Things You Should Know:

Peoples Health offers you three levels of healthcare coverage that are available to you at any time.

When you enroll in Peoples Health, you will choose a primary care physician (or PCP) who is affiliated with a Physician Team, which is designed to help you best coordinate your healthcare.

Your Physician Team has both primary care and specialty care physicians who understand your medical history and coordinate your care. Examples of PCPs include internists and general and family practitioners. An example of a specialist is a cardiologist (who cares for people with heart conditions).

We find that most of our members prefer to coordinate all of their care through their PCP because that physician usually knows the most about their medical history and lifestyle. The PCP can then make recommendations to other doctors within the Physician Team when specialized care is needed.

If you’re like most Peoples Health members, you’ll probably want to use your Physician Team to access covered healthcare services. But you’re free to access healthcare services from any Peoples Health network physician or access healthcare services out-of-network. You will pay less out-of-pocket costs by working within your Physician Team to access covered healthcare services from participating providers. All choices are listed below in further detail.

Within Physician Team
Coverage applies when you access healthcare services from providers within your Physician Team. You can benefit from the guidance and expertise of working with your PCP, who can help you coordinate your care with the doctors and hospitals in your Physician Team.

Within Peoples Health Network
Coverage applies when you access healthcare services from providers outside of your Physician Team but still within the Peoples Health network or providers. Services utilized at this level generally have a slightly higher cost.

Out-of-Network
Coverage applies when you access healthcare services directly from an out-of-network provider. This gives you the ability to see any doctor or specialist you choose. Services utilized at this level will have a higher cost.

Page content last updated: 07-01-08