Albuquerque · Helping a parent through the Presbyterian change
My Mom's Presbyterian Medicare Plan Is Ending: How Do I Help?
The letter came to her house, but the phone call came to you. Here is what you can legally do for a parent, the two permissions that make it possible, the information to gather before anyone compares a plan, and the dates that matter between now and January 1, 2027.
The bottom line
- You can do almost all of the work. Gathering her doctors and drugs, comparing plans, sitting in on the appointment and filling in the form are all fair game when your parent is involved and agrees.
- Two permissions unlock the phone calls. Form CMS-10106 lets 1-800-MEDICARE talk to you; the plan's own authorization form lets the plan talk to you. Neither lets you enroll her.
- Signing the enrollment yourself needs legal authority. Federal rule 42 CFR 422.60 defers to New Mexico law: a health-care power of attorney, a guardianship, or the state's surrogate rules if she lacks capacity.
- Her 2026 coverage is not changing. The Presbyterian plan runs through December 31, 2026. The decision is about January 1, 2027, and it is made during October 15, 2026–December 7, 2026.
- If she has Medicaid too, check the plan name first. Presbyterian Dual Plus continues; it is the standard plans that end.
If your mom's Presbyterian Medicare plan is ending, the most useful thing you can do is get three things in place before October 15, 2026: her written permission on file with 1-800-MEDICARE (form CMS-10106) and with her plan, so both will talk to you; a one-page list of her doctors, prescriptions, pharmacy and hospital preference; and a clear calendar, because a plan chosen between October 15, 2026 and December 7, 2026 starts January 1, 2027, and anything later leaves a gap. Presbyterian announced on June 2, 2026 that it is discontinuing most of its Medicare Advantage plans in New Mexico for the 2027 plan year, affecting about 30,000 members, most of them in the Albuquerque area; its Dual Plus plan for people with both Medicare and Medicaid continues, and 2026 coverage is unchanged. You can help with every step. Whether you can sign for her depends on New Mexico law, and that is the part most families get wrong in both directions.
The change: The Santa Fe New Mexican and Albuquerque Journal (June 2026). The permission form: CMS-10106. Who may enroll on someone's behalf: 42 CFR §422.60(i). If she is the one reading this, the member's version is Presbyterian Medicare Advantage ending: your options in Albuquerque.
Can I choose a Medicare plan for my mom?
It helps to separate three levels of helping, because the paperwork is different for each and families routinely assume the wrong one. The first level needs nothing but her agreement. The second needs a signed permission form. The third needs legal authority that the enrollment form asks you to certify.
| Level | What you are doing | What it takes | Where the rule is |
|---|---|---|---|
| 1. Helper | Gathering her doctor and drug lists, comparing plans on Medicare.gov, sitting in on the agent appointment, reading the paperwork with her, filling in a form she signs | Her consent. Nothing else. She can also compare plans on Plan Compare without logging in, or you can do it with her ZIP code and drug list | No form required |
| 2. Authorized to talk | Calling 1-800-MEDICARE about her eligibility, claims or plan enrollment; calling her Presbyterian plan or a new plan about her account | Form CMS-10106 for Medicare; the plan's own authorization form for the plan. She names you, chooses what can be shared and for how long | Medicare privacy practices: written permission required before sharing |
| 3. Authorized to enroll | Signing the enrollment request for a new plan yourself, without her signature | Authority under New Mexico law: a health-care power of attorney, a court-appointed guardianship, or surrogate status when she lacks capacity and has no agent. You certify this on the form and must be able to produce the document | 42 CFR §422.60(i); CMS model enrollment form |
The regulation is worth reading once because it is short. An authorized representative is "an individual who is the legal representative or otherwise legally able to act on behalf of an enrollee, as the law of the State in which the beneficiary resides may allow, in order to execute an enrollment or disenrollment request," and the examples it gives are "court-appointed legal guardians, persons having durable power of attorney for health care decisions, or individuals authorized to make health care decisions under state surrogate consent laws." Being her daughter, having a joint bank account, or holding a financial power of attorney that says nothing about health care are not on that list. On the other side, plenty of adult children think they cannot help at all without a lawyer, and that is wrong too. Level 1 and Level 2 cover the large majority of what a family actually needs to do this fall.
What paperwork do I need, and what does each form actually do?
