A non-government entity
Peoples Health Choices 65 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Peoples Health Choices 65 (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Peoples Health Choices 65 (HMO-POS) in 2026, please refer to our full plan details page.
Peoples Health Choices 65 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in New Orleans Metro Area and Northshore. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Peoples Health Choices 65 (HMO-POS) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Peoples Health Choices 65 (HMO-POS).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Peoples Health Choices 65 (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $355.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $5400.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
Sign up for Peoples Health Choices 65 (HMO-POS)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Peoples Health Choices 65 (HMO-POS) prescription drug plan features an annual drug deductible of $355. For Tier 1 preferred generic drugs, there is no copay for a 1-month or 3-month supply at standard pharmacies or via mail order. Tier 2 generic drugs cost a $5 copay for a 1-month standard pharmacy supply, but you can get a 3-month supply with no copay through preferred mail order. Higher-tier medications under this plan are covered with coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 21% coinsurance for both standard pharmacy and mail-order fills. Tier 4 non-preferred drugs carry a 43% coinsurance, and Tier 5 specialty drugs require a 29% coinsurance for a 1-month supply.
Additional Benefits
The Peoples Health Choices 65 (HMO-POS) plan offers robust medical coverage with no copay or coinsurance for primary care visits, preventive services, and home health care. Specialist visits feature a low copay ranging from no copay to $50, while inpatient hospital stays require a $295 daily copay for the first 10 days of acute stays and no copay for subsequent days. Emergency care is accessible with a $130 copay that is waived upon admission, alongside no copay or coinsurance for worldwide emergency services. For ancillary benefits, the plan provides routine dental, vision, and hearing exams with no copay, though comprehensive dental services require a 50% coinsurance. Durable medical equipment and dialysis services require a 20% coinsurance with no copay, whereas diabetic equipment and supplies are fully covered with no copay and no coinsurance. Skilled nursing facility care is also highly affordable, featuring no copay for the first 20 days of your stay.
Inpatient Hospital See details
Inpatient hospital services are covered by Peoples Health Choices 65 (HMO-POS) with no coinsurance and daily copays of $295 for days 1-10 of acute stays and days 1-7 of psychiatric stays, with no copay for subsequent days. Prior authorization is required, and certain services such as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Peoples Health Choices 65 (HMO-POS) covers outpatient services with no coinsurance, including no copay for ambulatory surgical center and blood services. Outpatient hospital and observation services require a copay of up to $295, while outpatient substance abuse services carry a copay of up to $25, with prior authorization required for most services.
Partial Hospitalization See details
Partial hospitalization is covered under the Peoples Health Choices 65 (HMO-POS) plan with a $55.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Peoples Health Choices 65 (HMO-POS) covers ground and air ambulance services with a $275 copay per service and no coinsurance, though prior authorization is required. Routine transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Peoples Health Choices 65 (HMO-POS) covers emergency services with a $130 copay (waived if admitted to the hospital within 24 hours) and no coinsurance, and urgently needed services with a copay ranging from no copay to $50 and no coinsurance. Worldwide emergency, urgent, and emergency transportation services are also covered with no copays, no coinsurance, and no plan-level deductibles.
Primary Care See details
Peoples Health Choices 65 (HMO-POS) offers primary care, telehealth, and opioid treatment services with no copay and no coinsurance, while specialist visits range from a $0 to $50 copay with no coinsurance. Physical, occupational, and speech therapies require a $50 copay with no coinsurance, mental health and psychiatric services have copays up to $25 with no coinsurance, and chiropractic and podiatry services are not covered.
Preventive Services See details
Peoples Health Choices 65 (HMO-POS) covers preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, glaucoma screenings, and fitness benefits. However, additional preventive services are only partially covered, excluding health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, weight management, alternative therapies, and telemonitoring.
Hearing Services See details
Peoples Health Choices 65 (HMO-POS) offers partially covered hearing services, featuring routine hearing exams with no copay or coinsurance and other exams for a $20 copay and no coinsurance. Prescription hearing aids carry a copay of $199 to $1,249, and OTC hearing aids range from $199 to $829 with no coinsurance, though fitting evaluations and inner, outer, or over-the-ear prescription aids are not covered.
Vision Services See details
Vision Services are partially covered by Peoples Health Choices 65 (HMO-POS), offering no copay and no coinsurance for routine eye exams (one per year, prior authorization required) and contact lenses. Eyeglass frames and lenses are covered with no coinsurance and copays ranging from $0 to $153, subject to a $150 combined maximum benefit every two years, while other eye exam services, upgrades, and packaged eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered under Peoples Health Choices 65 (HMO-POS), with implant services and orthodontics not covered. Medicare-covered dental services require a $40 copay and no coinsurance, preventive care has no copay and no coinsurance up to a $1,000 annual maximum, and comprehensive services require no copay and 50% coinsurance.
Home Infusion bundled Services See details
Peoples Health Choices 65 (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Covered Medicare Part B chemotherapy, radiation, insulin, and other drugs require a coinsurance ranging from no coinsurance up to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
Peoples Health Choices 65 (HMO-POS) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required for these covered services.
Medical Equipment See details
Peoples Health Choices 65 (HMO-POS) covers durable medical equipment and prosthetics with no copay and a 20% coinsurance. Diabetic equipment, supplies, and therapeutic shoes are covered with no copay and no coinsurance, with prior authorization required for these services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Peoples Health Choices 65 (HMO-POS) with prior authorization required. Lab work and diagnostic radiology are available with no copay and no coinsurance, while diagnostic tests have a $55 copay, outpatient X-rays have a $30 copay, and therapeutic radiology requires a 20% coinsurance.
Home Health Services See details
Home health services are covered by Peoples Health Choices 65 (HMO-POS) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by Peoples Health Choices 65 (HMO-POS) with no copay and no coinsurance, though prior authorization is required. While some services are covered, Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Peoples Health Choices 65 (HMO-POS) with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by Peoples Health Choices 65 (HMO-POS), which provides over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered under this plan, and prior authorization is required to receive the meal benefit.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved