Peoples Health Secure Health (HMO-POS D-SNP)
H1961-003
A plan with Part D drug coverage for people with Medicare and medical assistance from the state. This is a Medicare Special Needs Plan for people who also have Medicaid at levels ranging from the state paying your Part A or B premium to full Medicaid benefits. Available in all Louisiana parishes.
$0
Primary Care
Physician visit
$105/month
Debit Card for Food, Over-the-Counter Health & Wellness Items, and Utilities
$0
Up to 48
One-Way Trips
$0
Primary Care
Physician visit
$105/month
Debit card for food, utilities and over-the-counter (OTC)
health & wellness items
$0
Up to 48
One-Way Trips
Request a Free Medicare Information Kit
Get your FREE Medicare information kit, including these must-have guides: the 2023 Peoples Health Plan Overview and 8 Things You Need to Know About Medicare. Together, these booklets can help you better understand your coverage options under Medicare.
You asked for more. We listened!
Now it’s easier than ever to picture yourself with Peoples Health. Every year, we look for ways to take care of our members better. The enhancements we’ve made for 2023 are designed to do just that. Look for:
More doctors
We’ve added more doctors to our Louisiana network.
More dentists & more dental coverage
We’ve added 95% more network dental locations^, and all plans now feature out-of-network dental coverage, a $0 deductible, $0 restorative services and an expanded list of covered services.*
More eye doctors
We’ve more than doubled our network of vision providers.
More savings
For many of our plans, there are lower copays and bigger allowances for select services, as well as lower maximum out-of-pocket costs.
More flexibility
^ Compared to 2022 Peoples Health network.
*Point-of-service (POS) option allows out-of-network dental services. Those out-of-network services may have a higher cost to members. Dental coverage maximums vary by plan.
Plan Highlights
$0 Primary
Care Visits
$105/month
Debit Card for Food, Over-the-Counter Health & Wellness Items, and Utilities
$0
Hearing Aids
$0
Up to 48 one-way trips
$0
Dental Exams,
Cleanings & X-rays
$0 Meals
After Inpatient
Hospital Stay
$0
Eyeglasses
or Contacts
One Pass™
Fitness†
†One Pass is a trademark of Optum, Inc. and/or its affiliates. © 2022 Optum, Inc.
Plan Benefits
The benefits below are available with this Medicare Advantage plan. For a full list of benefits, please see the Evidence of Coverage for this plan.
| Peoples Health Secure Health (HMO-PPO D-SNP) | Your Cost |
| Monthly Plan Premium* | $0 |
| Doctor Visits & NurseLine | |
| Primary Care Physician Visit | $0 |
| Specialist Visit | $0 or $10 |
| Virtual Medical Visit | $0 |
| 24-Hour NurseLine | $0 |
| Preventive Care+ | |
| Pap Smears, Pelvic Exams, Mammograms | $0 |
| Prostate & Colorectal Cancer Screenings | $0 |
| Vaccinations (flu, pneumonia, hepatitis B, COVID-19)++ | $0 |
| Labs & Tests+ | |
| Lab Services | $0 |
| Diagnostic Tests and X-rays | $0 |
| Advanced Imaging (MRI, MRA, CT, PET scans, etc.) | $0 or $75 |
| Outpatient Surgery | |
| Surgery (outpatient hospital or ambulatory surgical center) | $0 |
| Inpatient Hospital Care per Admission | |
| Inpatient Deductible | $0 |
| Inpatient Stay per Day, for Days 1-10 | $0 or $75 |
| Inpatient Stay for Days 11 and Beyond | $0 |
| Emergency Care, Urgent Care & Emergency Transportation^ | |
| Emergency Care | $0 or $50 |
| Urgent Care | $0 |
| Emergency Ambulance Services (ground or air) | $0 or $75 |
| Worldwide (out of USA) Emergency Care, Urgent Care and Emergency Transportation (to nearest facility) | $0 |
| Home Health & Skilled Nursing Facility Care | |
| Home Health | $0 |
| Skilled Nursing Facility Care per Day (semiprivate room and board) | $0 for days 1-20 $0 or $100 per day, for days 21-100 |
| Outpatient Services & Supplies | |
| Occupational, Physical or Speech Therapy Visit | $0 |
| Durable Medical Equipment - DME (wheelchairs, oxygen, etc.) | $0 |
| Diabetes Monitoring Supplies (test strips, monitor, etc., from a DME provider or retail pharmacy) | $0 |
| Mental Health & Substance Abuse Treatment | |
| Inpatient Mental Health Care | $0 or $75 per Day, Days 1-10 $0 for Days 11-90 |
| Outpatient Mental Health Visit | $0 or $10 |
| Outpatient Substance Abuse Visit | $0 or $10 |
| Virtual Mental Health or Substance Abuse Treatment Visit | $0 |
| *This plan's premium is paid by Medicare's Extra Help program. +Office visit copay may apply. ++You will pay a $0 copay for all Part D covered vaccines, including Shingrix, from network providers. ^Emergency care copay waived if admitted to inpatient hospital care within 24 hours for the same condition Costs listed are based on use of network providers. Authorization is required for certain services. | |
You won’t pay more than $0 for a one-month supply of each insulin product covered by your plan through all coverage stages.
