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Peoples Health Secure Health (HMO SNP) | 2019

Looking for 2020 plan information? Click here.

$0 Monthly Plan Premium

A Medicare Advantage special needs plan designed for people with both Medicare and medical assistance from the state or Medicaid.

Blue circle with $0With this plan, you pay a $0 monthly plan premium and enjoy a long list of benefits, including Part D prescription drug coverage, with coverage through the gap. Plus, you get a Peoples Health  member ID card that’s widely accepted and easy to use.

Peoples Health Secure Health (HMO SNP) | 2019

A Medicare Advantage plan available to Medicare beneficiaries in the following parishes:

Acadia • Ascension • Assumption • Bossier • Caddo • Calcasieu • Cameron • East Baton Rouge • East Feliciana • Evangeline • Iberia • Iberville • Jefferson • Lafayette • Lafourche • Livingston • Orleans • Ouachita • Plaquemines • Pointe Coupee • St. Bernard • St. Charles • St. Helena • St. James • St. John the Baptist • St. Landry • St. Martin • St. Mary • St. Tammany • Tangipahoa • Terrebonne • Vermilion • Washington • West Baton Rouge • West Feliciana

Secure-Health-2019-plan-map-300px

Blue circle with $0Peoples Health Secure Health – $0 Monthly Plan Premium

A Medicare Advantage special needs plan designed for people with both Medicare and medical assistance from the state or Medicaid.

With this plan, you pay a $0 monthly plan premium and enjoy a long list of benefits, including Part D prescription drug coverage (with no coverage gap). Plus, you get a Peoples Health  member ID card that’s widely accepted and easy to use.

Over-the-Counter Items

Spend up to $200 Each Quarter Image

Peoples Health covers certain over-the-counter health-related items and nonprescription medications – up to $200 every three months from our network mail-order provider.