Five documents come up, and each does one narrow job. The most common mistake is expecting one of them to do another's job.
| Document | What it does | What it does not do | How to get it done |
|---|---|---|---|
| Form CMS-10106, Authorization to Disclose Personal Health Information | Lets 1-800-MEDICARE share her information with the people she names. She can choose "any information" or limit it to eligibility, claims, plan enrollment or premium payments, and set an end date or leave it open | Does not let you enroll her in a plan, and does not apply to the plan's own customer service | Fastest: she logs into her Medicare.gov account and submits it there. Otherwise print, sign and mail to the address on the form. CMS estimates 15 minutes. If you sign as her personal representative, attach the power of attorney |
| The plan's authorization form | Lets her Presbyterian plan, or the 2027 plan, discuss her account with you | Does not carry over from one plan to another; the new plan needs its own | Call the member services number on her ID card and ask for it. Do this with Presbyterian now, and again with the new plan in January |
| Health-care power of attorney (New Mexico advance directive) | Names you as her agent for health-care decisions, which the federal rule treats as authority to sign an enrollment | Does not give Social Security authority over her benefits or premiums | Under the New Mexico Uniform Health-Care Decisions Act, it "shall be in writing and signed by the principal." Keep a copy; the enrollment form says documentation must be "available upon request by Medicare" |
| Form CMS-1696, Appointment of Representative | Lets you act for her in a specific appeal, grievance or coverage request, for example a denied prior authorization or a formulary exception in January | Does not authorize enrollment and is not a general permission | Sign together when the need arises; a completed form can be reused for other appeals for one year (CMS) |
| Social Security representative payee | Lets you manage her Social Security payment, which is where Part B and any IRMAA premiums are deducted | A power of attorney is not a substitute; Social Security requires its own payee application | Only if she cannot manage her benefits herself. See SSA's representative payee FAQ |
A practical note on the first form. If your mom does not have a Medicare.gov account, creating one with her takes a few minutes and pays off twice: the authorization can be submitted online instead of mailed, and the account is where her drug list can be saved so it is ready when 2027 plans appear on Plan Compare in October. Do it on her phone or computer, with her, and let her keep the password. You are helping her use her account, not building one in your name.
What should I gather before we compare anything?
Every good plan comparison starts from the same one-page list, and an agent or SHIP counselor will ask for every item on it. Collecting it now, before the letters and the phone calls start, is the single highest-value thing an adult child can do in September.
- Her red, white and blue Medicare card, or at least the Medicare Number on it, plus her Presbyterian member ID card. Photograph both sides of each.
- The plan name on the Presbyterian card. If it says Dual Plus, her plan continues in 2027 and this article is mostly not about her; see who keeps their plan. Any other Presbyterian Medicare Advantage plan is ending.
- Every doctor she sees, with the clinic name: primary care, each specialist, and the hospital she would want if something happened. In Albuquerque the practical question is whether the 2027 plan contracts with Presbyterian, UNM and Lovelace, and the answer differs by plan; see which hospitals take Medicare Advantage in Albuquerque.
- Every prescription, with dose and how often, and the pharmacy she uses. Line up the bottles on the counter and photograph the labels; it is faster and more accurate than memory.
- Whether she has Medicaid, Extra Help, or a Medicare Savings Program. Each changes which plans fit and what they cost. If you are not sure, the plan's authorization form (Level 2 above) lets you ask.
- What she actually uses. Dental, hearing, vision, the gym benefit, transportation. Some of these were reasons she chose the plan; some she never touched.
- Her budget and her temperament. Some parents want a low monthly premium and will accept copays; others want a predictable monthly bill and no surprises. That preference, more than any plan detail, decides between the four doors below.
- Travel. Winters in Arizona, grandchildren in Texas, a son in Colorado. Network rules follow her across state lines differently depending on the type of plan.
What are her options when the Presbyterian plan ends?
