View important 2027 plan documents and forms.


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HMO-POS

The following materials are for Peoples Health Choices 65 (HMO-POS) Greater New Orleans and Baton Rouge Area.
This includes the parishes of Ascension, East Baton Rouge, East Feliciana, Iberville, Jefferson, Livingston, Orleans, St. Charles, St. Helena and West Baton Rouge.

Plan Overview – An overview of plan benefits

Annual Notice of Change – A summary of plan benefit changes compared to the previous year and other important plan details

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

Summary of Benefits – A general summary of plan benefits

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

Medicare Star Ratings Summary

The following materials are for Peoples Health Choices 65 (HMO-POS) Northshore and River Areas.
This includes the parishes of Plaquemines, Point Coupee, St. Bernard, St. James, St. John the Baptist, St. Tammany, Tangipahoa, Washington and West Feliciana.

Plan Overview – An overview of plan benefits

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

Summary of Benefits – A general summary of plan benefits

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

Medicare Star Ratings Summary

For members moving to this plan from Peoples Health Choices 65 (HMO-POS) Rural Southeast:

Annual Notlce of Change – A summary of plan benefit changes compared to the previous year and other important plan details

For all other members in this plan:

Annual Notlce of Change – A summary of plan benefit changes compared to the previous year and other important plan details

The following materials are for Peoples Health Choices 65 (HMO-POS) Southland.
This includes the parishes of Assumption, Lafourche, St. Mary and Terrebonne.

Plan Overview – An overview of plan benefits

Annual Notice of Change – A summary of plan benefit changes compared to the previous year and other important plan details

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

Summary of Benefits – A general summary of plan benefits

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

Medicare Star Ratings Summary

The following materials are for Peoples Health Essentials (HMO-POS).
This includes the parishes of Acadia, Bossier, Caddo, Calcasieu, Cameron, Evangeline, Iberia, Lafayette, Ouachita, Rapides, St. Landry, St. Martin and Vermilion.

Plan Overview – An overview of plan benefits

Annual Notice of Change – A summary of plan benefit changes compared to the previous year and other important plan details

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

Summary of Benefits – A general summary of plan benefits

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

Medicare Star Ratings Summary

The following materials are for Peoples Health Extras (HMO-POS).
This includes the parishes of Acadia, Bossier, Caddo, Calcasieu, Cameron, Evangeline, Iberia, Lafayette, Ouachita, Rapides, St. Landry, St. Martin and Vermilion.

Plan Overview – An overview of plan benefits

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

Summary of Benefits – A general summary of plan benefits

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

Medicare Star Ratings Summary

The following materials are for Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS).
This includes the parishes of Ascension, East Baton Rouge, East Feliciana, Iberville, Jefferson, Livingston, Orleans, St. Charles, St. Helena and West Baton Rouge.

Plan Overview – An overview of plan benefits

Annual Notice of Change – A summary of plan benefit changes compared to the previous year and other important plan details

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

Summary of Benefits – A general summary of plan benefits

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

Medicare Star Ratings Summary

The following materials are for Peoples Health Medicare Advantage Giveback Patriot No Rx LA (HMO-POS).
This plan includes all parishes in Louisiana.

Plan Overview – An overview of plan benefits

Annual Notice of Change – A summary of plan benefit changes compared to the previous year and other important plan details

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

Summary of Benefits – A general summary of plan benefits

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

Medicare Star Ratings Summary

The following materials are for Peoples Health Group Medicare (HMO-POS).

Plan Overview – An overview of plan benefits

Annual Notice of Change – A summary of plan benefit changes compared to the previous year and other important plan details

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

Summary of Benefits – A general summary of plan benefits

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

Medicare Star Ratings Summary

The following materials are for Peoples Health Group Medicare (HMO-POS) Office of Group Benefits (OGB).

Plan Overview – An overview of plan benefits

Annual Notice of Change – A summary of plan benefit changes compared to the previous year and other important plan details

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

Summary of Benefits – A general summary of plan benefits

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

Medicare Star Ratings Summary

HMO-POS C-SNP

The following materials are for Peoples Health Complete Care LA-5 (HMO-POS C-SNP).
This includes the parishes of Ascension, East Baton Rouge, East Feliciana, Iberville, Jefferson, Livingston, Orleans, St. Charles, St. Helena and West Baton Rouge.

