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Peoples Health Complete Care LA-7 (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-7 (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-7 (HMO-POS C-SNP) in 2025, please refer to our full plan details page.
Peoples Health Complete Care LA-7 (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 Select parishes in Louisiana. 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-7 (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-7 (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-7 (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-7 (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 $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 Complete Care LA-7 (HMO-POS C-SNP) plan has a $255 deductible for prescription drugs. After the deductible, you'll pay a copay for your prescriptions depending on the drug tier and pharmacy you use. For example, you'll pay a $5 copay for preferred generic drugs at a standard pharmacy, and $47 for standard generic drugs at a standard pharmacy. For preferred brand drugs, the copay is $100 at standard or mail order pharmacies. Non-preferred drugs have a 30% coinsurance.
Additional Benefits
The Peoples Health Complete Care LA-7 (HMO-POS C-SNP) plan offers a range of benefits, including coverage for inpatient and outpatient services, with varying copays depending on the service. You'll find that many services have no copay, such as primary care visits, hearing exams, and home health services. This plan also provides coverage for emergency services, ambulance services, and some vision and dental care. Additionally, the plan includes coverage for home infusion services, dialysis, and medical equipment, but may require prior authorization or have coinsurance costs.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you will pay a $155 copay for days 1-10 and no copay for days 11-90, and additional days have no copay. For Inpatient Hospital Psychiatric, you will pay a $155 copay for days 1-10 and no copay for days 11-90. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient services, including all outpatient hospital services, observation services, outpatient substance abuse services, and outpatient blood services are covered. Outpatient hospital services have a copay between $0 and $155, observation services have a $155 copay, and outpatient blood services have no copay. Individual outpatient substance abuse sessions have a copay between $0 and $25, while group sessions have a $15 copay.
Partial Hospitalization See details
Partial hospitalization is covered under this plan, but requires prior authorization. The copay for this benefit is $55.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Peoples Health Complete Care LA-7 (HMO-POS C-SNP) plan. All ambulance services are covered with a $120 copay for both ground and air ambulance services, 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 by Peoples Health Complete Care LA-7 (HMO-POS C-SNP). Emergency Services has a $125 copay, and Urgently Needed Services have a copay between $0 and $55; both have no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have no copay and no coinsurance.
Primary Care See details
Primary Care benefits include no copay for Primary Care Physician Services, a $20 copay for Chiropractic Services, and a $0-$20 copay for Physician Specialist Services. Occupational Therapy Services and Physical Therapy and Speech-Language Pathology Services have a copay of $0-$20, and Mental Health and Psychiatric individual and group sessions have copays ranging from $0-$25 and $15 respectively. Additional Telehealth Benefits and Opioid Treatment Program Services have no copay, while Podiatry Services are not covered.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services with no copay, an annual physical exam with no copay, and additional services with varying copays. Additional preventive services that are not covered include Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, and Remote Access Technologies. Other preventive services include Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit with no copay.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams are covered once per year with no copay. Prescription hearing aids are partially covered, with a copay between $199 and $1249 for all types, but inner ear, outer ear, and over the ear hearing aids are not covered. OTC hearing aids are covered with a copay between $99 and $829.
Vision Services See details
The Peoples Health Complete Care LA-7 (HMO-POS C-SNP) plan covers vision services, including routine eye exams and eyewear. Eye exams and contact lenses have no copay, while eyeglass lenses have a copay of $0-$153, and eyeglass frames have no copay. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services include coverage for oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services. Medicare Dental Services have a 20% coinsurance, and other services have no copay. Orthodontic, restorative, adjunctive general, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, and oral and maxillofacial surgery are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Peoples Health Complete Care LA-7 (HMO-POS C-SNP) plan, but require prior authorization. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies with 20% coinsurance; Durable Medical Equipment for use outside the home is not covered. Diabetic Equipment is covered with no copay for Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts, but other diabetic equipment has a copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by this plan. Diagnostic Procedures/Tests have a $40 copay, while Lab Services have no copay. Diagnostic Radiological Services have a copay of at most $250, and Therapeutic Radiological Services have a coinsurance of at most 20%. Outpatient X-Ray Services have a $20 copay.
Home Health Services See details
Home Health Services are covered by Peoples Health Complete Care LA-7 (HMO-POS C-SNP) 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 Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Peoples Health Complete Care LA-7 (HMO-POS C-SNP) plan, but require prior authorization. You will have no copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) Items and Meal Benefits, with no copay for each, though 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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