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Peoples Health Choices (PPO) - H4544-001-000
$0.00
Monthly Premium
Peoples Health Choices (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare
Plan ID: H4544-001-000
* Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system.
$0.00
Monthly Premium
Louisiana Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A and Part B) benefits into a single plan.
Most Medicare Advantage plans cover prescription drugs, and many plans may offer other additional benefits Original Medicare doesn’t cover.
Learn more about Louisiana Medicare Advantage plans like the one below and find a plan that offers the benefits you want at an affordable price.
Enrollment may be limited to certain times of the year. See why you may be able to enroll today.
Basic Costs and Coverage
| Coverage | Details |
|---|---|
| Monthly plan premium | $0.00 |
| Vision coverage | |
| Dental coverage | |
| Hearing coverage | |
| Prescription drugs | |
| Medical deductible | $600.00 |
| Out-of-pocket maximum | $6,700.00 |
| Initial drug coverage limit | $0.00 |
| Catastrophic drug coverage limit | $2,100.00 |
| Primary care doctor visit | Routine Annual Physical Exam: $0 copay 1 per year |
| Specialty doctor visit | $55 copay |
| Inpatient hospital care | In-Network: Acute Hospital Services: $295 per day for days 1 to 7 $0 per day for days 8 to 90 Prior Authorization Required for Acute Hospital Services Note: All inpatient substance abuse and mental health care (including both care received in an acute care facility and a Medicare-certified psychiatric facility) are included in category 1b. |
| Urgent care | $50 copay per visit ($0 copay when outside of the United States) |
| Emergency room visit | Emergency Care: Copayment for Emergency Care $130 Copayment for Medicare Covered Emergency Care waived if you are admitted to the hospital with in 24 hours Worldwide Coverage: Copayment for Worldwide Emergency Coverage $0 Copayment for Worldwide Emergency Transportation $0 |
| Ambulance transportation | In-Network: Ground Ambulance: Copayment for Ground Ambulance Services $120 Air Ambulance: Copayment for Air Ambulance Services $120 Prior Authorization Required for Air Ambulance |
Health Care Services and Medical Supplies
Peoples Health Choices (PPO) covers a range of additional benefits. Learn more about Peoples Health Choices (PPO) benefits, some of which may not be covered by Original Medicare (Part A and Part B).
| Coverage | Details |
|---|---|
| Chiropractic services | Out-of-Network: Chiropractic Services: Copayment for Medicare Covered Chiropractic Services $80 |
| Diabetes supplies, training, nutrition therapy and monitoring | In-Network: Diabetic Supplies and Services: Copayment for Medicare-covered Diabetic Supplies $0 Coinsurance for Medicare-covered Diabetic Therapeutic Shoes or Inserts 20% |
| Durable medical equipment (DME) | Out-of-Network: Durable Medical Equipment Services: Coinsurance for Medicare Covered Durable Medical Equipment 50% |
| Diagnostic tests, lab and radiology services, and X-rays | Diagnostic Procedures/Tests: $5 copay Lab Services: $0 copay Diagnostic Radiology Services: $260 copay X-Rays: $260 copay |
| Home health care | In-Network: Home Health Services: Copayment for Medicare-covered Home Health Services $0 Prior Authorization Required for Home Health Services |
| Mental health inpatient care | In-Network: Psychiatric Hospital Services: $295 per day for days 1 to 7 $0 per day for days 8 to 90 Prior Authorization Required for Psychiatric Hospital Services Benefit Details - General Note - NOTE ON INPATIENT SUBSTANCE ABUSE: All inpatient substance abuse and mental health care (including both care received in an acute care facility and a Medicare-certified psychiatric facility) are included in category 1b. |
| Mental health outpatient care | Copayment for Medicare Covered Individual Sessions $25 copay |
| Outpatient services/surgery | Out-of-Network: Outpatient Hospital Services: Coinsurance for Medicare Covered Outpatient Hospital Services 30% Coinsurance for Medicare Covered Ambulatory Surgical Center Services 30% Benefit Details - General 9a1 Note - NOTE ON COST SHARING RANGE FOR OUTPATIENT HOSPITAL SERVICES: $0 copayment for outpatient diagnostic colonoscopies. The higher cost share applies to all other outpatient procedures.Benefit Details - General 9a1 Note - NOTE ON OUTPATIENT HOSPITAL SERVICES: Benefit category includes both the facility and professional component. |