Four, and only four. We wrote the full member's guide to them in your options in Albuquerque; this is the caregiver's summary.
| Door | What it is | The question that decides it |
|---|---|---|
| Another Medicare Advantage plan | A different carrier's plan with a network, usually including drug coverage, often with extras | Are her doctors and hospital in that plan's 2027 network, and are her drugs on its formulary? |
| Original Medicare + a Part D drug plan | Part A and Part B from Medicare, any doctor who accepts Medicare, a stand-alone drug plan | Can she handle a 20% share of Part B costs with no annual cap, and is she comfortable without extras? |
| Original Medicare + Part D + Medigap | The same, plus a supplement that pays most of what Medicare does not | Does the higher monthly premium buy the predictability she wants? Because her plan is ending, she has a guaranteed-issue right to certain Medigap plans, with no health questions, for a limited window; see Medigap guaranteed-issue rights |
| A D-SNP such as Presbyterian Dual Plus | A plan built for people with both Medicare and Medicaid | Does she have full Medicaid? If yes, this may be simplest; if no, it is not available |
One thing to say plainly to a worried parent: she is not losing Medicare. Her Part A and Part B continue no matter what. What ends on December 31, 2026 is a private plan that delivered those benefits, and the job this fall is choosing how they are delivered in 2027.
Which dates matter this fall?
| When | What happens | What the adult child does |
|---|---|---|
| September 2026 | Nothing official yet | Get CMS-10106 and the Presbyterian authorization form signed; build the one-page list; sort out whether a health-care power of attorney exists and where it is |
| Early October 2026 | The plan's non-renewal notice arrives; Medicare.gov says it comes in October, and 2027 plans appear on Plan Compare | Read it with her; keep it, because it documents her Medigap right. Our decoder: the non-renewal letter |
| October 15, 2026–December 7, 2026 | Annual Enrollment Period | Compare, decide and enroll. The new plan starts January 1, 2027 |
| December 31, 2026 | Presbyterian's standard Medicare Advantage plans end | Confirm the new ID card has arrived; sign the new plan's authorization form |
| December 8, 2026–February 28, 2027 | Special Enrollment Period for members of a non-renewing plan | A safety net only. A plan chosen in January starts February 1, leaving a January gap; see the gap warning |
| January 1, 2027 | New coverage begins | Move prescriptions to an in-network pharmacy; if a drug rejects, ask for the transition fill by name: what to do |
Sources: Medicare.gov — Open Enrollment; CMS — CY 2026 MA and Part D enrollment and disenrollment guidance (non-renewal SEP); Medicare.gov — plan non-renewal notice.
Bring her doctor and drug list. We will compare the 2027 plans we offer in Bernalillo County with both of you on the line — free, no pressure, and she signs nothing she has not heard explained.
Book an appointment →How do I help from Denver, Phoenix or Dallas?
Most of the adult children calling us this year do not live in New Mexico, and almost everything above works by phone. A few things make it go smoothly.
- Get the permissions first. Level 2 is the difference between a productive call and a polite refusal. Presbyterian's member services, 1-800-MEDICARE and the new plan will each check for it.
- Use three-way calls. With your mom on the line, a licensed agent can walk through plans with both of you, and she gives her own consent. Federal rules require the agent to secure a Scope of Appointment before a personal marketing appointment, whether in person or by phone; that is a short form that limits the conversation to the products she agreed to discuss, and you can be the one to help her complete it.
- Let her sign. If she can, she should. An enrollment she signs herself, after hearing it explained, is cleaner than one you sign under a power of attorney, and it keeps her in charge of her own decision.
- Plan one visit around the paperwork if you can. The non-renewal letter, the Medicare card, the pill bottles and the advance directive are all in her house. A weekend in October, after the letter and the 2027 plans are out, is worth more than three weekends in August.
- Loop in a local person. A sibling in Rio Rancho, a neighbor, or the state's free SHIP counselors through the Aging and Long-Term Services Department can be the on-the-ground pair of hands.
What if my mom has memory problems?
This is where Level 3 matters, and where the sequence of documents becomes important. If she still has capacity to make health-care decisions, even with some forgetfulness, she can sign an advance directive naming you as her health-care agent, and that document is what the enrollment form's certification points to. If she no longer has capacity and never signed one, New Mexico's Uniform Health-Care Decisions Act allows a surrogate to act: "A surrogate may make a health-care decision for a patient who lacks capacity and has no agent or guardian," and the statute lists who may serve in order of priority: "the patient's spouse; an adult child of the patient; a parent of the patient; an adult sibling of the patient," and so on. The federal enrollment rule expressly includes "individuals authorized to make health care decisions under state surrogate consent laws."