Plan Highlights for 2019

N

Over-the-Counter Items

N

$0 Meals After Inpatient Stay

N

$0 Respite Care Sessions

N

$0 Hearing Aids

N

Dentures Included in Dental Coverage

N

Transportation to and From Doctors’ Appointments

$0

PRIMARY CARE PHYSICIAN VISIT

$0

DENTAL EXAMS & CLEANINGS

$0

HEARING AIDS

$0

SPECIALIST VISIT

$0

FITNESS CLUB MEMBERSHIP

$0

EYEGLASSES OR CONTACTS

Plan Highlights for 2019

N
Over-the-Counter Items
N

$0 Meals After Inpatient Stay

N

$0 Respite Care Sessions

N
$0 Hearing Aids
N

Dentures Included in Dental Coverage

N

Transportation to and From Doctors’ Appointments

Additional Benefits for 2019

$0

PRIMARY CARE PHYSICIAN VISIT

$0

SPECIALIST VISIT

$0

DENTAL EXAMS & CLEANINGS

$0

FITNESS CLUB MEMBERSHIP

$0

HEARING AIDS

$0

EYEGLASSES OR CONTACTS

Explore Plan Benefits

Doctor and Hospital Coverage

Peoples Health Secure Health
YOUR COST    
Monthly Plan Premium$0
Doctor Visits
Primary Care Physician Visit$0
Specialist Visit$0
Preventive Care
Pap Smears, Pelvic Exams and Mammograms$0
Prostate and Colorectal Cancer Screenings$0
Bone Mass Measurement$0
Vaccinations (flu, pneumonia, hepatitis B)$0
Labs and Tests
Lab Services$0
Diagnostic Tests and X-rays$0
Advanced Imaging (MRI, MRA, CT, CTA, PET scans, etc.)$0 or $75*
Outpatient Surgery
Outpatient Hospital Facility or Ambulatory Surgical Center$0
Inpatient Hospital Care
Inpatient Deductible$0
Hospital Stay$0 or $60* per day for days 1-8
$0 per day for days 9 and beyond
Worldwide Emergency and Urgent Care♦
Emergency Care – Copay waived if admitted$0 or $50* in the U.S. and its territories; $50 outside the U.S. and its territories
Urgently Needed Care$0
Emergency Transportation (per one-way trip)
Emergency Ambulance Services$0 or $75*
Home Health
Home Health Care$0
Skilled Nursing Facility Care
Semiprivate Room and Board per day
for days 1-20
$0
Semiprivate Room and Board
per day for days 21-100
$0 or $100*
Outpatient Services and Supplies
Occupational, Physical or Speech Therapy Visit
(Medicare limits apply)
$0
Durable Medical Equipment (DME)
(wheelchairs, oxygen, etc.)
$0
Diabetes Monitoring Supplies
(test strips, monitor, etc.,
from a DME provider)
$0
Mental Health and Substance Abuse Treatment
Inpatient Mental Health Care$0 or $60* per day for days 1-8
$0 per day for days 9-90
Outpatient Mental Health or Substance Abuse Treatment Visit$0 or $10*

Notes:

Authorization is required for certain services.

Costs listed are based on use of network providers.

*Cost-sharing varies based on your level of Louisiana Medicaid coverage.

♦Emergency care copay waived if admitted to inpatient hospital care within 24 hours for the same condition. Up to $5,000 of coverage for emergency and urgently needed care (combined) outside the U.S. and its territories.

Part D Prescription Drug Coverage

 FOR A 30-DAY SUPPLY or 90-DAY SUPPLY AT A NETWORK PHARMACY
Your plan has a $415 deductible for prescription drug coverage; however, because you receive extra help, Medicare pays this deductible on your behalf. Copays vary based on the level of extra help you receive. Please contact the plan for further details.
Generic Drugs$0 or $1.25 or $3.40
Brand Drugs $0 or $3.80 or $8.50

Additional Benefits – Not Covered by Original Medicare

Peoples Health Secure HealthYour Cost
Over-the-Counter Health-Related Items
$200 Allowance (every three months by mail order)$0
Meals
Meals After Hospital Stays (three meals per day for seven days after an inpatient hospital stay)$0
Routine Vision Services
Routine Eye Exam$0
Eyeglasses or Contact Lenses
(one pair per year)
$0
Hearing Services
Routine Hearing Exam$0
Hearing Exam for Evaluation and Fitting of Hearing Aids
Click here for more information
$0
Hearing Aids (one per ear, max of $1,000 for both ears)
Click here for more information
$0
Dental - up to $2,000 in coverage
Oral Exams and Cleanings (one every six months)
Fluoride Treatment (one per year)
$0
X-rays (one set per year)$0
Comprehensive Dental Services
(such as fillings and dentures)
$0
Nonemergency Transportation (such as trips to and from your doctor's office)
Routine Transportation
(per one-way trip within 40 miles of your home)
$0 for up to 48 trips per year
Respite Care
Respite Care Services (for members with Alzheimer's or dementia; up to 12 sessions per year)$0
Fitness
Health Club Membership$0

Notes:

Costs listed are based on use of network providers.

Authorization is required for certain services.

For a detailed list of all plan benefits, click here to download the 2019 Peoples Health Secure Health Evidence of Coverage.

