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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 $5900.00 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:
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Drug Coverage
The Peoples Health Choices 65 (HMO-POS) prescription drug plan features an annual drug deductible of $355. Under this plan, Tier 1 preferred generic drugs are highly affordable with no copay for 1-month or 3-month supplies at standard pharmacies and mail order. Tier 2 generic drugs require a $5 copay for a 1-month supply at standard pharmacies, but you can get a 3-month supply with no copay through preferred mail order. For brand-name and specialty medications, your costs are based on a percentage of the drug cost. Tier 3 preferred brand drugs carry a 21% coinsurance for standard pharmacy and mail order fills. Tier 4 non-preferred drugs require a 43% coinsurance, while Tier 5 specialty drugs have a 29% coinsurance for a 1-month supply.
Additional Benefits
The Peoples Health Choices 65 (HMO-POS) plan offers comprehensive medical coverage with no copays or coinsurance for primary care, telehealth, and routine preventive services. For specialist visits, members pay a copay of up to $35, while inpatient hospital stays require a $195 daily copay for the first 10 days and no copay for remaining days. Emergency room visits feature a $130 copay that is waived upon admission, and urgent care services require a copay of up to $50. Supplemental benefits include preventive dental care with no copay and comprehensive dental services covered at 50% coinsurance up to a $3,000 annual limit. Routine vision and hearing exams are covered with no copay, and the plan provides coverage for eyewear and hearing aids with no deductibles or coinsurance. Members also receive home health services, select over-the-counter items, and chronic illness meals with no copay and no coinsurance.
Inpatient Hospital See details
Peoples Health Choices 65 (HMO-POS) covers inpatient hospital services with no coinsurance, requiring a $195 daily copay for days 1 through 10 and no copay for days 11 through 90. Acute hospital stays include unlimited additional days with no copay, while psychiatric stays do not cover additional days, and both exclude upgrades and non-Medicare-covered stays.
Outpatient Services See details
Peoples Health Choices 65 (HMO-POS) covers outpatient services with no coinsurance, though prior authorization is required for most care. Outpatient hospital services feature a copay ranging from $0 to $195, while ambulatory surgical center and blood services have no copay. Outpatient substance abuse sessions require a copay of up to $25 for individual visits and $15 for group sessions.
Partial Hospitalization See details
Peoples Health Choices 65 (HMO-POS) covers partial hospitalization services 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 $280 copay and no coinsurance, though prior authorization is required. While some transportation services are covered, transportation to plan-approved health-related locations and any other health-related locations is not covered.
Emergency Services See details
Peoples Health Choices 65 (HMO-POS) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services feature a copay of $0 to $50 and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays and no coinsurance.
Primary Care See details
Peoples Health Choices 65 (HMO-POS) offers primary care and telehealth services with no copay and no coinsurance, while specialist visits cost a $0 to $35 copay with no coinsurance. Physical, occupational, and speech therapies require a $35 copay with no coinsurance, whereas podiatry is not covered, and some chiropractic services are covered though routine and other chiropractic services are not. Mental health and psychiatric individual sessions have a $0 to $25 copay with no coinsurance.
Preventive Services See details
Peoples Health Choices 65 (HMO-POS) offers comprehensive coverage for preventive services, including annual physicals, kidney disease education, and glaucoma screenings, all with no copay and no coinsurance. While fitness benefits and home safety devices are covered at no cost, several additional supplemental services, such as health education, nutritional therapy, and in-home support, are not covered.
Hearing Services See details
Peoples Health Choices 65 (HMO-POS) partially covers hearing services, excluding fitting or evaluation exams as well as inner, outer, or over-the-ear prescription hearing aids. Covered routine hearing exams feature no copay, while prescription hearing aids require a copay of $199 to $1,249 and OTC hearing aids require a copay of $199 to $829, all with no coinsurance or deductibles.
Vision Services See details
Peoples Health Choices 65 (HMO-POS) partially covers vision services with no deductible and no coinsurance, featuring no copay for annual routine eye exams and select eyewear like contact lenses and frames, up to a $300 maximum every two years. Eyeglass lenses require a copay of $0 to $153, while other eye exams, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by Peoples Health Choices 65 (HMO-POS) up to a $3,000 annual limit, excluding implant services and orthodontics which are not covered. Medicare-covered dental requires a $20 copay and no coinsurance, preventive care is available with no copay and no coinsurance, and comprehensive services require no copay and a 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. Associated Medicare Part B chemotherapy, radiation, and other Part B drugs have no coinsurance to 20% coinsurance, while Medicare Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Peoples Health Choices 65 (HMO-POS) covers Dialysis Services with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Peoples Health Choices 65 (HMO-POS) covers durable medical equipment and prosthetics with no copay and 20% coinsurance. Diabetic supplies and therapeutic shoes are also covered with no copay and no coinsurance, with prior authorization required for these medical equipment benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Peoples Health Choices 65 (HMO-POS) with prior authorization required. Lab services and diagnostic radiology have no copay and no coinsurance, diagnostic tests require a $50 copay and no coinsurance, outpatient X-rays require a $20 copay, and therapeutic radiology requires 20% coinsurance with no copay.
Home Health Services See details
Peoples Health Choices 65 (HMO-POS) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are technically covered with no coinsurance under the Peoples Health Choices 65 (HMO-POS) plan, but in practice, the benefit is not covered because cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) rehabilitation services are all excluded from coverage.
Skilled Nursing Facility (SNF) See details
Skilled nursing facility (SNF) services are covered by Peoples Health Choices 65 (HMO-POS) with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, a prior three-day inpatient hospital stay is not required, and additional days beyond the standard Medicare-covered days are not covered.
Other Services See details
Peoples Health Choices 65 (HMO-POS) partially covers other services, offering over-the-counter (OTC) items and a chronic illness meal benefit with no copay and no coinsurance. Acupuncture is not covered under this plan, and prior authorization is required for the meal benefit.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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