Presbyterian Senior Care Extra Health Plan with Rx (HMO) is a Medicare Advantage Plan by Presbyterian Health Plan.
This page features plan details for 2026 Presbyterian Senior Care Extra Health Plan with Rx (HMO) H3204 – 017 – 0.
IMPORTANT: This page has been updated with plan and premium data for 2026. Enrollment for 2026 plans starts Oct 15, 2025.
Presbyterian Senior Care Extra Health Plan with Rx (HMO) is offered in the following locations.
Presbyterian Senior Care Extra Health Plan with Rx (HMO) offers the following coverage and cost-sharing.
| Insurer: | Presbyterian Health Plan |
| Health Plan Deductible: | |
| MOOP: | $6,000.00 |
| Drugs Covered: | Yes |
Ready to sign up for Presbyterian Senior Care Extra Health Plan with Rx (HMO) ?
Get help from a licensed insurance agent.
Call 1-877-354-4611 / TTY 711.
M-F: 8:00 am – 10:00 pm EST
Sat-Sun: 8:00 am – 9:00 pm EST
| Part B | Part C | Part D | Part B Give Back | Total |
|---|---|---|---|---|
| $206.50 | $0.00 | $0.00 | $ | $ |
Presbyterian Senior Care Extra Health Plan with Rx (HMO) provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.
| Drug Deductible: | $615.00 |
| Drug Out-Of-Pocket maximum: | $2100.00 |
| Drug Benefit Type: | Defined Standard |
The Low-Income Subsidy (also known as LIS or “Extra Help”) helps people with Medicare lower the cost of prescription drugs.
The table below shows how the LIS impacts the Part D premium of this plan.
| Part D | LIS Full |
|---|---|
| $0.00 | $0.00 |
After you pay your $615.00 drug deductible, you will pay the following costs for drugs in each tier until your total drug costs (including what this plan has paid and what you have paid) reach $2100.00. Once you reach that amount, you will enter the next coverage phase.
After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $2100.00, you pay nothing for Medicare Part D covered drugs.
Ready to sign up for Presbyterian Senior Care Extra Health Plan with Rx (HMO) ?
Get help from a licensed insurance agent.
Call 1-877-354-4611 / TTY 711.
M-F: 8:00 am – 10:00 pm EST
Sat-Sun: 8:00 am – 9:00 pm EST