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Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Peoples Health Medicare Advantage Giveback LA-4 (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 Medicare Advantage Giveback LA-4 (HMO-POS) in 2026, please refer to our full plan details page.
Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Greater New Orleans and Baton Rouge area. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Peoples Health Medicare Advantage Giveback LA-4 (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 Medicare Advantage Giveback LA-4 (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 Medicare Advantage Giveback LA-4 (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. Additionally, this plan comes with a Part B Premium reduction of $105.00. You must continue to pay paying your reduced 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 $440.00 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 Medicare Advantage Giveback LA-4 (HMO-POS) plan features an annual drug deductible of $440. For Tier 1 preferred generic drugs, members enjoy no copay for a 1-month or 3-month supply at standard pharmacies and mail-order services. Tier 2 generic drugs are also highly affordable, costing a $10 copay for a 1-month supply at standard pharmacies, or no copay for a 3-month supply when using preferred mail order. For brand-name and specialty medications, costs transition to coinsurance percentages. Tier 3 preferred brand drugs require a 15% coinsurance for both standard pharmacy and mail-order options. Tier 4 non-preferred drugs and Tier 5 specialty drugs carry a 39% and 28% coinsurance respectively for a 1-month supply.
Additional Benefits
The Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS) plan offers comprehensive coverage with no copay and no coinsurance for primary care, preventive services, annual routine vision and hearing exams, and home health care. For inpatient hospital stays, members pay a daily copay of $435 for the first seven days, while emergency room visits have a $130 copay that is waived upon admission. Specialist visits and urgently needed care are also highly affordable, featuring low copays ranging from no copay up to $50. Preventive dental care is fully covered with no copay or coinsurance, while Medicare-covered dental, dialysis, and durable medical equipment require a 20% coinsurance. Diagnostic services like lab tests and diagnostic radiology are available with no copay, whereas outpatient X-rays carry a $30 copay and diagnostic tests have a $45 copay. Additionally, the plan provides a $200 eyewear allowance every two years and covers skilled nursing facility stays with no copay for the first 20 days.
Inpatient Hospital See details
Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS) covers inpatient acute hospital stays with no coinsurance and a $435 daily copay for days 1 to 7, and inpatient psychiatric stays with a $435 daily copay for days 1 to 5. There is no copay or coinsurance for additional acute hospital days, but room upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS) with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital services carry a copay of $0 to $435, observation services require a $435 daily copay, and outpatient substance abuse sessions have copays from $0 to $25.
Partial Hospitalization See details
Partial hospitalization is covered by the Peoples Health Medicare Advantage Giveback LA-4 (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 Medicare Advantage Giveback LA-4 (HMO-POS) covers ground and air ambulance services with a $270 copay 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 Medicare Advantage Giveback LA-4 (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 a copay of $0 to $50 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS) covers primary care, telehealth, and opioid treatment with no copay and no coinsurance. Specialist visits, therapy, and mental health services feature copays ranging from $0 to $50 with no coinsurance, though chiropractic and podiatry services are not covered.
Preventive Services See details
Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS) covers preventive services, including annual physical exams, kidney disease education, and glaucoma screenings, with no copay and no coinsurance. A fitness benefit is also covered with no copay or coinsurance, though multiple additional preventive services like health education, nutritional benefits, and in-home support are not covered.
Hearing Services See details
Hearing services are partially covered by Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS) with no coinsurance, though prior authorization is required for exams and prescription hearing aids. Hearing exams have a $20 copay (no copay for routine annual exams), while OTC hearing aids require a $199 to $829 copay and covered prescription hearing aids require a $199 to $1,249 copay (limit of two per year); fitting evaluations and inner, outer, or over-the-ear prescription aids are not covered.
Vision Services See details
Vision Services are covered by Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS) with no coinsurance, featuring no copay for one annual routine eye exam and a $200 maximum eyewear limit every two years. This benefit is partially covered, as other eye exams, upgrades, and combined eyeglasses (lenses and frames) are not covered, while individual eyeglass lenses carry a copay of $0 to $153.
Dental Services See details
Dental services are partially covered under the Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS) plan, which offers Medicare-covered dental care with no copay and a 20% coinsurance, and preventive dental services with no copay and no coinsurance. Non-covered services include restorative services, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS) with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and radiation, carry a coinsurance ranging from no coinsurance to 20%, while Part B insulin drugs require a $35 copay and up to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS) covers durable medical equipment and prosthetics with no copay and 20% coinsurance, subject to prior authorization and preferred vendor rules. Diabetic equipment, supplies, and therapeutic shoes are covered with no copay and no coinsurance, though prior authorization is required and brand limitations may apply.
Diagnostic and Radiological Services See details
Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS) covers diagnostic and radiological services, with prior authorization required. Outpatient diagnostic tests have a $45 copay, outpatient X-rays require a $30 copay, and therapeutic radiological services have a 20% coinsurance, while lab services and diagnostic radiological services are offered with no copay and no coinsurance.
Home Health Services See details
Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS) covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS) covers Cardiac Rehabilitation Services with no copay and no coinsurance, although only some services are covered in practice. Prior authorization is required, and cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20 and a $218 copay for days 21 through 100, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS) partially covers other services, offering a meal benefit for chronic illnesses with no copay and no coinsurance, though prior authorization is required. Acupuncture and over-the-counter (OTC) items are not covered under this benefit.
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