| Outpatient substance abuse care | Out-of-Network: Outpatient Substance Abuse Services: Copayment for Medicare Covered Individual Sessions $40 Copayment for Medicare Covered Group Sessions $30 Note: $0 copayment applies to Medicare covered telehealth for individual sessions. The higher cost share applies to all other Medicare covered services. |
| Over-the-counter items | $25 credit per quarter for OTC products like vitamins, pain relievers, first aid supplies and more in-store or online. |
| Podiatry services | $45 copay 6 visits per year |
| Skilled Nursing Facility (SNF) care | Out-of-Network: Skilled Nursing Facility Services: $250 per day for days 1 to 100 |
Dental Benefits
The following dental services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
| Coverage | Details |
|---|---|
| Dental care | Out-of-Network: Preventive Dental Services: Coinsurance for Medicare Covered Preventive Dental 30% |
Vision Benefits
The following vision services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage
| Coverage | Details |
|---|---|
| Vision care | Routine Eye Exam: $0 copay 1 per year Routine Eyewear: $0 copay for standard prescription lenses $150 allowance every 2 years for 1 pair of lenses/frames or contacts. |
Hearing Benefits
The following hearing services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
| Coverage | Details |
|---|---|
| Hearing care | Hearing Aids Package: $199 - $1,249 copay per device, up to 2 hearing aids per year Choose from a broad selection of OTC and brand-name prescription hearing aids through UnitedHealthcare Hearing. Access to one of the largest national networks with thousands of hearing professionals. |
Preventive Services and Health/Wellness Education Programs
The following services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
| Coverage | Details |
|---|---|
| Preventive services and health/wellness education programs | In-Network: $0.00 copay for Medicare Covered Preventive Services: Abdominal aortic aneurysm screening Alcohol misuse screenings & counseling Bone mass measurements (bone density) Cardiovascular disease screenings Cardiovascular disease (behavioral therapy) Cervical & vaginal cancer screening Colorectal cancer screenings Depression screenings Diabetes screenings Diabetes self-management training Glaucoma tests Hepatitis B (HBV) infection screening Hepatitis C screening test HIV screening Lung cancer screening Mammograms (screening) Nutrition therapy services Obesity screenings & counseling One-time Welcome to Medicare preventive visit Prostate cancer screenings(PSA) Sexually transmitted infections screening & counseling Shots:
Yearly "Wellness" visit |
Prescription Drug Costs and Coverage
The Peoples Health Choices (PPO) offers prescription drug coverage, with an annual drug deductible of $600.00 (excludes Tiers 1 and 2)
Coverage & Cost | |
|---|---|
| Coverage | Cost |
| Annual drug deductible | $600.00 (excludes Tiers 1 and 2) |
| Tier 1 |
|
| Tier 2 |
|
| Annual drug deductible | $600.00 (excludes Tiers 1 and 2) |
| Tier 1 |
|
| Tier 2 |
|
| Annual drug deductible | $600.00 (excludes Tiers 1 and 2) |
| Tier 1 |
|
| Tier 2 |
|
When reviewing Louisiana Medicare plans, be sure to find out if your doctors are part of the plan network. If a Medicare Advantage plan covers prescription drugs, make sure the plan formulary (list of drugs covered by the plan) includes your drugs.
You may be able to find plans in your part of Louisiana that offer similar benefits at similar or lower prices than the plan above. Call 1-800-557-6059 TTY 711, 24/7 to speak with a licensed insurance agent who can help you compare plans.
Plan Documents
| Links to plan documents |
Louisiana Counties Served
- Acadia
- Allen
- Ascension
- Assumption
- Avoyelles
- Beauregard
- Bienville
- Bossier
- Caddo
- Calcasieu
- Caldwell
- Cameron
- Catahoula
- Claiborne
- Concordia
- De Soto
- East Baton Rouge
- East Carroll
- East Feliciana
- Evangeline
- Franklin
- Grant
- Iberia
- Iberville
- Jackson
- Jefferson
- Jefferson Davis
- La Salle
- Lafayette
- Lafourche
- Lincoln
- Livingston
- Madison
- Miller
- Morehouse
- Natchitoches
- Orleans
- Ouachita
- Plaquemines
- Pointe Coupee
- Rapides
- Red River
- Richland
- Sabine
- Saint Bernard
- Saint Charles
- Saint Helena
- Saint James
- Saint Landry
- Saint Martin
- Saint Mary
- Saint Tammany
- St John The Baptist
- Tangipahoa
- Tensas
- Terrebonne
- Union
- Vermilion
- Vernon
- Washington
- Webster
- West Baton Rouge
- West Carroll
- West Feliciana
- Winn
We offer plans from Humana, UnitedHealthcare®, Anthem Blue Cross and Blue Shield*, Aetna, Healthspring, Wellcare, or Kaiser Permanente.
Enrollment may be limited to certain times of the year. See why you may be able to enroll today.