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Presbyterian Medicare Advantage 2027: Most Plans End, Only Dual Plus Remains

Reviewed by Russell Noga, Licensed Medicare Insurance Broker (all 50 states) — Last updated November 5, 2026

Presbyterian Health Plan is ending most of its Medicare Advantage plans on December 31, 2026. The Albuquerque-based nonprofit announced on June 2, 2026 that it would keep only one Medicare Advantage product for 2027: Presbyterian Dual Plus, a plan for people who have both Medicare and Medicaid. KOB 4 reports about 30,000 members must find new coverage.

Our count of CMS’s 2027 plan files backs this up. Every Presbyterian plan filed for 2027 is a Dual Plus D-SNP segment, and there is no Presbyterian plan anyone with Medicare alone can join. This guide covers why Presbyterian pulled back, who can still get Dual Plus, and which New Mexico plans former members are comparing for January 1, 2027.

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Presbyterian Medicare Advantage 2027: about 30,000 members must switch, 0 plans for Medicare-only members, Presbyterian Dual Plus in all 33 New Mexico counties, 61 New Mexico plans from 7 companies

Why Presbyterian Dropped Most of Its Medicare Advantage Plans

What happened Detail
Announcement June 2, 2026, alongside about 150 health plan and administrative job cuts (no direct patient care roles)
Plans ending Most Presbyterian Medicare Advantage plans, effective December 31, 2026
Plan kept Presbyterian Dual Plus Special Needs Plan (HMO D-SNP)
Members affected About 30,000 (KOB 4)
Losses cited More than $59 million in 2025 from the discontinued plans (Healthcare Finance News)

Sources: KOB 4, June 2-3, 2026; Healthcare Finance News; Santa Fe New Mexican via InsuranceNewsNet, June 19, 2026.

At a New Mexico legislative committee hearing in June, Presbyterian Chief Operations Officer John Johnson called it “financially unsustainable” for the organization to stay in the basic Medicare Advantage market, pointing to rising medical costs, regulatory changes and administrative complexity, the Santa Fe New Mexican reported. Fitch Ratings had already cut Presbyterian’s credit rating to AA- from AA in February 2026, citing weak operating results.

The hospitals and clinics are not going anywhere. Presbyterian Healthcare Services still runs its hospitals and medical group, and the cuts target the health plan side, not patient care.

Our Analysis: What Presbyterian Filed for 2027

Our analysis of CMS 2027 plan data

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One product, 3 filings: Presbyterian’s 2027 lineup is Presbyterian Dual Plus (HMO D-SNP), filed as 3 regional segments under contract H3204.

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All 33 counties: together the segments cover every New Mexico county. One covers the Albuquerque, Santa Fe and Las Cruces areas (Bernalillo, Doña Ana, Sandoval, Santa Fe, Valencia), one covers 8 counties such as San Juan, McKinley, Chaves and Curry, and one covers the other 20.

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0 plans for Medicare-only members: no Presbyterian HMO, PPO or giveback plan is in the 2027 files.

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4 dual plan companies statewide: 10 D-SNPs are filed in New Mexico for 2027, from UnitedHealthcare (4), Presbyterian (3 segments), Blue Cross and Blue Shield of New Mexico (2) and Molina (1). Every county has 7 of them.

If you have Medicare only, Presbyterian has nothing you can buy for 2027. Your options come from the other insurers in your county, covered below.

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Who Can Still Join Presbyterian Dual Plus

Dual Plus is a dual-eligible special needs plan. To qualify you need Medicare Part A and Part B and New Mexico Medicaid (Turquoise Care), and you must live in New Mexico. Which Medicaid levels each D-SNP accepts is spelled out in its 2027 Summary of Benefits, so check that before you assume you qualify.

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If you were already in Dual Plus, your plan continues for 2027. Read your Annual Notice of Change for any benefit or network changes.

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If you had a standard Presbyterian plan and also have Medicaid, Dual Plus or another company’s D-SNP may be open to you, and dual-eligible members can change plans more often than once a year.

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If you had a standard Presbyterian plan and Medicare only, you need a plan from another insurer.

Our special needs plans guide explains how D-SNPs work.