Plan Overview – An overview of plan benefits

Annual Notice of Change – A summary of plan benefit changes compared to the previous year and other important plan details

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

Summary of Benefits – A general summary of plan benefits

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

Medicare Star Ratings Summary

The following materials are for Peoples Health Complete Care LA-6 (HMO-POS C-SNP).
This includes the parishes of Acadia, Allen, Avoyelles, Beauregard, Bienville, Bossier, Caddo, Calcasieu, Caldwell, Cameron, Catahoula, Claiborne, Concordia, DeSoto, East Carroll, Evangeline, Franklin, Grant, Iberia, Jackson, Jefferson Davis, Lafayette, LaSalle, Lincoln, Madison, Morehouse, Natchitoches, Ouachita, Rapides, Red River, Richland, Sabine, St. Landry, St. Martin, St. Tammany, Tangipahoa, Tensas, Union, Vermilion, Vernon, Washington, Webster, West Carroll and Winn.

Plan Overview – An overview of plan benefits

Annual Notice of Change – A summary of plan benefit changes compared to the previous year and other important plan details

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

Summary of Benefits – A general summary of plan benefits

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

Medicare Star Ratings Summary

The following materials are for Peoples Health Complete Care LA-7 (HMO-POS C-SNP) Southland.
This includes the parishes of Assumption, Lafourche, St. Mary and Terrebonne.

Plan Overview – An overview of plan benefits

Annual Notice of Change – A summary of plan benefit changes compared to the previous year and other important plan details

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

Summary of Benefits – A general summary of plan benefits

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

Medicare Star Ratings Summary

 



The following materials are for Peoples Health Complete Care LA-7 (HMO-POS C-SNP) River Areas.
This includes the parishes of Plaquemines, Pointe Coupee, St. Bernard, St. James, St. John the Baptist and West Feliciana.

Plan Overview – An overview of plan benefits

Annual Notice of Change – A summary of plan benefit changes compared to the previous year and other important plan details

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

Summary of Benefits – A general summary of plan benefits

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

Medicare Star Ratings Summary

The following materials are for Peoples Health Complete Care Support (HMO-POS C-SNP) Greater New Orleans, Baton Rouge and River Areas.
This includes the parishes of East Baton Rouge, East Feliciana, Iberville, Jefferson, Livingston, Orleans, Pointe Coupee, St. Bernard, St. Charles, St. Helena, St. John the Baptist, St. Landry, West Baton Rouge and West Feliciana.

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

Summary of Benefits – A general summary of plan benefits

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

Medicare Star Ratings Summary

 



The following materials are for Peoples Health Complete Care Support (HMO-POS C-SNP) South, Northshore and Upland Areas.
This includes the parishes of Acadia, Allen, Ascension, Assumption, Avoyelles, Beauregard, Bienville, Bossier, Caddo, Calcasieu, Caldwell, Cameron, Catahoula, Claiborne, Concordia, DeSoto, East Carroll, Evangeline, Franklin, Grant, Iberia, Jackson, Jefferson Davis, Lafayette, LaSalle, Lincoln, Madison, Morehouse, Natchitoches, Ouachita, Plaquemines, Rapides, Red River, Richland, Sabine, St. James, St. Martin, St. Mary, St. Tammany, Tangipahoa, Tensas, Terrebonne, Union, Vermilion, Vernon, Washington, Webster, West Carroll and Winn.

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

Summary of Benefits – A general summary of plan benefits

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

Medicare Star Ratings Summary

HMO-POS D-SNP

The following materials are for Peoples Health Secure Health (HMO-POS D-SNP) Greater New Orleans, Baton Rouge and River Areas.
This includes the parishes of East Baton Rouge, East Feliciana, Iberville, Jefferson, Livingston, Orleans, Pointe Coupee, St. Bernard, St. Charles, St. Helena, St. John the Baptist, St. Landry, West Baton Rouge and West Feliciana.