Explore Plan Benefits

Doctor and Hospital Coverage

Peoples Health Secure Health
YOUR COST    
Monthly Plan Premium$0
Doctor Visits
Primary Care Physician Visit$0
Specialist Visit$0
Preventive Care
Pap Smears, Pelvic Exams and Mammograms$0
Prostate and Colorectal Cancer Screenings$0
Bone Mass Measurement$0
Vaccinations (flu, pneumonia, hepatitis B)$0
Labs and Tests
Lab Services$0
Diagnostic Tests and X-rays$0
Advanced Imaging (MRI, MRA, CT, CTA, PET scans, etc.)$0 or $75*
Outpatient Surgery
Outpatient Hospital Facility or Ambulatory Surgical Center$0
Inpatient Hospital Care
Inpatient Deductible$0
Hospital Stay$0 or $60* per day for days 1-8
$0 per day for days 9 and beyond
Worldwide Emergency and Urgent Care♦
Emergency Care – Copay waived if admitted$0 or $50* in the U.S. and its territories; $50 outside the U.S. and its territories
Urgently Needed Care$0
Emergency Transportation (per one-way trip)
Emergency Ambulance Services$0 or $75*
Home Health
Home Health Care$0
Skilled Nursing Facility Care
Semiprivate Room and Board per day
for days 1-20
$0
Semiprivate Room and Board
per day for days 21-100
$0 or $100*
Outpatient Services and Supplies
Occupational, Physical or Speech Therapy Visit
(Medicare limits apply)
$0
Durable Medical Equipment (DME)
(wheelchairs, oxygen, etc.)
$0
Diabetes Monitoring Supplies
(test strips, monitor, etc.,
from a DME provider)
$0
Mental Health and Substance Abuse Treatment
Inpatient Mental Health Care$0 or $60* per day for days 1-8
$0 per day for days 9-90
Outpatient Mental Health or Substance Abuse Treatment Visit$0 or $10*

Notes:

Authorization is required for certain services.

Costs listed are based on use of network providers.

*Cost-sharing varies based on your level of Louisiana Medicaid coverage.

♦Emergency care copay waived if admitted to inpatient hospital care within 24 hours for the same condition. Up to $5,000 of coverage for emergency and urgently needed care (combined) outside the U.S. and its territories.

Part D Prescription Drug Coverage

All tier 1 and 2 generics are COVERED through the Part D coverage gap. Brand drugs have partial coverage through the gap. 90-day supplies of maintenance medications on tiers 1, 2, 3 and 4 are available at retail pharmacies and by mail order.

 FOR A 30-DAY SUPPLY or 90-DAY SUPPLY AT A NETWORK PHARMACY
Your plan has a $415 deductible for prescription drug coverage; however, because you receive extra help, Medicare pays this deductible on your behalf. Copays vary based on the level of extra help you receive. Please contact the plan for further details.
Generic Drugs$0 or $1.25 or $3.40
Brand Drugs $0 or $3.80 or $8.50

Additional Benefits

Peoples Health Secure HealthYour Cost
Over-the-Counter Health-Related Items
$200 Allowance (every three months by mail order)$0
Meals
Meals After Hospital Stays (three meals per day for seven days after an inpatient hospital stay)$0
Routine Vision Services
Routine Eye Exam$0
Eyeglasses or Contact Lenses
(one pair per year)
$0
Hearing Services
Routine Hearing Exam$0
Hearing Exam for Evaluation and Fitting of Hearing Aids
Click here for more information
$0
Hearing Aids (one per ear, max of $1,000 for both ears)
Click here for more information
$0
Dental - up to $2,000 in coverage
Oral Exams and Cleanings (one every six months)
Fluoride Treatment (one per year)
$0
X-rays (one set per year)$0
Comprehensive Dental Services
(such as fillings and dentures)
$0
Nonemergency Transportation (such as trips to and from your doctor's office)
Routine Transportation
(per one-way trip within 40 miles of your home)
$0 for up to 48 trips per year
Respite Care
Respite Care Services (for members with Alzheimer's or dementia; up to 12 sessions per year)$0
Fitness
Health Club Membership$0
Notes:

Costs listed are based on use of network providers. Authorization is required for certain services.

For a detailed list of all plan benefits, click here to download the 2019 Peoples Health Secure Health Evidence of Coverage.

Find Doctors, Search Medications and More

Use our search tools to find out if your doctors and favorite pharmacy are in our network or if we cover your prescription drug. If you need help, call us at 1-800-978-9765 (TTY: 711).

