Medicare Advantage Plans in Bernalillo County, NM:
Your Complete 2025 Guide
For 2025, residents of Bernalillo County, NM can choose from 33 Medicare Advantage plan options. Of these, 24 cost nothing beyond the Part B premium. Enrollment in the County stands at approximately 53,661, with 19% of plans achieving 4 stars or better. The totals and data on this page do not cover Special Needs Plans. View SNPs available in Bernalillo County, NM.
- Page Updated
- Enrollment Data
- September 16, 2025
- CMS Quality Ratings
- * CMS reviews Medicare Advantage plans annually with a 5-star rating program. Data sources
Medicare Advantage PPO Plans
Preferred Provider Organization (PPO) plans allow members to choose care from both in-network and out-of-network providers. While using out-of-network doctors or hospitals usually means higher costs, PPOs may appeal to people who want more flexibility in how they access their healthcare.
- Total PPO Plans
- 18
- Average Premium
- $11.11/mo
- Beneficiaries Enrolled
- 14,048
- $0 Premium PPOs
- 13
- Average MOOP
- $5,920
- Most Popular PPO
- AARP Medicare Advantage from UHC NM-0004 (PPO) with 3,973 enrollees
- PPOs Without Drug Coverage
- 3
What is the typical premium for PPO plans available in Bernalillo?
On average, PPO plans in Bernalillo cost $11.11 per month.
Which PPO plan do most beneficiaries choose in Bernalillo?
The most popular PPO in Bernalillo is AARP Medicare Advantage from UHC NM-0004 (PPO), covering 3,973 beneficiaries.
How many PPO options are offered without drug coverage in Bernalillo?
3 PPO plans available in Bernalillo do not include Part D benefits.
Medicare Advantage HMO Plans
Health Maintenance Organization (HMO) plans generally require members to use doctors, hospitals, and other providers within the plan’s network, except in emergencies. Because of this structure, HMOs often come with lower premiums and out-of-pocket costs compared with other plan types.
- Total HMO Plans 12
- Average Premium $12.07/mo
- Beneficiaries Enrolled 34,867
- $0 Premium HMOs 9
- Average MOOP $4,096
- Most Popular HMO Presbyterian Senior Care Plan 2 with Rx (HMO) with 13,329 enrollees
- HMOs Without Drug Coverage 2
| HMO Plan Name | Rating* | Premium | MOOP | Rx Ded. |
|---|---|---|---|---|
| Blue Cross Medicare Advantage Basic | $15 | $4,200 | $250 | |
| CHRISTUS Health Medicare Guardian | $0 | $4,900 | N/A | |
| CHRISTUS Health Medicare Plus | $0 | $4,000 | $0 | |
| Humana Gold Plus H0028-019 | $0 | $4,150 | $0 | |
| Blue Cross Medicare Advantage Select | $0 | $3,900 | $0 | |
| Presbyterian Senior Care AssistPlus Plan with Rx | $12 | $5,000 | $590 | |
| Presbyterian Senior Care Plan 1 | $0 | $4,250 | N/A | |
| Presbyterian Senior Care Plan 2 with Rx | $0 | $5,000 | $0 | |
| Presbyterian Senior Care Plan 3 with Rx | $118 | $3,750 | $0 | |
| Cigna Preferred Medicare | $0 | $4,400 | $0 | |
| SCAN Classic | $0 | $2,800 | $0 | |
| SCAN MyChoice | $0 | $2,800 | $0 |
What is the total number of HMO plans offered in Bernalillo?
In 2025, Bernalillo County has 12 HMO plans with 34,867 members.
How much do HMO plans cost on average in Bernalillo?
The mean monthly HMO premium is $12.07, and 9 have no premium.
Medicare Advantage HMO-POS Plans
HMO-POS plans are structured like HMOs, requiring in-network care for the lowest costs, but they also permit some use of out-of-network doctors and hospitals. Those services are generally more expensive, but the added access can be valuable for people who don’t want to be fully limited to a single network.
- Total HMO-POS Plans
- 2
- Average Premium
- $0.00/mo
- Beneficiaries Enrolled
- 4,710
- $0 Premium HMO-POS
- 2
- Average MOOP
- $5,300
- Most Popular HMO-POS
- Presbyterian UltraFlex (HMO-POS) with 3,687 enrollees
- HMO-POS Without Drug Coverage
- 0
| HMO-POS Plan Name | Rating* | Premium | MOOP | Rx Ded. |
|---|---|---|---|---|
| AARP Medicare Advantage from UHC NM-0009 | $0 | $4,900 | $260 | |
| Presbyterian UltraFlex | $0 | $5,700 | $0 |
- What is the average monthly premium for HMO-POS plans?
- On average, HMO-POS plans in Bernalillo cost $0.00 per month.
- Which HMO-POS plan is most popular in Bernalillo?
- The leading HMO-POS in Bernalillo is Presbyterian UltraFlex (HMO-POS), with 3,687 members.
- How many HMO-POS plans in Bernalillo do not include drug coverage?
- There are 0 HMO-POS plans in Bernalillo without Part D benefits.
Medicare Advantage PFFS Plans
Private Fee-for-Service (PFFS) plans let members visit any Medicare-approved provider that accepts the plan’s payment rules and terms. This structure gives you more flexibility in selecting doctors and hospitals, but it’s important to check provider acceptance before receiving care.
