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Peoples Health Choices Gold (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Peoples Health Choices Gold (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 Gold (HMO-POS) in 2026, please refer to our full plan details page.
Peoples Health Choices Gold (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Southwest and North Louisiana. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Peoples Health Choices Gold (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 Gold (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 Gold (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 $6700.00 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 Gold (HMO-POS) Medicare plan has an annual prescription drug deductible of $355. Under this plan, Tier 1 preferred generic drugs are highly affordable, requiring no copay for 1-month or 3-month supplies at standard pharmacies and through mail order. Tier 2 generic drugs carry a $10 copay for a 1-month supply at standard pharmacies, though a 3-month supply has no copay when filled through preferred mail order. For brand-name and higher-tier medications, cost-sharing is based on coinsurance percentages. Tier 3 preferred brands require a 20% coinsurance for standard pharmacy and mail order fills, while Tier 4 non-preferred drugs have a 38% coinsurance. Tier 5 specialty drugs require a 29% coinsurance for a 1-month supply through standard pharmacies and mail order.
Additional Benefits
Peoples Health Choices Gold (HMO-POS) offers robust healthcare coverage with no copay for primary care, preventive care, and home health services. Specialist visits feature copays ranging from no copay to $40, while inpatient hospital stays require a $275 daily copay for the initial days of care with no coinsurance. Emergency services are covered with a $130 copay that is waived if admitted, and urgent care ranges from no copay to a $50 copay. The plan also provides excellent supplemental benefits, including routine dental, vision, and hearing exams with no copay. Dental services are covered up to a $2,000 annual limit, and members receive a $300 eyewear allowance every two years. Additionally, there is no copay for over-the-counter items, though durable medical equipment and dialysis services require a 20% coinsurance.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Peoples Health Choices Gold (HMO-POS) with no coinsurance, though prior authorization is required. For acute care, there is a $275 daily copay for days 1-10 and no copay for days 11-999, while psychiatric care requires a $275 daily copay for days 1-9 and no copay for days 10-90; upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services under the Peoples Health Choices Gold (HMO-POS) plan are covered with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital services require a copay of $0 to $275, and outpatient substance abuse sessions have a copay of $0 to $25, with prior authorization required for most services.
Partial Hospitalization See details
Partial hospitalization services are covered by Peoples Health Choices Gold (HMO-POS) with a $55.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Peoples Health Choices Gold (HMO-POS), with ground and air ambulance services requiring a $290 copay and no coinsurance. Prior authorization is required for ambulance services, and while some transportation services are covered, trips to plan-approved health-related locations and any health-related locations are not covered.
Emergency Services See details
Peoples Health Choices Gold (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 require no copay to a $50 copay with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Peoples Health Choices Gold (HMO-POS) provides primary care, telehealth, and opioid treatment services with no copay and no coinsurance, though chiropractic and podiatry services are not covered. Other covered benefits feature no coinsurance, with copayments ranging from $0 to $40 for specialists, $0 to $25 for mental health and psychiatric sessions, and $35 for physical, occupational, and speech therapies.
Preventive Services See details
Peoples Health Choices Gold (HMO-POS) provides preventive services with no copay and no coinsurance, covering annual physical exams, fitness benefits, home safety devices, kidney disease education, and select screenings. However, this benefit is only partially covered, as health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, remote access technologies, and counseling are not covered.
Hearing Services See details
Peoples Health Choices Gold (HMO-POS) covers hearing services, featuring one annual routine hearing exam with no copay and no coinsurance, though fitting and evaluation exams are not covered. The plan also covers up to two prescription hearing aids (with copays from $199 to $1,249) and up to two OTC hearing aids (with copays from $199 to $829) annually with no coinsurance, though inner, outer, and over-the-ear prescription models are not covered.
Vision Services See details
Peoples Health Choices Gold (HMO-POS) partially covers vision services, providing one annual routine eye exam with no copay or coinsurance, and a $300 eyewear allowance every two years with no coinsurance and copays ranging from $0 to $153. Contact lenses and eyeglass frames have no copay, while other eye exams, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Peoples Health Choices Gold (HMO-POS) partially covers dental services up to a $2,000 annual maximum, excluding implant services and orthodontics which are not covered. Medicare-covered dental services require a $35 copay and no coinsurance, while preventive services have no copay and no coinsurance, and comprehensive services require no copay and 50% coinsurance.
Home Infusion bundled Services See details
Peoples Health Choices Gold (HMO-POS) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Covered Medicare Part B chemotherapy and other drugs have no copay and coinsurance ranging from no coinsurance up to 20%, while Part B insulin carries a $35 copay and coinsurance ranging from no coinsurance up to 20%.
Dialysis Services See details
Dialysis Services are covered by Peoples Health Choices Gold (HMO-POS) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Peoples Health Choices Gold (HMO-POS) covers durable medical equipment and prosthetics with no copay and a 20% coinsurance. Diabetic equipment is covered with no coinsurance, offering diabetic supplies with no copay and diabetic therapeutic shoes or inserts for a $10 copay.
Diagnostic and Radiological Services See details
Peoples Health Choices Gold (HMO-POS) covers diagnostic and radiological services, both requiring prior authorization. Diagnostic tests and outpatient X-rays require a $30 copay, while lab services and diagnostic radiology have no copay, and therapeutic radiology requires a 20% minimum coinsurance.
Home Health Services See details
Peoples Health Choices Gold (HMO-POS) covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Peoples Health Choices Gold (HMO-POS) covers cardiac rehabilitation services with no coinsurance, though prior authorization is required. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Peoples Health Choices Gold (HMO-POS) covers skilled nursing facility services with no coinsurance and no prior three-day hospital stay required, though prior authorization is necessary. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services under Peoples Health Choices Gold (HMO-POS) are partially covered, featuring over-the-counter (OTC) items and chronic illness meals with no copay and no coinsurance. Acupuncture is not covered under this benefit, and the meal benefit requires prior authorization.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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