Updated: January 27, 2026
Advertising & Editorial Disclosure
Presbyterian Health Plan is the best Medicare Advantage provider in New Mexico for HMO coverage with $0 monthly premiums, a $6,000 maximum out-of-pocket limit and 3 CMS star rating.
UnitedHealthcare has the best HMO-POS plans in New Mexico at $0 monthly with a $5,900 MOOP, while Humana leads PPO options at $0 monthly and a higher $7,850 MOOP limit.
When choosing a Medicare Advantage plan in New Mexico, take time to compare monthly premiums, annual out-of-pocket maximums, provider network access and prescription drug coverage.
We identified the best Medicare Advantage plans available to New Mexico residents based on CMS star ratings, premiums, maximum out-of-pocket costs and coverage features.
Presbyterian Health Plan is the best provider in the state for HMO coverage, offering $0 monthly premiums and an average out-of-pocket maximum of $6,000, along with a 3 CMS star rating. UnitedHealthcare ranks highest for HMO-POS plans with a 4-star rating, while Humana leads the state’s PPO offerings with a 3.5-star rating.
| HMO | Presbyterian Health Plan | 3.00 | $0 | $6,000 | Presbyterian Senior Care Extra Health Plan with Rx (HMO) |
| HMO-POS | UnitedHealthcare | 4.00 | $0 | $5,900 | AARP Medicare Advantage from UHC NM-0010 (HMO-POS) |
| PPO | Humana | 3.50 | $0 | $7,850 | HumanaChoice H5216-223 (PPO) |
Medicare Advantage plans work differently than Original Medicare by offering private insurance alternatives that bundle hospital, medical and prescription drug coverage. These Part C plans must cover everything Original Medicare does while adding extra benefits like dental, vision and hearing coverage.
Best HMO
CMS Star Rating
Plan Types
Best HMO-POS
CMS Star Rating
Plan Types
Best PPO
CMS Star Rating
Plan Types
New Mexico has nine HMO Medicare Advantage plans available, with CMS star ratings ranging from 2.5 to 4.0 and only one plan earning four stars or higher. Most options are low cost, with seven plans carrying $0 monthly premiums. Annual maximum out-of-pocket limits average $4,489 and generally fall between $3,800 and $6,000.
| Presbyterian Health Plan | 3.00 | $0 | $6,000 | 3 | 5.00 |
| CHRISTUS Health Advantage | 3.50 | $0 | $4,200 | 1 | 4.75 |
| Cigna HealthCare | 3.00 | $0 | $4,201 | 1 | 4.14 |
| Blue Cross Blue Shield | 2.57 | $3 | $4,200 | 2 | 4.00 |
HMO plans offer the lowest premiums and out-of-pocket costs among Medicare Advantage options, making them attractive for budget-conscious seniors. You'll need to choose a primary care doctor and get referrals for specialist visits.
UnitedHealthcare is the exclusive HMO-POS Medicare Advantage provider in New Mexico. The provider has two HMO-POS plans available featuring 4-star CMS ratings, $0 monthly premium, and $5,900 maximum out-of-pocket limits. As the sole HMO-POS provider in the state, UnitedHealthcare delivers reliable coverage and consistent quality for New Mexico residents, even though choice is limited.
| UnitedHealthcare | 4.00 | $0 | $5,900 | 2 | 5.00 |
If you're looking for lower premiums than PPO plans but want more flexibility than standard HMOs, HMO-POS plans offer an appealing middle ground for New Mexico residents. These plans let you access out-of-network providers when you need specialized care that's not available within your HMO network, though you'll pay higher costs for those visits.
