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Looking for 2024 Peoples Health Choices Gold (HMO-POS)? Click here.

Peoples Health Choices Gold (HMO-POS) | 2025

H1961-017

A Medicare Advantage plan with Part D prescription drug coverage. Available in the following parishes: Acadia, Bossier, Caddo, Calcasieu, Cameron, Evangeline, Iberia, Lafayette, Ouachita, Rapides, St. Landry, St. Martin, Vermilion

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$0
Primary Care
Provider Visit

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$45/Quarter
Over-the-Counter
Items Allowance

Tooth icon

$0
Dental Exams, Cleanings
& X-rays

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Stethoscope icon

$0
Primary Care
Physician Visit

Tooth icon

$0
Dental Exams,
Cleanings & X-rays

Icon of a bandage

$45/quarter
Over-the-Counter
Items Allowance

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Get your FREE Medicare information kit, including these must-have guides: 2025 Peoples Health Plan Overview and Get Ready for Medicare. Together, these booklets can help you better understand your Medicare coverage options.

Plan Highlights | 2025

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$0 Primary
Care Visits

Tooth icon

$0
Dental Exams,
Cleanings & X-rays

Icon of a bandage

$45 Over-the-Counter
Allowance per Quarter

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$0
Respite Care
Services

Fitness icon

$0
Fitness Benefit

Glasses icon

$0
Eyeglasses
or Contacts**

Pill bottle icon

$0 Tier 1 & 2 
Drug Coverage*

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$0 Meals
After Inpatient
Hospital Stay

*$0 tier 2 drugs available by preferred mail-order as a 100-day supply.
**$0 Standard Eyeglass Lenses; Allowance Amount for Eyeglass Frames or Contacts

Plan Benefits | 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.

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100-day supplies of maintenance medications on tiers 1, 2 and 3 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.

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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.

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Notes:

Costs listed are based on use of network providers.

Authorization is required for certain services.

Doctor and Hospital Coverage

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Part D Prescription Drug Coverage

100-day supplies of maintenance medications on tiers 1, 2 and 3 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.

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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.

Additional Benefits

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Notes:

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

Important Documents | 2025

Plan Overview for Peoples Health Choices Gold – An overview of plan benefits

Annual Notice of Changes for Peoples Health Choices Gold – A summary of plan benefit changes compared to the previous year and other important plan details

Evidence of Coverage for Peoples Health Choices Gold – Information about plan benefits, membership, covered and noncovered services, member rights and responsibilities, and other important plan details

Summary of Benefits for Peoples Health Choices Gold – A general summary of plan benefits

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

Medicare Star Ratings Summary

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How to Enroll | 2025

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