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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 2025, 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 2025.
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 $106.00. 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 $340.00 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 has an enhanced alternative drug benefit. The plan has a deductible of $340.00. During the initial coverage phase, after the deductible is met, you will pay a copay for your prescriptions. For standard generic drugs, the copay is $10.00, and for preferred brand drugs, the copay is $100.00. For non-preferred drugs, you pay 29% coinsurance.
Additional Benefits
The Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS) plan offers comprehensive coverage with a variety of benefits. You can expect no copays for primary care, preventive services such as an annual physical exam, vision services like eye exams, dental services like oral exams, and home health services. Inpatient hospital stays have a $350 copay for the first week, then no copay for the remainder of the stay. This plan also includes coverage for outpatient services with varying copays, and ambulance services with a $275 copay per service. Additional benefits include hearing, vision, and dental coverage with copays that vary by service. The plan also covers medical equipment, diagnostic and radiological services, and skilled nursing facility stays with specific copayments.
Inpatient Hospital See details
Inpatient Hospital benefits include coverage for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, you will pay a $350 copay for days 1-7, and no copay for days 8-90, and for Inpatient Hospital Psychiatric, you will pay a $350 copay for days 1-6, and no copay for days 7-90. Non-Medicare-covered Stay for Inpatient Hospital-Acute, Additional Days for Inpatient Hospital Psychiatric, and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services with a copay between $0 and $350, observation services with a $350 copay, Ambulatory Surgical Center (ASC) services with no copay, outpatient substance abuse services with a copay between $0 and $25 for individual sessions and a $15 copay for group sessions, and outpatient blood services with no copay. Prior authorization is required for all of these services.
Partial Hospitalization See details
Partial Hospitalization is covered by the Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS) plan with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
The Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS) plan covers ambulance services, including both ground and air ambulance services, each with a $275 copay and no coinsurance. Transportation services to health-related locations are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS) plan. Emergency Services have a $125 copay, Urgently Needed Services have a copay between $0 and $55, and Worldwide Emergency Services have a copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS) plan offers primary care services with no copay, chiropractic services with a $20 copay, and occupational therapy with a copay between $0 and $40. The plan also covers physician specialist services with a copay between $0 and $40, mental health specialty services with a copay between $0 and $25 for individual sessions and $15 for group sessions, other health care professional services with a copay between $0 and $40, psychiatric services with a copay between $0 and $25 for individual sessions and $15 for group sessions, physical therapy and speech-language pathology services with a copay between $0 and $45, additional telehealth benefits with no copay, and opioid treatment program services with no copay. Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
Preventive Services include coverage for Medicare-covered preventive services, an annual physical exam with no copay, and additional preventive services which may have a copay. This plan also covers Fitness Benefit and Home and Bathroom Safety Devices and Modifications with no copay. Some preventive services like health education, in-home safety assessment, and others are not covered.
Hearing Services See details
Hearing exams are covered with a $20 copay, and routine hearing exams are covered with no copay for one visit every year. Prescription hearing aids are covered with a copay between $199 and $1249 for up to two hearing aids every year, and OTC hearing aids are covered with a copay between $99 and $829 for up to two hearing aids every year. Fitting/evaluation for hearing aids, prescription hearing aids - inner ear, prescription hearing aids - outer ear, and prescription hearing aids - over the ear are not covered.
Vision Services See details
The Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS) plan covers vision services, including eye exams with no copay, and eyewear with no copay for contact lenses, eyeglass frames, and eyeglass lenses. Eyeglasses (lenses and frames) and upgrades are not covered, and there is a combined maximum of $200 for eyewear every two years.
Dental Services See details
Dental Services are partially covered by the Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS) plan, with 20% coinsurance for Medicare Dental Services. Oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive dental services have no copay, but other services such as orthodontics, restorative services, and more are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. Insulin has a $35 copay and a coinsurance between 0% and 20%. Other Medicare Part B Drugs and Medicare Part B Chemotherapy/Radiation Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization. You will pay a coinsurance of 20% for these services.
Medical Equipment See details
Medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, are covered. Durable medical equipment has a 20% coinsurance, while prosthetics and medical supplies have a 20% coinsurance, and diabetic supplies and diabetic therapeutic shoes/inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services and radiological services. Diagnostic Procedures/Tests have a copay of $45, while Lab Services have no copay. Diagnostic Radiological Services have a copay of up to $250, Therapeutic Radiological Services have 20% coinsurance, and Outpatient X-Ray Services have a $25 copay.
Home Health Services See details
Home Health Services are covered by the Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS) plan with no copay and no coinsurance. Additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover any of the listed sub-services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS) plan. You will have no copay for days 1-20, and a $203 copay for days 21-100; additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include coverage for Over-the-Counter (OTC) Items and Meal Benefits with no copay, but acupuncture and several other services are not covered. The OTC benefit includes no copay and covers nicotine replacement therapy and Naloxone.
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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