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Peoples Health Group Medicare (HMO-POS) and Group Medicare OGB (HMO-POS) | 2021

Peoples Health Group Medicare (HMO-POS)

$0

Monthly Plan
Premium

A Medicare Advantage HMO plan with a point-of-service (POS) option, which lets you see providers who are not in the plan’s provider network for certain services. Not all services received from out-of-network providers are covered.

A Medicare Advantage HMO plan with a point-of-service (POS) option, which lets you see providers who are not in the plan’s provider network for certain services. Not all services received from out-of-network providers are covered.

Peoples Health Group Medicare (HMO-POS) for Office of Group Benefits (OGB)

A Medicare Advantage Prescription Drug plan exclusively for Louisiana Office of Group Benefits retirees. This plan features the coordinated, in-network care for which Peoples Health is known. It also offers out-of-network coverage.

A Medicare Advantage Prescription Drug plan exclusively for Louisiana Office of Group Benefits retirees. This plan features the coordinated, in-network care for which Peoples Health is known. It also offers out-of-network coverage.

Plan Benefits for Group Medicare

The benefits below are available with this Medicare Advantage plan.  To see a full list of benefits, please see the Evidence of Coverage for this plan.

 

Notes:

Authorization is required for certain services.

*See the Provider Directory for network lab and diagnostic providers. 

+Office visit copay may apply.

♦Emergency care copay waived if admitted to inpatient hospital care within 24 hours for the same condition.

All drugs are COVERED through the Part D coverage gap. 90-day supplies of maintenance medications for tiers 1-4 are available at retail pharmacies and by mail order.

*With coverage through the gap

Notes:

Costs listed are based on use of network providers.

Authorization is required for certain services.

Plan Benefits for Group Medicare for Office of Group Benefits (OGB)

The benefits below are available with this Medicare Advantage plan.  To see a full list of benefits, please see the Evidence of Coverage for this plan.

 

Notes:

Authorization is required for certain services.

*See the Provider Directory for network lab and diagnostic providers.

+Office visit copay may apply.

♦Emergency care copay waived if admitted to inpatient hospital care within 24 hours for the same condition.

All drugs are COVERED through the Part D coverage gap. 90-day supplies of maintenance medications for tiers 1-4 are available at retail pharmacies and by mail order.

*With coverage through the gap

Notes:

Costs listed are based on use of network providers.

Authorization is required for certain services.

Plan Benefits for Group Medicare

Doctor and Hospital Coverage

Notes:

Authorization is required for certain services.

*See the Provider Directory for network lab and diagnostic providers. 

+Office visit copay may apply.

♦Emergency care copay waived if admitted to inpatient hospital care within 24 hours for the same condition.

Part D Prescription Drug Coverage

All drugs are COVERED through the Part D coverage gap. 90-day supplies of maintenance medications for tiers 1-4 are available at retail pharmacies and by mail order.

*With coverage through the gap

Additional Benefits


Notes:

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

Plan Benefits for Group Medicare for Office of Group Benefits (OGB)

Doctor and Hospital Coverage

Notes:
Costs listed are based on use of network providers.

Authorization is required for certain services.

*See the Provider Directory for network lab and diagnostic providers. Lab services, diagnostic tests and X-rays at a doctor’s office or outpatient hospital may have higher out-of-pocket costs.

+Office visit copay may apply.

♦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 drugs are COVERED through the Part D coverage gap. 90-day supplies of maintenance medications for tiers 1-4 are available at retail pharmacies and by mail order.

*With coverage through the gap

Additional Benefits


Notes:

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

Important Documents

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GROUP MEDICARE DOCUMENTS

Plan Overview for Peoples Health Group Medicare – An overview of plan benefits

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

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

Vendor Information – A listing of providers offering benefit-related services for your plan

GROUP MEDICARE fOR OGB DOCUMENTS

Plan Overview for Peoples Health Group Medicare for Office of Group Benefits (OGB) – An overview of plan benefits

Annual Notice of Changes for Peoples Health Group Medicare for Office of Group Benefits (OGB) – A summary of plan benefit changes compared to the previous year and other important plan details

Evidence of Coverage for Peoples Health Group Medicare for Office of Group Benefits (OGB) – Information about plan benefits, membership, covered and noncovered services, member rights and responsibilities, and other important plan details

Vendor Information – A listing of providers offering benefit-related services for your plan

How to Enroll

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HOW DO I ENROLL BY APPOINTMENT?

Employer Group members should contact the employer office that administers your benefits for enrollment information.

OGB members can call 1-866-912-8304, Monday through Friday, from 8 a.m. to 8 p.m.

TTY users may call 711.

A representative can schedule an appointment for you with a licensed representative.

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HOW DO I ENROLL BY MAIL?

Write to us and request an enrollment packet. The address is:

Peoples Health Group Medicare or Group Medicare for Office of Group Benefits Enrollment Packet Request
Three Lakeway Center
Attn: Sales & Membership Operations
3838 N. Causeway Blvd.
Suite 2200
Metairie, LA 70002

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