Peoples Health Group Medicare Office of Group Benefits (OGB)

Peoples Health Group Medicare Office of Group Benefits (OGB) | 2025

The Peoples Health plan offered through OGB is a Medicare Advantage Prescription Drug plan. We designed it exclusively for OGB retirees, and it features the coordinated care Peoples Health is known for, as well as the flexible out-of-network coverage you may want.

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Peoples Health Group Medicare
Office of Group Benefits (OGB) | 2025

At Peoples Health, we focus on one thing: helping people with Medicare. And we’ve been doing just that for OGB retirees since 2008.

The Peoples Health plan offered through OGB is a Medicare Advantage Prescription Drug plan. We designed it exclusively for OGB retirees, and it features the coordinated care Peoples Health is known for as well as the flexible out-of-network coverage you may want.

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Looking for Peoples Health Group Medicare (HMO-POS)? Click here.

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Plan Benefits for Peoples Health Group Medicare Office of Group Benefits (OGB) | 2025

The benefits below are available with this Medicare Advantage plan. For a full list of benefits, please see the Evidence of Coverage for this plan.


Peoples Health Group Medicare (HMO-POS) Office of Group Benefits (OGB)	In-network	Out-of-network
Out-of-Pocket Maximum	$2,500	Does not apply
Doctor Visits & NurseLine
Primary Care Provider Visit	$0	20% coinsurance
Specialist Visit	$10	20% coinsurance
Virtual Medical Visit or 24-Hour NurseLine	$0	Available through contracted provider
Preventive Care+
Pap Smears, Pelvic Exams, Mammograms	$0	20% coinsurance
Prostate & Colorectal Cancer Screenings	$0	20% coinsurance
Bone Mass Measurement	$0	20% coinsurance
Vaccinations (COVID-19, flu, pneumonia)++	$0	$0
Labs & Tests+
Lab Services, Diagnostic Tests, X-rays and Advanced Imaging (MRI, MRA, CT, PET scans etc.)	$0	20% coinsurance
Outpatient Surgery
Outpatient Surgery (outpatient hospital or ambulatory surgical center)	$0	20% coinsurance
Inpatient Hospital Care per Admission
Inpatient Deductible	$0	Same as Medicare
Inpatient Stay (per day) days 1-10	$50 per day	Same as Medicare
Inpatient Stay (per day) days 11 and beyond	$0	Same as Medicare
Worldwide Emergency and Urgent Care ^
Emergency Care (worldwide)	$50	$50
Urgent Care (inside the U.S.)	$5	$5
Urgent Care (outside the U.S.)	Does not apply	$50
Emergency Transportation (per one-way trip)
Emergency Ambulance Services (ground or air)	$50	$50
Home Health & Skilled Nursing Facility Care
Home Health	$0	20% coinsurance
Skilled Nursing Facility Care (semi private room and board, days 1-20)	$0	$0
Skilled Nursing Facility Care (semi private room and board, per each additional day)	$25 per day	$25 per day
Outpatient Services & Supplies
Occupational, Physical or Speech Therapy Visit	$0	20% coinsurance
Durable Medical Equipment (wheelchairs, oxygen, etc.)	5% coinsurance	20% coinsurance
Diabetes Monitoring Supplies (test strips, monitor, etc., from a retail pharmacy or a DME provider)	$0	20% coinsurance
Mental Health & Substance Abuse Treatment
Inpatient Mental Health (days 1-5)	$25 per day	Same as Medicare
Inpatient Mental Health (days 6-90)	$0	Same as Medicare
Outpatient Mental Health or Substance Abuse Group or Individual Visit	$0	20% coinsurance
Virtual Mental Health Visit	$0	Available through contracted provider
+Office visit copay may apply. ^Emergency care copay waived if admitted to inpatient hospital care within 24 hours for the same condition. ++You will pay a $0 copay for most Part D covered vaccines, including Shingrix, from network providers.

90-day supplies of maintenance medications are available at retail pharmacies and by mail order.

You will pay a maximum of $35 for each 1-month supply of Part D-covered insulin drugs through all drug payment stages, except the catastrophic coverage stage, where you pay $0.

You will pay a $0 copay for most Part D-covered vaccines, including Shingrix.


