Medical Insurance
Insurance Carriers
UNM offers medical insurance from two carriers:
Lovelace
www.lovelacehealthplan.com
Lovelace Handbook (coming soon)
Lovelace
Summary of Benefits
Presbyterian
www.phs.org
Presbyterian Handbook (coming soon)
Presbyterian
Summary of Benefits
To enroll in medical insurance, you must first choose one of the two
carriers. Be sure to choose the plan that best suits your needs (i.e.,
your current doctor is an in-network provider with that carrier).
Remember, after initial enrollment or a qualifying change in status, you
cannot change your carrier until Open Enrollment in May.
Note: The main difference between the two carriers in terms of the
offered benefits is the list of providers who are considered in-network
(Tier II) for the specific carrier- and each provider's prescription
formulary may differ. Information on both can be found at their
websites.
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Tiers of Coverage
Once you have enrolled with your chosen carrier, you will have an
option of three different tiers of coverage each time you need medical
care. These coverage tiers are referred to as networks, and they
determine your co-pays for your medical care (click
here for a comparison chart). These three tiers are the exact same
for the two insurance carriers.
Tier I: LoboCare Network:
- HSC/UNMH Providers and Facilities.
- Primary care locations throughout Albuquerque.
- LoboCare Clinic for same-day or next-day acute care appointments.
- Lower out-of-pocket costs and co-pays than in-network and
out-of-network options.
- Both Lovelace and Presbyterian subscribers have the same access to
the LoboCare Network.
- http://hsc.unm.edu/lobocare
Tier II: In-Network: (Lovelace or Presbyterian contracted providers)
- Carrier-contracted providers and facilities.
- National in-network capability (note: you should notify
your insurance carrier if you plan to use their National PPO).
- To find out if your doctor is on the list of providers:
Lovelace - http://www.lovelacehealthplan.com/content/ProviderMembers.htm
Presbyterian - https://www.geoaccess.com/Presbyterian/po/.
Tier III: Out-of-Network:
- Providers and facilities not contracted with your insurance carrier
(note: if you use this option, notify your carrier first
to receive the maximum available benefit).
- Only usual and customary charges are covered.
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Insurance Carrier Contacts
For additional information or questions, please contact:
LoboCare Network
(505) 272-8481
(Or via email: lobocare@salud.unm.edu)
Lovelace
(505) 262-7363
(800) 808-7363 (Outside Albuquerque only)
Presbyterian
(505) 923-6980
(800) 923-6980 (Outside Albuquerque only)
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