Choices 65 (FAQ)
How can Choices 65 give me so much coverage without charging me a monthly plan premium?
Am I giving up my Medicare coverage when I join Choices 65?
Who is my Primary Care Physician (PCP)?
What is a Physician Team?
Why is a Physician Team effective at managing my care?
What is the difference between Choice 1 and Choice 2?
Are there any special requirements to enroll in Choices 65?
Do I need to take a physical
What if I enroll in Choices 65 and find that the plan is not right for me?
How would I benefit from enrolling in Choices 65?
Is Choices 65 the Medicare solution for everyone?
What does Choices 65 do to monitor my health and optimize my well-being?
Is it true that there is virtually no claim paperwork?
Q: How can Choices 65 give me so much coverage without charging me a monthly plan premium?
A: We're able to provide more coverage than Medicare alone because our physicians and hospitals are committed to working together to give you high-quality, affordable care. Choices 65 is approved and funded by the Centers for Medicare and Medicaid Services (CMS), the agency that administers Medicare. When you join the plan, Medicare pays Choices 65 to provide your health coverage. That's why you continue paying your Medicare Part B premiums -- but no additional health plan premiums are required.
Q: Am I giving up my Medicare coverage when I join Choices 65?
A: Absolutely not. Choices 65 covers all of your Medicare benefits and additional benefits not covered by Medicare. You still pay your Medicare Part B premium, but in return you'll receive more benefits than Medicare without paying an additional plan premium.
Q: Who is my Primary Care Physician (PCP)?
A: When you join Choices 65, you'll select a Primary Care Physician (PCP) from our extensive physician list. Your current physician may already be affiliated with our network -- but if not, there are many highly qualified physicians to choose from. You should have no trouble finding a new physician in your neighborhood that you feel comfortable with.
Q: What is a Physician Team?
A Physician Team is a group of primary care and specialty care physicians who work together to coordinate your healthcare.
Q: Why is a Physician Team effective at managing my care?
A: Peoples Health has created Physician Teams for you to facilitate your healthcare as well as coordinate your hospital inpatient and outpatient visits. Because the physicians have established relationships and open lines of communication, they are able to work closely together to coordinate your care.
Q: What is the difference between Choice 1 and Choice 2?
A: Unlike other Medicare health plans, Choices 65 is an Open Access 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 provider within your Physician Team. 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.
- Choice 2 (Within Choices 65 Network) - Go directly to a provider within the Choices 65 provider network. No referral is needed!
Q: Are there any special requirements to enroll in Choices 65?
A: All we require is that you live in one of our service areas: Orleans, Jefferson, Plaquemines or St. Tammany parish. In addition, you must be enrolled in Medicare Part B and be entitled to Medicare Part A and do not have End-Stage Renal Disease.
Q: Do I need to take a physical?
A: No physical is required. You only have to answer a few brief questions that Medicare requires on your enrollment form to verify that you do not have End-Stage Renal Disease.
Q: What if I enroll in Choices 65 and find that the plan is not right for me?
A: If you find that Choices 65 is not best suited for your needs and you would like to discontinue your membership, you have the option to enroll in another plan or return to traditional Medicare at any time. You may have additional rights depending on your previous coverage. Call a Benefits Advisor for more information.
Q: How would I benefit from enrolling in Choices 65?
A: Unlike an HMO, we are an Open Access health plan. This means that as a member of Choices 65, you have the flexibility to choose your own Primary Care Physician (PCP) and specialists from our extensive network of providers. You also have the ability see specialists without a referral from your PCP.
Choices 65 also gives you all the benefits of a Medicare and Medicare Supplement plus much more including:
- 100% coverage for Medicare-approved hospital stays
- Physician office visits for $5 or $15 (PCP and specialists)
- Drug coverage through the gap for both generic and preferred brand drugs
- No monthly premiums
- Vision coverage (eye exam plus one pair of glasses or contacts per year)
- Preventive and Comprehensive dental care
Q: Is Choices 65 the Medicare solution for everyone?
A: If you have a strong relationship with a provider who is not in our network, and do not wish to consider changing to one of our providers, Choices 65 may not be the best option for you. You may want to consider other plans including HealthCare Select or Secure Health.
Q: What does Choices 65 do to monitor my health and optimize my well-being?
A: Choices 65 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
- Complementary fitness center membership and classes
- Disease Management Programs
Q: Is it true that there is virtually no claim paperwork?
A: Yes! Claims are forwarded to Choices 65 directly and we take care of the paperwork.