Initial Coverage Period	30-Day Supply	90-Day Supply
Tier 1	$0	$0
Tier 2	$0	$0
Tier 3	$20	$40
Tier 4	$40	$80
Tier 5	20% coinsurance	20% coinsurance

The Medicare Prescription Payment Plan: Starting Jan. 1, 2025, if you spend more than $2,000 for covered Part D prescription drugs each year, you may want to participate in the Medicare Prescription Payment Plan. This payment plan spreads your out-of-pocket prescription drug costs over the remainder of the calendar year. Learn more about the Medicare Prescription Payment Plan.


Peoples Health Group Medicare (HMO-POS) Office of Group Benefits (OGB)	Your Cost
Meals After Inpatient Hospital Stay
Up to 28 meals over 14 days	$0
Respite Care
Members diagnosed with dementia may be eligible for a maximum of 12 respite care sessions per year from the network respite care provider	$0
Fitness
Health Clubs, Online Classes and More	$0
Vision Services
Routine Eye Exam	$0
Glasses or Contact Lenses ($200 allowance)	$0
Hearing Services
Hearing Aids ($750 allowance)	$0
Routine Hearing Exam	$0
Dental - $2,000 Coverage Maximum
Dental - Preventive (X-rays, cleanings, exams - coverage frequency varies)	$0
Dental - Comprehensive/Restorative	$0
Dental - Bridges and Dentures	50% coinsurance

Notes:

Costs listed are based on use of network providers.

Authorization is required for certain services.

Doctor and Hospital Coverage


Peoples Health Group Medicare (HMO-POS) Office of Group Benefits (OGB)	In-network	Out-of-network
Out-of-Pocket Maximum	$2,500	Does not apply
Doctor Visits & NurseLine
Primary Care Provider Visit	$0	20% coinsurance
Specialist Visit	$10	20% coinsurance
Virtual Medical Visit or 24-Hour NurseLine	$0	Available through contracted provider
Preventive Care+
Pap Smears, Pelvic Exams, Mammograms	$0	20% coinsurance
Prostate & Colorectal Cancer Screenings	$0	20% coinsurance
Bone Mass Measurement	$0	20% coinsurance
Vaccinations (COVID-19, flu, pneumonia)++	$0	$0
Labs & Tests+
Lab Services, Diagnostic Tests, X-rays and Advanced Imaging (MRI, MRA, CT, PET scans etc.)	$0	20% coinsurance
Outpatient Surgery
Outpatient Surgery (outpatient hospital or ambulatory surgical center)	$0	20% coinsurance
Inpatient Hospital Care per Admission
Inpatient Deductible	$0	Same as Medicare
Inpatient Stay (per day) days 1-10	$50 per day	Same as Medicare
Inpatient Stay (per day) days 11 and beyond	$0	Same as Medicare
Worldwide Emergency and Urgent Care ^
Emergency Care (worldwide)	$50	$50
Urgent Care (inside the U.S.)	$5	$5
Urgent Care (outside the U.S.)	Does not apply	$50
Emergency Transportation (per one-way trip)
Emergency Ambulance Services (ground or air)	$50	$50
Home Health & Skilled Nursing Facility Care
Home Health	$0	20% coinsurance
Skilled Nursing Facility Care (semi private room and board, days 1-20)	$0	$0
Skilled Nursing Facility Care (semi private room and board, per each additional day)	$25 per day	$25 per day
Outpatient Services & Supplies
Occupational, Physical or Speech Therapy Visit	$0	20% coinsurance
Durable Medical Equipment (wheelchairs, oxygen, etc.)	5% coinsurance	20% coinsurance
Diabetes Monitoring Supplies (test strips, monitor, etc., from a retail pharmacy or a DME provider)	$0	20% coinsurance
Mental Health & Substance Abuse Treatment
Inpatient Mental Health (days 1-5)	$25 per day	Same as Medicare
Inpatient Mental Health (days 6-90)	$0	Same as Medicare
Outpatient Mental Health or Substance Abuse Group or Individual Visit	$0	20% coinsurance
Virtual Mental Health Visit	$0	Available through contracted provider
+Office visit copay may apply. ^Emergency care copay waived if admitted to inpatient hospital care within 24 hours for the same condition. ++You will pay a $0 copay for most Part D covered vaccines, including Shingrix, from network providers.