Plan Overview – An overview of plan benefits

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

Summary of Benefits – A general summary of plan benefits

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

Medicare Star Ratings Summary

For members moving to this plan from Peoples Health Secure Complete (HMO-POS D-SNP):

Annual Notice of Change – A summary of plan benefit changes compared to the previous year and other important plan details

For all other members in this plan:

Annual Notice of Change – A summary of plan benefit changes compared to the previous year and other important plan details

 


 

The following materials are for Peoples Health Secure Health (HMO-POS D-SNP) South, Northshore and Upland Areas.
This includes the parishes of Acadia, Allen, Ascension, Assumption, Avoyelles, Beauregard, Bienville, Bossier, Caddo, Calcasieu, Caldwell, Cameron, Catahoula, Claiborne, Concordia, DeSoto, East Carroll, Evangeline, Franklin, Grant, Iberia, Jackson, Jefferson Davis, Lafayette, Lafourche, LaSalle, Lincoln, Madison, Morehouse, Natchitoches, Ouachita, Plaquemines, Rapides, Red River, Richland, Sabine, St. James, St. Martin, St. Mary, St. Tammany, Tangipahoa, Tensas, Terrebonne, Union, Vermilion, Vernon, Washington, Webster, West Carroll and Winn.

Plan Overview – An overview of plan benefits

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

Summary of Benefits – A general summary of plan benefits

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

Medicare Star Ratings Summary

For members moving to this plan from Peoples Health Secure Complete (HMO-POS D-SNP):

Annual Notice of Change – A summary of plan benefit changes compared to the previous year and other important plan details

For all other members in this plan:

Annual Notice of Change – A summary of plan benefit changes compared to the previous year and other important plan details

The following materials are for Peoples Health Secure Complete (HMO-POS D-SNP) Greater New Orleans, Baton Rouge and River Areas.
This includes the parishes of East Baton Rouge, East Feliciana, Iberville, Jefferson, Livingston, Orleans, Pointe Coupee, St. Bernard, St. Charles, St. Helena, St. John the Baptist, St. Landry, West Baton Rouge and West Feliciana.

Plan Overview – An overview of plan benefits

Annual Notice of Change – A summary of plan benefit changes compared to the previous year and other important plan details

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

Summary of Benefits – A general summary of plan benefits

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

Medicare Star Ratings Summary
 



The following materials are for Peoples Health Secure Complete (HMO-POS D-SNP) South, Northshore and Upland Areas.
This includes the parishes of Acadia, Allen, Ascension, Assumption, Avoyelles, Beauregard, Bienville, Bossier, Caddo, Calcasieu, Caldwell, Cameron, Catahoula, Claiborne, Concordia, DeSoto, East Carroll, Evangeline, Franklin, Grant, Iberia, Jackson, Jefferson Davis, Lafayette, Lafourche, LaSalle, Lincoln, Madison, Morehouse, Natchitoches, Ouachita, Plaquemines, Rapides, Red River, Richland, Sabine, St. James, St. Martin, St. Mary, St. Tammany, Tangipahoa, Tensas, Terrebonne, Union, Vermilion, Vernon, Washington, Webster, West Carroll and Winn.

Plan Overview – An overview of plan benefits

Annual Notice of Change – A summary of plan benefit changes compared to the previous year and other important plan details

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

Summary of Benefits – A general summary of plan benefits

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

Medicare Star Ratings Summary

The following materials are for Peoples Health Dual Complete LA-S5 (HMO-POS D-SNP) Greater New Orleans, Baton Rouge and River Areas.
This includes the parishes of East Baton Rouge, East Feliciana, Iberville, Jefferson, Livingston, Orleans, Pointe Coupee, St. Bernard, St. Charles, St. Helena, St. John the Baptist, St. Landry, West Baton Rouge and West Feliciana.

Plan Overview – An overview of plan benefits

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

Summary of Benefits – A general summary of plan benefits

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

Medicare Star Ratings Summary

For members moving to this plan from Peoples Health Secure Health (HMO-POS D-SNP):

Annual Notice of Change - A summary of plan benefit changes compared to the previous year and other important plan details

For members moving to this plan from Peoples Health Secure Complete (HMO-POS D-SNP):

Annual Notice of Change – A summary of plan benefit changes compared to the previous year and other important plan details

For all other members in this plan:

Annual Notice of Change – A summary of plan benefit changes compared to the previous year and other important plan details
 