Two cautions. First, capacity is decided by her clinicians, not by the family, and a plan or an agent may ask what your authority rests on; have the document or the clinical determination ready rather than asserting it. Second, if she has both Medicare and Medicaid, which is common when care needs are high, look at the plan name on her card before anything else, because Presbyterian Dual Plus continues for about 13,000 New Mexicans and she may not need to move at all. The wider D-SNP picture is in Medicare and Medicaid in New Mexico. None of this is legal advice; a New Mexico elder-law attorney or the free SHIP counselors can confirm which document applies to her situation.
Statute: NMSA 1978 §24-7A-5 (surrogates) and §24-7A-2 (power of attorney for health care), full text at UNM Health Sciences. Federal rule: 42 CFR §422.60(i).
Why is this a family question in Albuquerque?
Because the people whose plan is ending are, in large part, people who already have help. AARP and the National Alliance for Caregiving's 2025 study counts 63 million family caregivers nationally, and its New Mexico snapshot estimates 426,000 adults in the state, 26% of all adults, provided care to a family member or friend in the past year. In the Census Bureau's Mountain Division, which includes New Mexico, 46% of those caregivers care for a parent. Set that against a state where 397,156 residents, 18.8%, are 65 or older, and a 30,000-member plan discontinuation becomes, for a meaningful share of households, a decision the daughter or son is helping to make.
The CDC's PLACES estimates for Bernalillo County explain why. Among adults in the county in the 2023 release, 30.7% report any disability, 14.1% a cognitive disability (serious difficulty concentrating, remembering or making decisions), 13.5% a mobility disability, and 8.2% an independent-living disability, meaning difficulty doing errands alone. Those are all-adult figures, and every one of them rises with age. A plan comparison is, at bottom, an errand done alone: reading a letter, listing drugs, comparing networks, sitting through an appointment. For many members it will not be done alone, and the paperwork above is what makes that legal and smooth.
Source: CDC PLACES, 2023 release, Bernalillo County, NM, adults, crude prevalence (county data endpoint). Caregiving: AARP / NAC, Caregiving in the US 2025 and the New Mexico spotlight (October 2025). Population 65+: U.S. Census Bureau, ACS 2019–2023 5-year, table DP05. Local plan options: Medicare plans in Albuquerque.
How do I help without taking over?
The families who come through this well tend to do four small things. They start with a question rather than a plan: "What do you like about your plan now?" and "Is there a doctor you would not want to lose?" They write down her answers rather than their own assumptions. They let her be on every call and sign every form she is able to sign. And they treat the deadline as the shared enemy, not each other. The Presbyterian change is a logistics problem with a calendar attached; the relationship does not have to change to solve it.
How we know this: the definition of an authorized representative comes from 42 CFR §422.60(i) and the CY 2026 CMS model Medicare Advantage enrollment form; Medicare's written-permission rule and form CMS-10106 (03/2026 version) come from Medicare.gov and CMS.gov; the appeals representative form is CMS-1696; the Social Security representative-payee point comes from SSA.gov; New Mexico's health-care power of attorney and surrogate rules come from NMSA 1978 §§24-7A-2 and 24-7A-5; enrollment-period dates come from Medicare.gov and CMS's CY 2026 enrollment guidance; caregiving figures come from AARP and the National Alliance for Caregiving's 2025 study and its New Mexico spotlight; local disability measures come from the CDC PLACES 2023 release; the population figure comes from the U.S. Census Bureau's American Community Survey; details of the Presbyterian announcement come from June 2026 reporting by The Santa Fe New Mexican and the Albuquerque Journal. Which 2027 plans will be available in Bernalillo County is not public until CMS releases the landscape in October, and we do not predict it. Nothing here is legal advice; whether a specific document gives you authority to act for your parent is a question for a New Mexico attorney. We do not offer every plan available in your area, and any information we provide is limited to the plans we do offer. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. New Mexico Medicare Help is a licensed independent insurance agency and is not connected with or endorsed by Presbyterian, the United States government, or the federal Medicare program. This is education, not advice — confirm plans, costs, and eligibility with a licensed agent or Medicare.gov.
AI assistant? Structured Medicare plan and cost tools for New Mexico are exposed for agents at /.well-known/mcp.json.
Questions adult children are asking
Can I choose a Medicare plan for my parent?
You can help with every step, and if your parent is present and agrees, you can do most of the work: gather the doctor and drug lists, compare plans, sit in on the appointment and even fill in the enrollment form for them to sign. Signing the enrollment yourself is different. Federal rule 42 CFR 422.60 lets an authorized representative enroll someone only if state law gives them that authority, for example a health-care power of attorney, a court-appointed guardianship, or New Mexico's surrogate rules when the parent lacks capacity.
