PFFS)
$103.00 $300.00 No N/A FormularyEnroll
Humana Gold Plus H2649-029 (HMO)
$0.00 $0.00 No $4,500 FormularyEnroll
HumanaChoice H5216-077 (PPO)
$0.00 $4,900 Enroll
HumanaChoice H5216-079 (PPO)
$25.00 $195.00 No $6,700 FormularyEnroll
Molina Medicare Options (HMO)
$0.00 $0.00 Yes $4,500 Formulary
Presbyterian MediCare PPO Plan 1 (PPO)
$95.00 $6,700
Presbyterian MediCare PPO Plan 2 with Rx (PPO)
$163.00 $375.00 No $6,700 Formulary
Presbyterian Senior Care Plan 1 (HMO)
$0.00 $6,700
Presbyterian Senior Care Plan 2 with Rx (HMO)
$37.00 $400.00 No $6,700 Formulary
Presbyterian Senior Care Plan 3 with Rx (HMO)
$127.00 $250.00 Yes $3,000 Formulary
Return to 2018 Medicare Advantage Plans in New Mexico

* Plan Type does not offer Medicare Part D drug coverage.

2018 Medicare Special Needs Plans in Valencia county New Mexico

Plan Name Monthly
Premium C+D
Part D
 Gap  Special Needs
Overall Rating
Blue Cross Medicare Advantage Dual Care (HMO SNP)
(H3822- 006)
   $24.60 $405.00  No Dual-Eligible
Molina Medicare Options Plus (HMO SNP)
(H9082- 007)
   $24.60 $405.00  No Dual-Eligible
Presbyterian Dual Plus (HMO SNP)
(H3204- 012)
   $24.60 $405.00  No Dual-Eligible
UnitedHealthcare Dual Complete (PPO SNP)
(H2228- 046)
   $20.00 $405.00  No Dual-Eligible

Plan Type Is the type of organization offering the Medicare Plans.

  • HMO - Health Maintenance Organization
  • PPO - Preferred Provider Organization
  • PDP - Prescription Drug Plan
  • SNP - Special Needs Plan
  • POS - Point of Service
  • PFFS - Private Fee For Service

Monthly Consolidated Premium (Includes Part C + D) Your premium may be lower depending on your eligibility for medical assistance. Call your provider for details.

Part D Total Premium: The Part D Total Premium is the sum of the Basic and Supplemental Premiums. Note: the Part D Total Premium is net of any Part A/B rebates applied to "buy down" the drug premium for Medicare Advantage; for some plans the total premium may be lower than the sum of the basic and supplemental premiums due to negative basic or supplemental premiums.

Benefit Type
  • (EA) Enhanced Alternative may offer additional gap coverage which is calculated as the percentage of generic formulary products with coverage above standard generic coverage gap cost-sharing benefit and/or the percentage of brand formulary products covered in addition to the coverage gap discount for applicable drugs.
  • (DS) Defined Standard Benefit
  • (BA) Basic Alternative
  • (AE) Actuarially Equivalent Standard


In 2018 once you and your plan provider have spent $3750 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA "donut hole") Once you reach the coverage gap you will pay 35% of the plans cost for covered brand-name prescription drugs and 44% on generic drugs unless your plan offers additional coverage.

Maximum Out-of-Pocket (MOOP) limit on enrollee spending that includes costs for all in-network Part A and Part B Services. NOT Part D - prescription drugs. N/A is defined as Not Applicable

Source: CMS.

Data as of September 5, 2017.

Plans are subject to change as contracts are finalized.

Includes 2018 approved contracts. Employer sponsored 800 series and plans under sanction are excluded. For 2018, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part D benefit.

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