Frequently Asked Questions

Q: Am I giving up my Medicare coverage when I join Peoples Health Group Medicare (HMO-POS)?
A: Absolutely not. Peoples Health Group Medicare (HMO-POS) covers all of your Medicare benefits and additional benefits not covered by Medicare. You will still have to pay your Medicare Part B premium, but in return you'll receive more benefits than Medicare.

Q: Who is my primary care physician (PCP)?
A: When you join a Peoples Health Group Medicare (HMO-POS) plan, you'll select a primary care physician (PCP) from our extensive physician list. Your current physician may already be affiliated with our network of doctors -- but if not, there are many highly qualified physicians to choose from. You should have no trouble finding a new physician that you feel comfortable with.

Q: What is a physician team?
A: A physician team is a group of primary care and specialty care physicians who work together to coordinate your healthcare. Each physician team is also associated with specific hospitals. When you join a Peoples Health Group Medicare (HMO-POS) plan, you select a primary care physician (PCP), who is associated with a physician team.

Q: Why is a physician team effective at managing my care?
A: Peoples Health has created physician teams for you to facilitate the coordination of your healthcare including your hospital inpatient and outpatient visits. Because the physicians in the physician team have established relationships with one another and open lines of communication, they are able to work closely together to coordinate your care.

Q: What are my options for accessing care?
A: Peoples Health Group Medicare (HMO-POS) is a triple-option health plan. Each time you need to see a physician, you choose how you receive your care:

• Choice 1 (Within Physician Team) - Access care from any physician within your physician team, which is composed of primary care physicians and specialist physicians. You can benefit from the guidance and expertise of your primary care physician (PCP) who can help you coordinate care with the doctors and hospitals in your physician team. Office visits to your PCP cost just $5, and your visits to specialists within your physician team are only $10.
  
  
• Choice 2 (Peoples Health Group Medicare (HMO-POS) Network) - You can see any physician in the Peoples Health Group Medicare (HMO-POS) network of physicians for only $25 per visit.
  
  
• Choice 3 (Out-of-Network) - You can go to a non-participating or an out-of-network provider and still receive Medicare-level benefits. You pay 20% of the total costs when you see any physician who is not part of the Peoples Health Group Medicare (HMO-POS) network of physicians.

Q: Are there any special requirements to enroll in Peoples Health Group Medicare (HMO-POS)?
A: All that we require is that you are a retiree of the employer group that is contracted with Peoples Health and that you live in the service area that is designated individually by each employer group. In addition, you must be enrolled in Medicare Part B and Medicare Part A, and not have End-Stage Renal Disease (with limited exceptions, such as if you develop ESRD when you are already a member of a plan that we offer, or you were a member of a different plan that was terminated).

Q: Do I need to take a physical? What about pre-existing conditions?
A: No physical is required. You only have to answer a few brief questions that Medicare requires on your enrollment request form to verify that you do not have End-Stage Renal Disease.

Q: How would I benefit from enrolling in Peoples Health Group Medicare (HMO-POS)?
A: As a member of Peoples Health Group Medicare (HMO-POS), you have the flexibility to choose your own primary care physician (PCP) and specialists from our extensive network of physicians, as well as from outside our network of physicians. You also have the ability see specialists without a referral from your PCP. Peoples Health Group Medicare (HMO-POS) also gives you all the benefits of Medicare and Medicare Supplement plus much more including:

• 100% coverage for Medicare-approved hospital stays
• PCP office visits for only $5
• Specialist office visits for $10
• Prescription drug coverage through the gap
• Vision coverage (eye exam plus one pair of glasses or contacts per year)
• Preventive and comprehensive dental care

Q: What does Peoples Health Group Medicare (HMO-POS) do to monitor my health and optimize my well-being?
A: Peoples Health Group Medicare (HMO-POS) takes a proactive approach to maintaining and even improving your overall well-being. We offer many wellness features and programs to members, including:

• New member wellness evaluation
• Complimentary fitness center membership and classes
• Smoking cessation program
• Care Management programs to help manage chronic health conditions

Q: Is it true that there is virtually no paperwork?
A: Yes! Claims are forwarded to Peoples Health Group Medicare (HMO-POS) directly and we take care of the paperwork.

Still have questions?

Call us toll-free at (800)978-9765, Monday through Friday, from 8 a.m. to 8 p.m.