Things You Should Know

When you enroll in a Peoples Health Group Medicare (HMO-POS) plan, you will choose a primary care physician (PCP) who is affiliated with a physician team.

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.

You can use your physician team to access covered healthcare services, but you’re also free to access healthcare services from any Peoples Health Group Medicare (HMO-POS) physician or access healthcare services from a physician who is not contracted with Peoples Health (out-of-network physician). 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
Access healthcare services from healthcare 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 Group Medicare (HMO-POS) Network
Access healthcare services from healthcare providers outside of your physician team but still within the Peoples Health Group Medicare (HMO-POS) network of providers. Services utilized at this level generally have a slightly higher cost than those accessed at the "Within Physicians Team" level.

Out-of-Network
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 than those accessed at the "Within Physician Team" or "With Peoples Health Group Medicare (HMO-POS) Network" levels.