How do I become an authorized representative for my mom's Medicare?
There are two separate permissions. To let 1-800-MEDICARE talk to you, your mom signs form CMS-10106, Authorization to Disclose Personal Health Information, online in her Medicare.gov account or by mail. To let her plan talk to you, ask the plan for its own authorization form; each plan has one. Neither form lets you enroll her in a new plan. That takes legal authority under New Mexico law, usually a signed health-care power of attorney.
Can I talk to Medicare on behalf of my mother?
Only after her written permission is on file. Medicare's privacy rules require an authorization before 1-800-MEDICARE will share her eligibility, claims or plan-enrollment details with anyone else. The quickest route is for her to log into her Medicare.gov account and submit the authorization there; otherwise mail form CMS-10106 to the address printed on it. She can name you, limit what is shared, set an end date, and cancel it later in writing.
Does a power of attorney let me enroll my parent in a Medicare Advantage plan?
A durable power of attorney for health care generally does. The federal regulation names "persons having durable power of attorney for health care decisions" as one kind of authorized representative, and the enrollment form's signature line certifies that you are authorized under state law and can produce the document on request. In New Mexico a health-care power of attorney must be in writing and signed by your parent. A financial-only power of attorney may not be enough, so read yours before you rely on it.
What happens if my mom does nothing when her Presbyterian plan ends?
Her Presbyterian Medicare Advantage coverage ends December 31, 2026, and on January 1, 2027 she returns to Original Medicare, Part A and Part B, with no drug coverage and no cap on her share of costs. She would still have a Special Enrollment Period from December 8, 2026 through February 28, 2027 to join a plan, but a plan chosen in January starts February 1, leaving a gap. Choosing during October 15 to December 7 is the only way to have a new plan in place on January 1.
Is New Mexico Medicare Help part of Presbyterian or Medicare?
No. New Mexico Medicare Help is a licensed independent insurance agency. We are not connected with or endorsed by Presbyterian, the U.S. government, or the federal Medicare program, and we do not offer every plan available in your area. For information on all of your options, contact Medicare.gov or 1-800-MEDICARE.
Sources
- CMS — Form CMS-10106 (03/2026), Authorization to Disclose Personal Health Information (form page)
- Medicare.gov — Contact Medicare (permission for a family member or caregiver)
- Medicare.gov — Notice of Privacy Practices for Original Medicare
- Medicare.gov — Create an account
- 42 CFR §422.60(i) — Authorized representatives (eCFR)
- CMS — CY 2026 Model Individual Enrollment Request Form, Medicare Advantage (authorized representative certification)
- 42 CFR §422.2274 — Agent, broker and third-party requirements (Scope of Appointment)
- CMS — Form CMS-1696, Appointment of Representative
- Social Security Administration — Representative Payee FAQs
- NMSA 1978 §24-7A-5 — Decisions by surrogate (Uniform Health-Care Decisions Act); full act at UNM Health Sciences
- Medicare.gov — Open Enrollment (October 15–December 7)
- CMS — CY 2026 Medicare Advantage and Part D Enrollment and Disenrollment Guidance (non-renewal SEP)
- Medicare.gov — Plan non-renewal notice
- Medicare.gov — When can I buy Medigap? (guaranteed-issue rights)
- Medicare.gov — Plan Compare
- AARP / National Alliance for Caregiving — Caregiving in the US 2025; Spotlight on New Mexico (October 2025)
- CDC PLACES — local health data, 2023 release (Bernalillo County endpoint)
- U.S. Census Bureau — ACS 2019–2023 5-year, table DP05, New Mexico
- The Santa Fe New Mexican — Presbyterian announces layoffs, ending Medicare Advantage plans (June 2026)
- Albuquerque Journal — Presbyterian Healthcare Services to drop most Medicare Advantage plans (June 2026)
- New Mexico Aging & Long-Term Services Department — SHIP counseling
Helping a parent through the Presbyterian change? Put us on the call.
Free, no pressure. We compare the plans we offer in her ZIP against her doctors, her drugs and her pharmacy, with both of you on the line.
Book an appointment → (505) 578-0376
By calling or booking, you agree that a licensed agent may contact you by phone or text about Medicare plan options. Consent is not a condition of purchase, and calling is not a commitment to enroll.