A non-government entity
Peoples Health Choices (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Peoples Health Choices (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Peoples Health Choices (PPO) in 2026, please refer to our full plan details page.
Peoples Health Choices (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in State of Louisiana. This plan received an overall rating of 2.5 out of 5 stars in 2026.
It's important to know that Peoples Health Choices (PPO) 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 (PPO).
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 (PPO), 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 $600.00 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 combined Maximum Out-Of-Pocket cost of $10100.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $10100.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 (PPO) prescription drug plan features an annual drug deductible of $600. For Tier 1 preferred generic drugs, members pay no copay at standard pharmacies and through both preferred and standard mail orders. Tier 2 generic medications require a $10 copay for a one-month supply at standard pharmacies, but offer no copay for a three-month supply via preferred mail order. For brand-name and specialty medications, costs transition to coinsurance percentages during the initial coverage phase. Tier 3 preferred brand drugs incur a 16% coinsurance for standard pharmacy and mail order options. Tier 4 non-preferred drugs require a 41% coinsurance and Tier 5 specialty tier drugs carry a 26% coinsurance for a one-month supply across standard pharmacies and mail order options.
Additional Benefits
The Peoples Health Choices (PPO) plan offers affordable coverage with no copay and no coinsurance for primary care visits, telehealth, home health services, and preventive care. For inpatient hospital stays, members pay a $295 copay per day for the first seven days and no copay for subsequent days, while outpatient hospital services range from no copay up to a $295 copay. Emergency care is available with a $130 copay, which is waived if admitted, and urgent care costs range from no copay to a $50 copay. Routine vision, hearing, and preventive dental exams feature no copay and no coinsurance, though comprehensive dental services are not covered. Diagnostic lab services and diagnostic radiology require no copay, while durable medical equipment and dialysis require a 20% coinsurance with no copay. Additionally, the plan covers over-the-counter items and chronic illness meals with no copay and no coinsurance.
Inpatient Hospital See details
Inpatient hospital services are covered by Peoples Health Choices (PPO) with no coinsurance, requiring a $295 copay for days 1 through 7 and no copay for days 8 and beyond. The plan partially covers these services, excluding upgrades, non-Medicare-covered stays, and additional days for psychiatric stays.
Outpatient Services See details
Outpatient services under Peoples Health Choices (PPO) are covered with no coinsurance, though prior authorization is required for most treatments. Patients will pay no copay for ambulatory surgical center and blood services, a $0 to $295 copay for outpatient hospital services, and a $0 to $25 copay for outpatient substance abuse sessions.
Partial Hospitalization See details
Peoples Health Choices (PPO) covers partial hospitalization benefits with a $55.00 copay and no coinsurance. Prior authorization is required to access these covered services.
Ambulance and Transportation Services See details
Peoples Health Choices (PPO) partially covers ambulance and transportation services, offering ground and air ambulance services for a $120 copay and no coinsurance, subject to prior authorization. Transportation services to plan-approved or any other health-related locations are not covered.
Emergency Services See details
Peoples Health Choices (PPO) 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 Choices (PPO) provides primary care and telehealth services with no copay and no coinsurance, while specialist visits require a $0 to $55 copay and no coinsurance. Other benefits like physical therapy ($20 copay) and mental health services ($0 to $25 copay) feature no coinsurance, though chiropractic services are not covered in practice.
Preventive Services See details
Preventive services are partially covered by Peoples Health Choices (PPO) with no copay and no coinsurance for covered services, including annual physical exams, kidney disease education, fitness benefits, and glaucoma screenings. However, several supplemental services are not covered, such as health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, weight management, alternative therapies, therapeutic massage, and in-home support.
Hearing Services See details
Hearing services are partially covered by Peoples Health Choices (PPO), featuring routine hearing exams with no copay and no coinsurance, though fitting and evaluation exams are not covered. Prescription and OTC hearing aids are covered with no coinsurance and copays ranging from $199 to $1,249 for prescription aids and $199 to $829 for OTC aids, but inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by Peoples Health Choices (PPO) with no coinsurance, offering one routine eye exam annually with no copay, though other eye exam services are not covered. Eyewear is also partially covered with no coinsurance and copays ranging from $0 to $153 up to a $150 maximum limit every two years for contact lenses, lenses, and frames, while upgrades and packaged eyeglasses (lenses and frames) are not covered.
Dental Services See details
Peoples Health Choices (PPO) partially covers dental services, offering preventive care like cleanings and exams with no copay and no coinsurance, and Medicare-covered dental services with no copay and a 20% coinsurance. Comprehensive dental services, including restorative, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics, are not covered.
Home Infusion bundled Services See details
Peoples Health Choices (PPO) covers home infusion bundled services with no copay, although prior authorization is required. Medicare Part B chemotherapy and other drugs carry a coinsurance ranging from no coinsurance to 20%, while Medicare Part B insulin is covered with a $35 copay and up to 20% coinsurance.
Dialysis Services See details
Peoples Health Choices (PPO) covers dialysis services with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Peoples Health Choices (PPO) covers durable medical equipment, prosthetics, medical supplies, and diabetic supplies with no copay and 20% coinsurance. Diabetic therapeutic shoes and inserts are also covered with 20% coinsurance, and prior authorization is required for these medical equipment benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Peoples Health Choices (PPO) with no coinsurance, but prior authorization is required. There is no copay for lab services and diagnostic radiology, a $5 copay for diagnostic tests and outpatient X-rays, and copays starting at $25 for therapeutic radiology.
Home Health Services See details
Home Health Services are covered under the Peoples Health Choices (PPO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Peoples Health Choices (PPO) with no coinsurance, although prior authorization is required. While some services are covered, in practice, cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled nursing facility (SNF) services are covered by Peoples Health Choices (PPO) with no coinsurance and do not require a prior three-day inpatient hospital stay. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Peoples Health Choices (PPO) offers partial coverage for other services, which includes over-the-counter items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture and other miscellaneous services are not covered under this benefit.
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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