2 Presbyterian Medicare Advantage Plans will ensure access to benefits in the following manner when a disaster or emergency is declared and there is disruption of access to healthcare. A disruption of access to healthcare is an interruption or interference in the service area such that members do not have the ability to access contracted providers or contracted providers do not have the ability to provide needed services to members, resulting in Presbyterian Medicare Advantage Plans failing to meet the normal prevailing patterns of community healthcare delivery in the service area: •Cover Medicare Part A and B services and supplemental Part C benefits furnished at non-contracted facilities •Waive requirements for gatekeeper referrals where applicable •Provide the same cost-sharing as if the service or benefit had been furnished at a contracted facility • Make the changes that benefit members effective immediately without the required 30-day notice A declaration of disaster will identify the geographic area affected by the event and may be made as one of the following: • Presidential declaration of disaster or emergency under either: »The Stafford Act »The National Emergencies Act • Secretarial declaration of a public health emergency under section 319 of the Public Health Service Act • Declaration by the Governor of the State of New Mexico Presbyterian Medicare Advantage Plans will continue furnishing access to benefits as described above for 30 days after the following, whichever is earlier: •All sources that declared a disaster or emergency declare an end • No end date was identified, and all applicable emergencies or disasters declared for the area have ended, including through expiration of the declaration or any renewal of such declaration • There is no longer a disruption of access to healthcare MEDICARE TRANSFORMATION A new Presbyterian Health Plan retail center By 2030, New Mexico is expected to be among the top six states with the greatest proportion of residents over the age of 65. Presbyterian Health Plan is ready to support this need by creating a Health Plan Place that is designed to provide you with many of the services you need and want in one location, with a dedicated team to help you. Health Plan Place is a Presbyterian Health Plan support and wellness center designed to give members wellness and tech education in a communityoriented social environment. Within Health Plan Place, cross-trained specialists will help restore existing members’ confidence and provide new members with a face-to-face enrollment experience. This is a value-based clinic designed to promote the best care for Medicare members. This includes: • Preventive care • Complex screenings Health Plan Place is located at Winrock Town Center, an Albuquerque landmark. This familiar setting includes neighbors such as New Mexico Orthopaedics, Albuquerque Hearing and Balance, TriCore Reference Laboratories, StretchLab, Chuze Fitness, and Uptown Park Dental and is complemented by dozens of shopping and dining options. This location promotes an active and social lifestyle for all members. As we move forward, we plan to expand access to care to meet the needs of our Medicare members. For more information about Health Plan Place, please visit www.hsd.state.nm.us/wp-content/uploads/DB-22-Demographics.pdf. • Therapies • Virtual care • Fall prevention • Nutrition Obtaining needed care during a state of disaster or public health emergency
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