Presbyterian for Retirees
About the Plan
The Presbyterian medical plan is available to benefits-eligible retirees and their eligible dependents, and provides access to these networks.
UNM LoboCare Network
Tier 1
UNM Health System
Optum Health (formerly DaVita Medical Group)
First Choice Community Health Providers and Facilities
LoboCare Clinic for same-day or next-day acute care appointments
Presbyterian In-Network
Tier 2
Presbyterian Health Plan providers, hospital/clinic facilities and pharmacies within New Mexico.
Nationally, outside of New Mexico for in-network tier 2 level coverage, members may access the Multi-Plan Network.
Out of Network
Tier 3
Only usual and customary charges are covered
Providers and facilities not contracted with your Third-Party Administrator (TPA). Notify your TPA first to receive the maximum available benefit if you use this option
FY27 (July 1, 2026 – June 30, 2027) plan year
- Retiree Medical Rates for Retirees with 25+ Grandfathered VEBA Service Credits
- VEBA 5-9 Medical Rates for Retirees with 5 to 9 VEBA Service Credits
- VEBA 10-14 Medical Rates for Retirees with 10-14 VEBA Service Credits
- Participant Benefit Booklet (Coming Soon)
- Schedule of Benefits
- Summary of Benefits and Coverage
- Find a Doctor
- Mandatory Notices
- Register for myPRES (mobile app) to access info and tools designed for you
- Presbyterian Fitness Pass
FY26 (July 1, 2025 – June 30, 2026) plan year
- FY26 Retiree Medical Rates for Retirees with 25+ Grandfathered VEBA Service Credits
- FY26 VEBA 5-9 Medical Rates for Retirees with 5 to 9 VEBA Service Credits
- FY26 VEBA 10-14 Medical Rates for Retirees with 10-14 VEBA Service Credits
- FY26 Participant Benefit Booklet
- FY26 Schedule of Benefits
- FY26 Summary of Benefits and Coverage
- Find a Doctor
- FY26 Mandatory Notices
- Register for myPRES (mobile app) to access info and tools designed for you
- Presbyterian Fitness Pass
Eligibility
Post-retirement medical and dental benefits are only available to retirees who were employed with UNM on June 30, 2015 and prior and who have met the VEBA participation requirements. To access these benefits, a potential retiree must meet the criteria outlined in University Administrative Policy 3600, Section 3.1.
A Pre-65 Retiree is defined as an employee who retires from UNM before the age of 65. Immediately prior to retirement, the retiree may elect the same medical coverage he or she had as an active employee, but pay premiums based on the percentages outlined in the VEBA premium contribution rate schedule. Retiree premiums are determined by service credits paid into VEBA. Read more about the Voluntary Employee Beneficiary Association (VEBA).
When and How to Enroll
Eligible Pre-65 retirees have the following enrollment opportunities
- During the UNM retirement application process
Enroll by contacting your Benefits representative. - During the annual Open Enrollment period, typically held in April/May
Make changes to existing coverage by completing the Pre-65 Open Enrollment Change Form. - When you experience a Qualifying Change in Status
Make changes via the Retiree Medical and Dental Change Form.
Finally, if you are enrolling dependents, be prepared to provide “proof documentation”. Some Examples of Dependent Proof Documents are available here. Deadlines for submission of these documents vary in accordance with the enrollment opportunities listed above.
Using Your Presbyterian Medical Benefit
- Use an In-Network provider and find doctors, services, and hospitals on phs.org. Or;
- Use an Out-of-Network provider where only usual and customary charges are covered, and providers and facilities are not contracted with your third-party administrator (TPA). Notify your TPA first to receive the maximum available benefit if you use this option.
- Make an appointment with your selected provider.
- Present your medical ID card. Presbyterian ID Cards will be created for each plan participant and mailed to the primary member by Presbyterian.
- For information about your prescription drug benefit, see the Prescription Drug Plan page.