You will pay a $0 copay for all Part D covered vaccines, including Shingrix.
| Medicare Part D Prescription Drugs 30-day or 100-day supply from a retail network pharmacy |
| All Covered Drugs: $0 |
| 100-day supplies of maintenance drugs available at retail pharmacies and by mail order. Specialty drugs limited to a 30-day supply. |
| Peoples Health Secure Health (HMO D-SNP) | Your Cost |
| Over-the-Counter Items | |
| $105 (every month) Combined Food, OTC and Utilities Debit Card | $0 |
| Meals After Inpatient Hospital Stay | |
| Up to 28 Meals over 14 Days | $0 |
| Vision Services | |
| Routine Eye Exam | $0 |
| Eyeglasses or Contact Lenses (one pair per year - $450 Allowance) | $0 |
| Hearing Services | |
| Hearing Aids ($1,100 per year allowance) | $0 |
| Routine Hearing Exam | $0 |
| Nonemergency Transportation (such as trips, within 40 miles of your home, to and from your doctor’s office) | |
| Up to 48 one-way trips | $0 |
| Respite Care | |
| Members diagnosed with dementia may be eligible for a maximum of 12 respite care sessions per year from the network respite care provider | $0 |
| Dental - $2,500 Coverage Maximum ($0 deductible) | |
| Dental - Preventive (X-rays, cleanings, exams, fluoride - coverage frequency varies) | $0 |
| Dental - Comprehensive (fillings, crowns, bridges, dentures, etc.) | $0 |
| Fitness | |
| One Pass™ Fitness Membership (health clubs, online classes, brain health exercises and more) | $0 |
Notes:
Costs listed are based on use of network providers.
Authorization is required for certain services.
Doctor and Hospital Coverage
| Peoples Health Secure Health (HMO-PPO D-SNP) | Your Cost |
| Monthly Plan Premium* | $0 |
| Doctor Visits & NurseLine | |
| Primary Care Physician Visit | $0 |
| Specialist Visit | $0 or $10 |
| Virtual Medical Visit | $0 |
| 24-Hour NurseLine | $0 |
| Preventive Care+ | |
| Pap Smears, Pelvic Exams, Mammograms | $0 |
| Prostate & Colorectal Cancer Screenings | $0 |
| Vaccinations (flu, pneumonia, hepatitis B, COVID-19)++ | $0 |
| Labs & Tests+ | |
| Lab Services | $0 |
| Diagnostic Tests and X-rays | $0 |
| Advanced Imaging (MRI, MRA, CT, PET scans, etc.) | $0 or $75 |
| Outpatient Surgery | |
| Surgery (outpatient hospital or ambulatory surgical center) | $0 |
| Inpatient Hospital Care per Admission | |
| Inpatient Deductible | $0 |
| Inpatient Stay per Day, for Days 1-10 | $0 or $75 |
| Inpatient Stay for Days 11 and Beyond | $0 |
| Emergency Care, Urgent Care & Emergency Transportation^ | |
| Emergency Care | $0 or $50 |
| Urgent Care | $0 |
| Emergency Ambulance Services (ground or air) | $0 or $75 |
| Worldwide (out of USA) Emergency Care, Urgent Care and Emergency Transportation (to nearest facility) | $0 |
| Home Health & Skilled Nursing Facility Care | |
| Home Health | $0 |
| Skilled Nursing Facility Care per Day (semiprivate room and board) | $0 for days 1-20 $0 or $100 per day, for days 21-100 |
| Outpatient Services & Supplies | |
| Occupational, Physical or Speech Therapy Visit | $0 |
| Durable Medical Equipment - DME (wheelchairs, oxygen, etc.) | $0 |
| Diabetes Monitoring Supplies (test strips, monitor, etc., from a DME provider or retail pharmacy) | $0 |
| Mental Health & Substance Abuse Treatment | |
| Inpatient Mental Health Care | $0 or $75 per Day, Days 1-10 $0 for Days 11-90 |
| Outpatient Mental Health Visit | $0 or $10 |
| Outpatient Substance Abuse Visit | $0 or $10 |
| Virtual Mental Health or Substance Abuse Treatment Visit | $0 |
| *This plan's premium is paid by Medicare's Extra Help program. +Office visit copay may apply. ++You will pay a $0 copay for all Part D covered vaccines, including Shingrix, from network providers. ^Emergency care copay waived if admitted to inpatient hospital care within 24 hours for the same condition Costs listed are based on use of network providers. Authorization is required for certain services. | |
Part D Prescription Drug Coverage
You won’t pay more than $0 for a one-month supply of each insulin product covered by your plan through all coverage stages.
