A non-government entity
Peoples Health Patriot (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Peoples Health Patriot (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Peoples Health Patriot (PPO) in 2026, please refer to our full plan details page.
Peoples Health Patriot (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 Patriot (PPO) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Peoples Health Patriot (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 Patriot (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. Additionally, this plan comes with a Part B Premium reduction of $185.00. 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.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
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
Prescription drugs are not covered by Peoples Health Patriot (PPO).
Additional Benefits
The Peoples Health Patriot (PPO) plan offers robust medical coverage with no copay for primary care visits, annual physicals, and home health services. For inpatient hospital stays, members pay a $295 daily copay for days 1 through 6 and no copay for days 7 through 90, with skilled nursing facilities requiring no copay for the first 20 days. Emergency room visits require a $130 copay, while outpatient services range from no copay up to a $295 copay with no coinsurance. Specialty care features dental benefits up to a $5,000 annual maximum with no copay and a 50% coinsurance for comprehensive services. Routine annual hearing and vision exams have no copay, with a $300 eyewear allowance every two years and hearing aid copays ranging from $199 to $1,249. Durable medical equipment and dialysis services are also covered with no copay and a 20% coinsurance.
Inpatient Hospital See details
Peoples Health Patriot (PPO) inpatient hospital benefits are partially covered, offering acute and psychiatric stays with no coinsurance and a $295 daily copay for days 1 through 6, and no copay for days 7 through 90. While unlimited additional acute care days are covered at no copay, upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Peoples Health Patriot (PPO) covers outpatient services with no coinsurance, including ambulatory surgical center and outpatient blood services which have no copays. Outpatient hospital and observation services require copays ranging from $0 to $295, while outpatient substance abuse services carry copays up to $25, with prior authorization required for these benefits.
Partial Hospitalization See details
Peoples Health Patriot (PPO) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance services are covered by Peoples Health Patriot (PPO) with a $275 copay and no coinsurance for both ground and air transport, though prior authorization is required. Routine transportation services to health-related locations are not covered.
Emergency Services See details
Peoples Health Patriot (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 and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Peoples Health Patriot (PPO) offers primary care physician visits, telehealth, and opioid treatment services with no copay and no coinsurance. Other covered services also feature no coinsurance, with copays ranging from $0 to $55 for specialists, $45 for occupational therapy and podiatry, and $50 for physical and speech therapy, while routine and other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by Peoples Health Patriot (PPO) with no copay and no coinsurance for annual physical exams, fitness benefits, home safety devices, and kidney disease education. However, several additional services are not covered under this benefit, including health education, personal emergency response systems (PERS), medical nutrition therapy, and weight management programs.
Hearing Services See details
Hearing services are partially covered by Peoples Health Patriot (PPO) with no coinsurance, offering one routine hearing exam per year with no copay, while fitting and evaluation services are not covered. Up to two prescription hearing aids (copays of $199 to $1,249) and OTC hearing aids (copays of $199 to $829) are covered annually with no coinsurance, though 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 Patriot (PPO) with no deductibles or coinsurance, featuring one annual routine eye exam and eyeglass frames with no copay. Covered eyewear has a combined maximum benefit of $300 every two years—including contact lenses with no copay and eyeglass lenses with a $0 to $153 copay—while other eye exams, upgrades, and packaged eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are covered by the Peoples Health Patriot (PPO) up to a $5,000 annual maximum, offering preventive care with no copay and no coinsurance, and Medicare-covered dental with no copay and a 20% coinsurance. Comprehensive dental benefits are partially covered with no copay and a 50% coinsurance, excluding implant services and orthodontics which are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by Peoples Health Patriot (PPO) with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy and other drugs range from no coinsurance to 20% coinsurance, while Part B insulin drugs have a $35 copay and up to 20% coinsurance.
Dialysis Services See details
Peoples Health Patriot (PPO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive this covered benefit.
Medical Equipment See details
Peoples Health Patriot (PPO) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes or inserts require a 20% coinsurance, with prior authorization required for these services.
Diagnostic and Radiological Services See details
Peoples Health Patriot (PPO) covers diagnostic and radiological services, with prior authorization required for all services. Diagnostic tests carry a $50 copay with no coinsurance, outpatient X-rays have a $30 copay, therapeutic radiology has a 20% coinsurance, and lab services and diagnostic radiology are covered with no copay and no coinsurance.
Home Health Services See details
Home health services are covered by Peoples Health Patriot (PPO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Peoples Health Patriot (PPO) covers Cardiac Rehabilitation Services with no coinsurance and prior authorization, but in practice, only some services are covered. Standard cardiac, intensive cardiac, pulmonary (which carries a $15 copay), and SET for PAD services (which carries a $15 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Peoples Health Patriot (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, prior hospital stays of less than three days are allowed, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Peoples Health Patriot (PPO) provides coverage for select other services, including over-the-counter (OTC) items and meal benefits for chronic illnesses with no copay and no coinsurance. Prior authorization is required for the meal benefit, and acupuncture is not covered under this plan.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
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