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Peoples Health Complete Care LA-5 (HMO-POS C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Peoples Health Complete Care LA-5 (HMO-POS C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Peoples Health Complete Care LA-5 (HMO-POS C-SNP) in 2025, please refer to our full plan details page.
Peoples Health Complete Care LA-5 (HMO-POS C-SNP) is a HMO-POS C-SNP 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 Complete Care LA-5 (HMO-POS C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Peoples Health Complete Care LA-5 (HMO-POS C-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Peoples Health Complete Care LA-5 (HMO-POS C-SNP).
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 Complete Care LA-5 (HMO-POS C-SNP), 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 $255.00 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 $3900.00 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 Complete Care LA-5 (HMO-POS C-SNP) plan has a $255 deductible for prescription drugs. After meeting your deductible, you will pay a copay for your prescriptions. For example, you will pay a $5 copay for standard generic drugs, and a $47 copay for standard generic drugs. For preferred brand drugs, the copay is $100, regardless of whether you get them at a standard pharmacy or through mail order. For non-preferred drugs, you will pay 30% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The Peoples Health Complete Care LA-5 (HMO-POS C-SNP) plan offers a wide range of benefits with varying cost-sharing. You can expect no copay for primary care, preventive services, hearing exams, vision exams, and many dental services. There are also no copays for home health services, over-the-counter items, and meal benefits. The plan includes copays for inpatient hospital stays, outpatient services, ambulance services, emergency services, and specialist visits. Additionally, the plan covers prescription hearing aids, eyewear, and offers some dental services, with some services having coinsurance.
Inpatient Hospital See details
Inpatient Hospital services are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both requiring prior authorization; Inpatient Hospital-Acute has a $95 copay for days 1-10, and no copay for days 11-90, while Inpatient Hospital Psychiatric has the same cost sharing. Additional days for Inpatient Hospital-Acute have no copay, but Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a copay between $0 and $125, Observation Services with a $125 copay, and Ambulatory Surgical Center (ASC) Services with no copay. Outpatient Substance Abuse Services are covered with a copay between $0 and $25 for individual sessions, and a $15 copay for group sessions, and Outpatient Blood Services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the Peoples Health Complete Care LA-5 (HMO-POS C-SNP) plan, but requires prior authorization. You will have a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Peoples Health Complete Care LA-5 (HMO-POS C-SNP) plan. Ground and Air Ambulance Services have a copay of $145.00. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Peoples Health Complete Care LA-5 (HMO-POS C-SNP) plan. Emergency Services have a $140 copay, while Urgently Needed Services have a copay between $0 and $65; both have no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay and no coinsurance.
Primary Care See details
The Peoples Health Complete Care LA-5 (HMO-POS C-SNP) plan covers primary care physician services with no copay. Chiropractic services have a $20 copay, while occupational therapy services have a copay between $0 and $10. Physician specialist services and physical therapy/speech-language pathology services have a copay between $0 and $10. Mental health and psychiatric services, and other health care professional services have varying copays. Opioid treatment program services have no copay. Additional telehealth benefits are covered with no copay. Podiatry services are not covered, and routine chiropractic care is not covered.
Preventive Services See details
Preventive Services include coverage for Medicare-covered preventive services, annual physical exams with no copay, and additional preventive services including Fitness Benefit, Home and Bathroom Safety Devices, and Modifications with no copay. Some services such as health education, in-home safety assessments, and counseling services are not covered.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams are covered once per year with no copay, but fitting/evaluation for hearing aids are not covered. Prescription hearing aids are covered, with copays between $199 and $1249, and OTC hearing aids are covered with a copay between $99 and $829.
Vision Services See details
Vision Services includes coverage for eye exams with no copay, and routine eye exams with no copay for one exam per year. Eyewear is covered with no copay for contact lenses, and eyeglass frames, while eyeglass lenses have a copay of $0-$153. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
The Peoples Health Complete Care LA-5 (HMO-POS C-SNP) plan covers dental services, including Medicare dental services with 20% coinsurance. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatments, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, maxillofacial prosthetics, oral and maxillofacial surgery are covered with no copay, while prosthodontics (removable and fixed) have 0-50% coinsurance. However, implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is 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 benefits are covered, including Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment with a copay for Medicare-covered diabetic supplies and therapeutic shoes/inserts. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests with a $25 copay and Lab Services with no copay. Diagnostic Radiological Services have a maximum copay of $150, while Therapeutic Radiological Services have a 20% coinsurance, and Outpatient X-Ray Services have a $15 copay.
Home Health Services See details
Home Health Services are covered by the Peoples Health Complete Care LA-5 (HMO-POS C-SNP) plan with no copay and no coinsurance, however, 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 Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services. Prior authorization is required, and the copay information is available within the plan details.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Peoples Health Complete Care LA-5 (HMO-POS C-SNP) plan, but require prior authorization. There is no copay for days 1-20, and a $203 copay for days 21-100.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) Items and a Meal Benefit with no copay. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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