Medicaid Benefits

Peoples Health Secure Health members have coverage from both Medicare and Medicaid. These members receive their Medicare health care and prescription drug coverage through Peoples Health Secure Health. They are also eligible to receive additional health care services and coverage through Louisiana MedicaidClick here for more information on providers who participate in Louisiana Medicaid. For detailed information about Louisiana Medicaid benefits, please visit the Medicaid website and select the Learn about Medicaid Services link.

Eligibility Guidelines

Louisiana state map with Secure Health parishes highlighted
Determining if you’re eligible to enroll in Peoples Health Secure Health is easy. If you meet the following Medicare enrollment requirements, you’re eligible to become a member of this plan:

N
Have medical assistance from the state or Medicaid

N
Be enrolled in Medicare Part A and Medicare Part B

N
Not have end-stage renal disease (ESRD), 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 is no longer available

N
Continue to pay your Medicare Part B premium, unless otherwise paid for you by the state or another third party

N
Live in the plan’s service area, which includes the following Louisiana parishes: Acadia, Ascension, Assumption, Bossier, Caddo, Calcasieu, Cameron, East Baton Rouge, East Feliciana, Evangeline, Iberia, Iberville, Jefferson, Lafayette, Lafourche, Livingston, Orleans, Ouachita, Plaquemines, Pointe Coupee, St. Bernard, St. Charles, St. Helena, St. James, St. John the Baptist, St. Landry, St. Martin, St. Mary, St. Tammany, Tangipahoa, Terrebonne, Vermilion, Washington, West Baton Rouge and West Feliciana

How to Enroll

ENROLL ONLINE

Image of senior hands on a laptop
Enrolling only takes about 20 minutes.

ENROLL BY PHONE

Image of a senior woman talking on the phone
Call toll-free at 1-800-978-9765, Seven days a week, from 8 a.m. to 8 p.m. TTY users may call 711. A plan representative will help you.

ENROLL BY APPOINTMENT

Image of a senior couple meeting with a younger sales agent
Call us toll-free at 1-800-978-9765 Seven days a week, from 8 a.m. to 8 p.m. TTY users may call 711.

A sales representative will schedule an appointment with you at your home or meet you at one of our offices.

Peoples Health – Baton Rouge
7434 Perkins Road, Suite 200
Baton Rouge, LA 70808 
View Map: Peoples Health – Baton Rouge

Peoples Health – Metairie
Three Lakeway Center
3838 N. Causeway Blvd., Suite 2200
Metairie, LA 70002 
View Map: Peoples Health – Metairie

 

ENROLL BY MAIL

Image of a hand putting mail in a mailbox
Write to us and request an enrollment packet. The address is:

Peoples Health Secure Health Enrollment Packet Request

Three Lakeway Center
3838 N. Causeway Blvd.
Suite 2200
Metairie, LA 70002

Extra Help

Peoples Health Secure Health Monthly Plan Premium for People Who Get Extra Help From Medicare to Help Pay Their Prescription Drug Costs

If you get extra help from Medicare to help pay your Medicare prescription drug plan costs, your monthly plan premium will be lower than what it would be if you did not get extra help from Medicare. The amount of extra help you get will determine your total monthly plan premium as a member of our plan.

Peoples Health Secure Health’s premium includes coverage for both medical services and prescription drugs.

Download the Extra Help Plan Premium Summary and Table.

See If You Qualify for Extra Help

If you aren’t getting extra help, you can see if you qualify by calling:

  • Medicare at 1-800-MEDICARE, 24 hours a day, seven days a week (TTY users call 1-877-486-2048)
  • Louisiana Medicaid at 1-888-342-6207, Monday through Friday, from 7 a.m. to 4:30 p.m. (TTY users call 1-800-220-5404)
  • Social Security Administration at 1-800-772-1213, Monday through Friday, from 7 a.m. to 7 p.m. (TTY users call 1-800-325-0778)

Extra Help Monthly Plan Premium

This table shows you what your monthly plan premium will be if you get extra help.