Part D Prescription Drug Coverage

90-day supplies of maintenance medications are available at retail pharmacies and by mail order.

You will pay a maximum of $35 for each 1-month supply of Part D-covered insulin drugs through all drug payment stages, except the catastrophic coverage stage, where you pay $0.

You will pay a $0 copay for most Part D-covered vaccines, including Shingrix.


Initial Coverage Period	30-Day Supply	90-Day Supply
Tier 1	$0	$0
Tier 2	$0	$0
Tier 3	$20	$40
Tier 4	$40	$80
Tier 5	20% coinsurance	20% coinsurance

Additional Benefits


Peoples Health Group Medicare (HMO-POS) Office of Group Benefits (OGB)	Your Cost
Meals After Inpatient Hospital Stay
Up to 28 meals over 14 days	$0
Respite Care
Members diagnosed with dementia may be eligible for a maximum of 12 respite care sessions per year from the network respite care provider	$0
Fitness
Health Clubs, Online Classes and More	$0
Vision Services
Routine Eye Exam	$0
Glasses or Contact Lenses ($200 allowance)	$0
Hearing Services
Hearing Aids ($750 allowance)	$0
Routine Hearing Exam	$0
Dental - $2,000 Coverage Maximum
Dental - Preventive (X-rays, cleanings, exams - coverage frequency varies)	$0
Dental - Comprehensive/Restorative	$0
Dental - Bridges and Dentures	50% coinsurance

Notes:

Costs listed are based on use of network providers.
Authorization is required for certain services.

Find Doctors, Medications & More | 2025

Doctors, Hospitals, Providers

Dental Providers

Medications

Pharmacies

Hearing

Medications

Important Documents | 2025

Plan Overview for Peoples Health Group Medicare (HMO-POS) Office of Group Benefits (OGB) – An overview of plan benefits

Annual Notice of Changes for Peoples Health Group Medicare (HMO-POS) Office of Group Benefits (OGB) – A summary of plan benefit changes compared to the previous year and other important plan details

Evidence of Coverage for Peoples Health Group Medicare (HMO-POS) Office of Group Benefits (OGB) – Information about plan benefits, membership, covered and noncovered services, member rights and responsibilities, and other important plan details

Summary of Benefits for Peoples Health Group Medicare (HMO-POS) Office of Group Benefits (OGB) – A general summary of plan benefits

Vendor Information – A listing of providers offering benefit-related services

Vendor List | 2025


Benefit Type	Vendor Name	Contact Information
Hearing Aids	UnitedHealthcare Hearing	1-866-445-2071 uhchearing.com/retiree
Routine Vision Services	UnitedHealthcare Vision	1-866-877-5403 peopleshealthretiree.com
Routine Dental Benefit	UnitedHealthcare Dental	1-800-807-9904 peopleshealthretiree.com
Prescription Drug Home Delivery	Optum Home Delivery, a service of OptumRx	1-888-279-1828 peopleshealthretiree.com
NurseLine	Nurseline	1-877-365-7949
Personal Emergency Response System	Lifeline	1-855-595-8485 lifeline.com/uhcgroup
Fitness Benefit	Renew Active	1-866-877-5403 peopleshealthretiree.com
Behavioral Health (including virtual visits)	Optum Behavioral Health	1-877-566-7913 liveandworkwell.com/?pin=PHPMA

How to Enroll | 2025

2022 Quick Guide C651-Choices-Patriot_male

2022 Quick Guide C651-Choices-Patriot_bfemale

2022 Quick Guide C651-Choices-Patriot_hmale

2022 Quick Guide C651-Choices-Patriot_afemale

By Mail

Write to us and request an enrollment packet.

Indicate your group plan – either:

Peoples Health Group Medicare OR Peoples Health Group Medicare for Office of Group Benefits Enrollment Packet Request
Three Lakeway Center
3838 N. Causeway Blvd.
Suite 2500
Metairie, LA 70002

Peoples Health Group Medicare Office of Group Benefits (OGB) | 2025

Peoples Health Group Medicare
Office of Group Benefits (OGB) | 2025

Member Website and App | 2025

Member Website

Member App