H4544-01
A PPO plan that includes coverage for services outside the network and prescription drugs under Part D is available in all parishes of Louisiana.
$0 Visit to a Primary Care Doctor.
$50 per quarter for Health Related Items that can be purchased directly at the counter.
$0Dental Check-ups, Cleanings & X-rays.
$0 Visit to a Primary Care Doctor.
$50 per quarter for Health Related Items that can be purchased directly at the counter.
$0Dental Check-ups, Cleanings & X-rays.
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You asked for more. We listened!
Every year, we look for ways to enhance and improve the care we provide to our valued members, with a focus on the year 2023. It is now easier than ever to envision a healthier future for ourselves and the people we serve.
We have increased the number of physicians in our Louisiana network.
We have added an expanded list of covered services and restorative services with $0 deductible and dental coverage with an out-of-network feature to all our dental plans. Additionally, we have included dental network coverage in over 95% of locations.
We have increased our network of vision providers by more than twice.
For many of our plans, there are lower copays and bigger allowances for select services, as well as lower maximum out-of-pocket costs.
Obtain diabetes testing supplies at nearby network pharmacies by utilizing a retail alternative. Conduct health and wellness purchases without prescription by utilizing our newly introduced retail card.
Compared to the Peoples Health network in 2022, dental services outside of the network may incur a higher expense for members.
Plan Benefits
The Part D coverage gap includes all tier 1 and 2 generic drugs. This gap offers limited coverage for brand-name medications. Retail pharmacies and mail order services provide 100-day quantities of maintenance drugs in tiers 1, 2, 3, and 4.
You will pay a maximum of $35 for every one-month stock of Part D select insulin medications through all stages of coverage.
You will have no out-of-pocket expenses for all Part D covered vaccines, including Shingrix.
Medical Practitioner and Healthcare Facility Coverage.
Prescription Drug Coverage under Part D.
During the Part D coverage gap, all generic drugs categorized as tier 1 and 2 are included in the coverage. Brand medications, on the other hand, receive only partial coverage throughout this gap. Both retail pharmacies and mail order services provide 100-day supplies of maintenance drugs across tiers 1, 2, 3, and 4.
You will pay a maximum of $35 for every one-month stock of Part D select insulin medications through all stages of coverage.
You will have no out-of-pocket expenses for all Part D covered vaccines, including Shingrix.
Additional Benefits.
Plan Highlights
The prices for the healthcare services mentioned below are from providers within the network.
$50 Allowance for Over-the-Counter Products per Quarter.
$0 Tier 1 and 2 Drug Coverage*.
$0Dental Check-ups, Cleanings & X-rays.
No cost meals following a stay in the hospital.
Pass One is a trademark of Optum, Inc., Its affiliates, and Inc. Optum, 2022 ©. It offers a 100-day supply of preferred mail-order drugs in Tier 2 for $0*.
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How to Enroll
Important Documents
Extra Help
Your total monthly plan premium will be determined by the amount of Extra Help you receive as a member of our plan. If you are not eligible for Extra Help from Medicare, your monthly plan premium would be higher compared to the scenario where you receive Extra Help from Medicare to assist with the costs of your Medicare prescription drug plan.
The premium of Peoples Health Choices (PPO) includes coverage for medical services as well as prescription drug coverage.
See if You Qualify for Extra Help
If you are not receiving Additional Assistance, you can check if you meet the requirements by contacting:.
Extra Help Monthly Plan Premium Table
This chart displays the amount of your monthly plan premium if you receive Additional Assistance.
*This does not encompass any Medicare Part B fee you may need to contribute.