YOUR LEVEL OF EXTRA HELPMONTHLY PREMIUM FOR PEOPLES HEALTH SECURE HEALTH*
100%$0
75%$0
50%$0
25%$0
*This does not include any Medicare Part B premium you may have to pay.

What to Expect Next

1

ENROLL

We will mail a confirmation of your enrollment to you.

2

NEW MEMBER PACKET

We will mail a packet to you with important information about your coverage through your Peoples Health plan. Be sure to read everything in the packet and call us with any questions.  We will also send you a member ID card.

3

TRANSITION CALL

As a new member, you will receive a call from a Peoples Health representative to coordinate continuation of any special services you may need. This helps us make sure there are no interruptions in your health care.

Important Documents

i

View important 2019 plan documents here.

Plan Overview for Peoples Health Secure Health – An overview of plan benefits

Annual Notice of Changes for Peoples Health Secure Health – A summary of plan benefit changes compared to the previous year and other important plan details

Evidence of Coverage for Peoples Health Secure Health – Information about plan benefits, membership, covered and noncovered services, member rights and responsibilities, and other important plan details

Prior Authorization Criteria – Detailed criteria for select covered drugs

Step Therapy Criteria – Detailed criteria for select covered drugsSummary of Benefits for Peoples Health Secure Health – A general summary of plan benefits

Why Medicare Advantage?

Peoples Health Secure Health is a Medicare Advantage HMO SNP plan with a $0 monthly plan premium*.

As good as Medicare is, it doesn’t cover everything. To protect yourself from high health care costs, consider a Medicare Advantage plan, like the ones offered by Peoples Health. Also known as Medicare Part C, Medicare Advantage combines your Part A (hospital insurance) and Part B (medical coverage), such as doctor’s visits and outpatient services, into one plan. Medicare Advantage plans usually include prescription drug coverage (Part D). Additionally, Medicare Advantage plans may include extra benefits, like worldwide urgent and emergency care, routine dental and vision coverage, and gym memberships.

A Medicare Advantage plan from Peoples Health is an all-inclusive package, making your health insurance easy and convenient. Our rich health care benefits make Peoples Health one of the most popular Medicare Advantage plans in the New Orleans and Baton Rouge areas. It’s no wonder Peoples Health has been covering people with Medicare in Louisiana for over 20 years.

During select parts of the year, like Medicare’s Annual Enrollment Period, you have the option to compare Medicare health insurance plans and decide what fit is best for you. Let us help make that decision easy. The Peoples Health’s Secure Health plan offers more benefits than ever before, like up to $200 per quarter for over-the-counter items, $0 meals after an inpatient stay, $0 respite care sessions, transportation to and from doctors’ appointments, and much, much more.

Unlike supplemental insurance, which typically costs more for fewer services, a Medicare Advantage plan from Peoples Health offers you more benefits and saves you money. Peoples Health Secure Health includes Part D drug coverage at no additional cost per month! Lower your out-of-pocket-costs and get more health coverage with this affordable Medicare plan. Enroll in a Medicare Advantage plan with Peoples Health to enjoy these health care benefits.

If you live in one of the following Louisiana parishes, you may be eligible to enroll in Secure Health: Acadia, Ascension, Assumption, Bossier, Caddo, Calcasieu, Cameron, East Baton Rouge, East Feliciana, Evangeline, Iberia, Iberville, Jefferson, Lafayette, Lafourche, Livingston, Orleans, Ouachita, Plaquemines, Pointe Coupee, St. Bernard, St. Charles, St. Helena, St. James, St. John the Baptist, St. Landry, St. Martin, St. Mary, St. Tammany, Tangipahoa, Terrebonne, Vermilion, Washington, West Baton Rouge and West Feliciana. Do you live in a different Louisiana parish? Shop our other Medicare Advantage plans.

*The plan’s monthly premium of $33.10 is paid by Medicare’s Extra Help program. The Medicare Part B premium is paid by the state of Louisiana. You must continue to pay your Medicare Part B premium if not paid by the state or another third party.

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