New Mexico residents have access to 26 PPO Medicare Advantage plans, with monthly premiums ranging from $0 to $135. While more expensive than HMO plans, PPOs provide greater flexibility in choosing healthcare providers. Out-of-pocket maximums in the state average $5,762, and 14 plans earn a CMS rating of 4 stars or higher.
| Humana | 3.50 | $0 | $7,850 | 7 | 5.00 |
| UnitedHealthcare | 4.00 | $12 | $5,747 | 12 | 4.67 |
| Blue Cross Blue Shield | 3.00 | $43 | $6,158 | 7 | 3.25 |
PPO plans cost more than other Medicare Advantage options, but they're worth it if you want complete freedom in choosing providers. New Mexico residents can see any doctor without referrals and access out-of-network specialists when needed, though staying in-network saves money.
Your ideal Medicare Advantage plan depends on balancing your medical needs, costs and how much provider choice you want. Evaluate these elements when selecting coverage in the Land of Enchantment.
Contact your doctors and hospitals to verify they're in the plan's network, not just with the insurance company generally. Each plan from the same insurer can have different provider networks.
Plans with no premium may carry higher out-of-pocket costs through copays and deductibles. Factor in your expected medication expenses and typical specialist visits.
Review the drug list to verify your prescriptions are included and check which tier they're in. You'll pay more for higher-tier medications, and some drugs need prior approval from the plan.
Pick an HMO plan type for the lowest premiums and coordinated care through your primary doctor. HMO-POS works if you want occasional out-of-network flexibility. PPO suits frequent travelers or those wanting unrestricted specialist access.
Star ratings measure plan quality, service and member satisfaction on a 1-5 scale. Higher-rated plans, those with 4 or 5 stars, deliver superior care and customer service.
Many New Mexico Medicare Advantage plans include dental, vision, hearing, fitness memberships and over-the-counter allowances.
Out-of-pocket maximums protect you from excessive medical expenses by capping what you pay annually. Plans with lower caps offer stronger financial protection but charge higher monthly premiums.
Plan type is the main factor impacting Medicare Advantage costs in New Mexico. HMO plans offer the most affordable option with $0 median premiums and $15 average monthly costs, plus $4,489 average out-of-pocket maximums. HMO-POS plans present a middle ground at $0 average monthly premiums but higher $5,900 out-of-pocket limits. PPO plans cost the most at $20 per month on average with $5,762 out-of-pocket maximums.
| HMO | $0 | $15 | $4,489 |
| HMO-POS | $0 | $0 | $5,900 |
| PPO | $0 | $20 | $5,762 |
Get answers about Medicare Advantage enrollment processes, what's covered and enrollment timing in New Mexico.
First enroll in Medicare Parts A and B, then select a plan during open enrollment (Oct. 15-Dec. 7) via Medicare.gov, insurers, or licensed agents. Coverage begins Jan. 1 or during other qualifying periods.
Medicare Advantage plans cover everything Original Medicare does, plus most include prescription drugs and extra benefits like dental, vision, and fitness memberships.
Medicare Advantage replaces Original Medicare with bundled coverage from private insurers, while Medicare Supplement (Medigap) works alongside Original Medicare to cover deductibles and copays.
Medicare Advantage open enrollment in New Mexico runs Oct. 15 to Dec. 7 annually. Current members can also make changes Jan. 1 to March 31.
We analyzed Medicare Advantage plans using a weighted scoring system that prioritizes affordability and quality. Our methodology scores three main factors to help you find plans that offer the best value for your health care needs.
This scoring system helps you compare plans objectively while accounting for what matters most: what you'll pay and the quality of care you'll receive.
About Mark Fitzpatrick
Mark Fitzpatrick, a Licensed Property and Casualty Insurance Producer, is MoneyGeek's resident Personal Finance Expert. He has analyzed the insurance market for over five years, conducting original research for insurance shoppers. His insights have been featured in CNBC, NBC News and Mashable.
Fitzpatrick holds a master’s degree in economics and international relations from Johns Hopkins University and a bachelor’s degree from Boston College. He's also a five-time Jeopardy champion!
He writes about economics and insurance, breaking down complex topics so people know what they're buying.