New Mexico 2027 Medicare Advantage plans by carrier: UnitedHealthcare 30, Humana 12, Devoted Health 11, Presbyterian 3, Blue Cross and Blue Shield of New Mexico 3, HealthSpring 1, Molina 1

Where Former Presbyterian Members Can Go in 2027

Carrier 2027 New Mexico plans Notes
UnitedHealthcare 30 All 33 counties; largest lineup, including 4 dual plans
Humana 12 28 of 33 counties
Devoted Health 11 13 counties
Blue Cross and Blue Shield of New Mexico 3 Cut back for 2027; dual plans in all 33 counties plus one general HMO in 4 counties (Searchlight New Mexico)
Presbyterian 3 Dual Plus segments only (Medicare and Medicaid)
HealthSpring and Molina 1 each Limited options

Source: our analysis of CMS 2027 Plan Benefit Package and plan-county files, individual (non-employer) plans, including special needs plans. Wellcare files no New Mexico plans for 2027.

Choices vary a lot by county. Bernalillo and Sandoval counties each have 36 plans for 2027, while Harding, Otero and Union counties have 11. See the full breakdown in our guide to Medicare Advantage plans in New Mexico.

Keeping your Presbyterian doctors

Leaving the Presbyterian health plan does not have to mean leaving Presbyterian doctors. Before you enroll in a replacement plan, search its 2027 provider directory for your Presbyterian Medical Group doctors and the hospital you use, by exact plan name, and call the office to confirm.

What to Do Before December 7, 2026

1

Find your non-renewal letter. Presbyterian sent members of ending plans a notice explaining when coverage stops. You are not moved into a new plan automatically unless the letter says so.

2

Check whether you get Medicaid or Extra Help. That decides whether Dual Plus or another D-SNP is an option.

3

Make a list of your doctors, hospital and drugs, and check each replacement plan’s 2027 directory and drug list.

4

Enroll by December 7, 2026 for coverage that starts January 1, 2027, with no gap in drug coverage.

5

If you miss it, people whose plan is not renewing get a special enrollment period that runs through the end of February 2027, but coverage starts the month after you join.

Presbyterian’s member line for questions is (505) 923-2000 (TTY 711), according to KOB 4. For other exits this year, see Medicare Advantage plans ending in 2027.

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Presbyterian Medicare Advantage 2027 — Frequently Asked Questions

➤ Is Presbyterian Medicare Advantage ending in 2027?

Most of it. Presbyterian Health Plan is ending its standard Medicare Advantage plans on December 31, 2026, and keeping only Presbyterian Dual Plus, its plan for people with Medicare and Medicaid.

➤ How many people are losing their Presbyterian Medicare Advantage plan?

KOB 4 reports about 30,000 Presbyterian health plan members need new coverage for 2027.

➤ Why is Presbyterian leaving Medicare Advantage?

Presbyterian said the plans were financially unsustainable. Healthcare Finance News reports the discontinued plans lost more than $59 million in 2025, and executives cited rising medical costs and regulatory changes.

➤ Can I keep my Presbyterian doctors on another plan?

Possibly. Presbyterian’s hospitals and medical group keep operating, so check whether your doctors are in the 2027 network of the plan you are considering before you enroll.

➤ Is Presbyterian Dual Plus still available in 2027?

Yes. CMS’s 2027 files list Presbyterian Dual Plus (HMO D-SNP) in all 33 New Mexico counties, for people who have both Medicare and New Mexico Medicaid.

➤ What happens if I do nothing about my ending Presbyterian plan?

Your Presbyterian coverage ends December 31, 2026. You would have Original Medicare, without drug coverage unless you join a plan, so pick a replacement by December 7.

➤ Which insurer has the most Medicare Advantage plans in New Mexico for 2027?

UnitedHealthcare, with 30 of the state’s 61 individual plans in our count of CMS 2027 data, followed by Humana with 12 and Devoted Health with 11.

New to Medicare?

If you are new to Medicare, then you can enroll in a 2027 Medicare Advantage plan up to three months prior to your Medicare Part B effective date.

Call one of our licensed insurance agents to see what the best time frame is for you to enroll, based on your current situation. You can contact them at 1-855-454-9051 (TTY 711), Mon–Fri 8am–9pm EST.

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