- Total PFFS Plans 1
- Average Premium $31.00/mo
- Beneficiaries Enrolled 36
- $0 Premium PFFS 0
- Average MOOP $6,700
- Most Popular PFFS Humana Gold Choice H8145-164 (PFFS) with 36 enrollees
- PFFS Without Drug Coverage 0
| PFFS Plan Name | Rating* | Premium | MOOP | Rx Ded. |
|---|---|---|---|---|
| Humana Gold Choice H8145-164 | $31 | $6,700 | $300 |
What is the total number of PFFS plans in Bernalillo?
There are 1 PFFS plans in 2025, covering 36 beneficiaries.
How much do PFFS plans cost on average in Bernalillo?
The average PFFS premium is $31.00, with 0 costing $0.
What is the top PFFS plan in Bernalillo?
Humana Gold Choice H8145-164 (PFFS) is the most popular PFFS plan in Bernalillo, with 36 enrollees.
What is the number of PFFS plans without Part D coverage in Bernalillo?
0 PFFS plans in Bernalillo do not include prescription drug coverage.
The table below shows the quality ratings for Medicare Advantage plans offered in Bernalillo County, NM for 2025.
| Rating Category | Number of Plans | Percent of Plans |
|---|---|---|
| 5 Stars | No 5-star plans available. | 0% |
| 4 Stars (includes 5 Stars) | 6 | 19% |
| 3 Stars | 24 | 77% |
| Below 3 Stars | 1 | 3% |
| Not Rated | 2 | 6% |
| Average Rating | 3.37 | |
Medicare Advantage comes with strict enrollment windows. By knowing when and how to sign up, you’ll avoid missed deadlines and keep your healthcare coverage aligned with your needs.
Understanding Enrollment Windows
- Initial Enrollment Period (IEP): Beginning three months before you turn 65 and lasting until three months after, this is the initial chance to join Medicare. You may also select a Medicare Advantage plan if it fits your needs. Learn more
- Medicare Advantage Open Enrollment Period (MA OEP): Running from January 1 to March 31 each year, this period allows one change to your current Medicare Advantage coverage or a move back to Original Medicare. Learn more
- Annual Enrollment Period (AEP): This yearly window, running October 15 to December 7, gives you the opportunity to join, switch, or drop Medicare Advantage and Part D plans. Learn more
- Special Enrollment Periods (SEPs): Certain qualifying events, such as a change in residence or loss of existing coverage, may allow you to enroll in or change Medicare Advantage plans outside of the usual enrollment windows. Learn more
Enrollment Options Explained
- Talk with a Licensed Agent: Licensed agents at HealthCompare can explain your Medicare Advantage choices. Reach them at 1-833-748-3201 (TTY 711), Monday–Friday 5am–6pm and Saturday 6am–5pm PST.
- Contact the Plan Provider Directly: Enrollment can also be completed by calling the plan provider’s customer service line or visiting their official website.
- Use Medicare.gov: The official Medicare website, Medicare.gov, lets you review available plans and complete enrollment online.
The MA and MAPD plans on this page are available to people on Medicare enrolled in both Medicare Part A and Part B living in Cedar Crest, Sandia Park, Tijeras, Albuquerque, and all other areas of Bernalillo County, New Mexico.
Plans Offered for Enrollment through Medicare.org
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, Healthy Blue, HealthSun, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
CMS Plan IDs Presented
The Medicare Advantage plan pages listed in the tables above include localization to assist beneficiaries with plans available in their service area. However, most Part C plans are available in more than one service area, which can lead to confusion. The following list of CMS IDs links to our master plan pages without localization.
- CMS.gov, Landscape Source Files — Last accessed September 13, 2025
- CMS.gov, Medicare Part C & D Performance — Last accessed September 13, 2025
- CMS.gov, Plan Benefits Package — Last accessed September 13, 2025
- CMS.gov, Medicare Advantage/Part D Contract and Enrollment Data — Last accessed September 16, 2025
Some facts and percentages shown on this page (such as average premiums, distribution of plan types, and percentage of $0 premium plans) are calculated by Medicare.org using data from the CMS Landscape file, Plan Benefits Package (PBP) files and Part C & D Performance files. All underlying values originate from CMS, and calculations are refreshed whenever CMS issues updated data. Enrollment counts and rankings (such as Top 3 plans by enrollment) are derived from CMS monthly enrollment files and aggregated at the county level.
Medicare.org separates Medicare Advantage (MA/MAPD) plans and Special Needs Plans (SNPs) into different pages for clarity. As a result, plan counts, percentages, and other calculations shown here may differ from the aggregate totals published in the CMS Landscape files. All plan availability and benefit details originate from CMS.
Learn more about how we use CMS data.
- Medicare.gov, "Understanding Medicare Advantage Plans" — Last accessed 25 May, 2025
- Medicare.gov, "Explore your Medicare coverage options" — Last accessed 25 May, 2025
- NCOA.org, "5 Steps to Choosing the Right Medicare Plan for You" — Last accessed 25 May, 2025
Medicare.org is owned and operated by Health Network Group, LLC, an Allstate company. Medicare.org provides information only and is not connected with or endorsed by the U.S. Government or the federal Medicare program.
Data provenance documentation is maintained in alignment with the U.S. Core Data for Interoperability (USCDI) Provenance standard.
Page content managed by David Bynon, Medicare Analyst.