You will pay a $0 copay for all Part D covered vaccines, including Shingrix.
| Medicare Part D Prescription Drugs 30-day or 100-day supply from a retail network pharmacy |
| All Covered Drugs: $0 |
| 100-day supplies of maintenance drugs available at retail pharmacies and by mail order. Specialty drugs limited to a 30-day supply. |
Additional Benefits
| Peoples Health Secure Health (HMO D-SNP) | Your Cost |
| Over-the-Counter Items | |
| $105 (every month) Combined Food, OTC and Utilities Debit Card | $0 |
| Meals After Inpatient Hospital Stay | |
| Up to 28 Meals over 14 Days | $0 |
| Vision Services | |
| Routine Eye Exam | $0 |
| Eyeglasses or Contact Lenses (one pair per year - $450 Allowance) | $0 |
| Hearing Services | |
| Hearing Aids ($1,100 per year allowance) | $0 |
| Routine Hearing Exam | $0 |
| Nonemergency Transportation (such as trips, within 40 miles of your home, to and from your doctor’s office) | |
| Up to 48 one-way trips | $0 |
| Respite Care | |
| Members diagnosed with dementia may be eligible for a maximum of 12 respite care sessions per year from the network respite care provider | $0 |
| Dental - $2,500 Coverage Maximum ($0 deductible) | |
| Dental - Preventive (X-rays, cleanings, exams, fluoride - coverage frequency varies) | $0 |
| Dental - Comprehensive (fillings, crowns, bridges, dentures, etc.) | $0 |
| Fitness | |
| One Pass™ Fitness Membership (health clubs, online classes, brain health exercises and more) | $0 |
Notes:
Costs listed are based on use of network providers.
Authorization is required for certain services.
Find Doctors, Medications & More
Find Doctors, Medications & More
Important Documents
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
Annual Notice of Changes for Peoples Health Secure Choice – 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
Summary of Benefits for Peoples Health Secure Health – A general summary of plan benefits
Vendor Information – A listing of providers offering benefit-related services
How to Enroll
Online
Enrolling online only takes about 20 minutes. You’ll need your red, white and blue Medicare card to complete the online application.
By 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. You can also request an enrollment packet.
By Appointment
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 sales representative will schedule an appointment with you.
Extra Help
If you get Extra Help from Medicare to help pay for 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 (HMO-POS D-SNP)’s premium includes coverage for both medical services and prescription drug coverage.
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 (1-800-633-4227), 24 hours a day, seven days a week (TTY users call 1-877-486-2048
- Louisiana Medicaid at 1-888-342-6207 (TTY users call 1-800-220-5404), or
- 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 Table
This table shows you what your monthly plan premium will be if you get Extra Help.
| YOUR LEVEL OF EXTRA HELP | MONTHLY PREMIUM FOR PEOPLES SECURE HEALTH (HMO D-SNP) * |
| 100% | $0.00 |
| 75% | $9.60 |
| 50% | $19.20 |
| 25% | $28.80 |
*This does not include any Medicare Part B premium you may have to pay.