Choices Plus (HMO-POS)

Plan Details

Choices Plus (HMO-POS) is available to Medicare-eligible residents in the Choices Plus (HMO-POS) service area: Ascension, East Baton Rouge, Livingston, St. Bernard, St. Charles, St. James, St. John and West Baton Rouge parishes in Louisiana.

With Choices Plus (HMO-POS), you can get more coverage than with Medicare alone for no monthly premium above what you pay now for Medicare Part B. Choices Plus (HMO-POS) is a triple-option health plan. As a member, you can access your benefits in one of three ways:

Choice 1 (Within Physician Team) – You select a primary care physician (PCP) and physician team from the Choices Plus (HMO-POS) network of physicians when you enroll. A physician team is composed of primary care physicians and specialist physicians, such as cardiologists and orthopedists. Office visits to your primary care physician (PCP) cost just $5, and visits to specialists within your physician team are only $15.

Choice 2 (Within Choices Plus (HMO-POS) Network) – You can see any physician in the Choices Plus (HMO-POS) network of physicians for only $25 per visit.

Choice 3 (Out-of-Network) – You can go to a non-participating or an out-of network physician and still receive Medicare-level benefits. A non-participating or out-of-network physician is a physician who has not contracted with Choices Plus (HMO-POS) to provide services to plan members. Choice 3 has higher out-of-pocket costs than Choice 1 or Choice 2. You pay 20% of the total costs for visits to out-of-network physicians.

As a Choices Plus (HMO-POS) member, you pay no additional premium*, but you receive MORE benefits than with Original Medicare, including 100% coverage for many services with NO Medicare deductibles. Some Choices Plus (HMO-POS) plan benefits include ...

  • Primary care physician visits for only $5
  • Specialist physician visits for only $15
  • Emergency care coverage worldwide
  • Unlimited prescription drug coverage in the coverage gap for generic and preferred brand-name drugs
  • Comprehensive and preventive dental coverage

Plus, you'll save even more with these additional benefits:

  • Vision coverage (routine eye exam and one pair of glasses or contacts per year)
  • Hearing services discounts
  • Health club membership and fitness classes at no cost to you

And much more ... all for no additional premium beyond what you pay now for Medicare Part B!

*You must continue to pay your Part B premium.

Peoples Health Network is the administrator for Peoples Health, Inc.
Peoples Health is a Medicare Advantage organization with a Medicare contract.

http://www.urac.org/directory/DirectorySearch.aspx?name=peoples+health


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Last Update: January 05, 2010