The following materials are for Peoples Health Dual Complete LA-S5 (HMO-POS D-SNP) South, Northshore and Upland Areas.
This includes the parishes of Acadia, Allen, Ascension, Assumption, Avoyelles, Beauregard, Bienville, Bossier, Caddo, Calcasieu, Caldwell, Cameron, Catahoula, Claiborne, Concordia, DeSoto, East Carroll, Evangeline, Franklin, Grant, Iberia, Jackson, Jefferson Davis, Lafayette, Lafourche, LaSalle, Lincoln, Madison, Morehouse, Natchitoches, Ouachita, Plaquemines, Rapides, Red River, Richland, Sabine, St. James, St. Martin, St. Mary, St. Tammany, Tangipahoa, Tensas, Terrebonne, Union, Vermilion, Vernon, Washington, Webster, West Carroll and Winn.

Plan Overview – An overview of plan benefits

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

Summary of Benefits – A general summary of plan benefits

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

Medicare Star Ratings Summary

For members moving to this plan from Peoples Health Secure Health (HMO-POS D-SNP):

Annual Notice of Change – A summary of plan benefit changes compared to the previous year and other important plan details

For members moving to this plan from Peoples Health Secure Complete (HMO-POS D-SNP):

Annual Notice of Change – A summary of plan benefit changes compared to the previous year and other important plan details

For all other members in this plan:

Annual Notice of Change – A summary of plan benefit changes compared to the previous year and other important plan details

Other Important Documents, Links and Forms | 2027

Prior Authorization Criteria – Detailed criteria for select covered drugs

(Last updated: Coming Soon)

Download Prior Authorization Request Form

Peoples Health Choices 65 (HMO-POS)  
Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS)  
Peoples Health Essentials (HMO-POS)
Peoples Health Extras (HMO-POS)
Peoples Health Group Medicare (HMO-POS)  
Peoples Health Group Medicare (HMO-POS) Office of Group Benefits

Peoples Health Secure Health (HMO-POS D-SNP)  
Peoples Health Secure Complete (HMO-POS D-SNP)  
Peoples Health Dual Complete LA-S5 (HMO-POS D-SNP)

Peoples Health Complete Care LA-5 (HMO-POS C-SNP)  
Peoples Health Complete Care LA-6 (HMO-POS C-SNP)  
Peoples Health Complete Care LA-7 (HMO-POS C-SNP)
Peoples Health Complete Care Support (HMO-POS C-SNP)

 


Step Therapy Criteria – Detailed criteria for select covered drugs

(Last updated: Coming Soon)

Peoples Health Choices 65 (HMO-POS)    
Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS)  
Peoples Health Essentials (HMO-POS)
Peoples Health Extras (HMO-POS)
Peoples Health Group Medicare (HMO-POS)  
Peoples Health Group Medicare (HMO-POS) Office of Group Benefits

Peoples Health Secure Health (HMO-POS D-SNP)  
Peoples Health Secure Complete (HMO-POS D-SNP)  
Peoples Health Dual Complete LA-S5 (HMO-POS D-SNP)

Peoples Health Complete Care LA-5 (HMO-POS C-SNP)  
Peoples Health Complete Care LA-6 (HMO-POS C-SNP)  
Peoples Health Complete Care LA-7 (HMO-POS C-SNP)
Peoples Health Complete Care Support (HMO-POS C-SNP)

 


 

Comprehensive Formulary

(Last updated: Coming Soon)

Choices 65 (HMO-POS), Medicare Advantage Giveback LA-4 (HMO-POS), Essentials (HMO-POS), Extras (HMO-POS)
Peoples Health Group Medicare (HMO-POS)
Peoples Health Group Medicare Office of Group Benefits (HMO-POS)

Complete Care LA-5 (HMO-POS C-SNP), Complete Care LA-6 (HMO-POS C-SNP), Complete Care LA-7 (HMO-POS C-SNP), Complete Care Support (HMO-POS C-SNP)

Dual Complete LA-S5, Secure Health and Secure Complete (HMO-POS D-SNP)

Formulary Additions   

Formulary Deletions

Mail-Order Delivery Form

(Last updated: Coming Soon)

Peoples Health Choices 65 (HMO-POS) Greater New Orleans and Baton Rouge Area
Peoples Health Choices 65 (HMO-POS) Northshore and River Areas
Peoples Health Choices 65 (HMO-POS) Southland
Peoples Health Essentials (HMO-POS)
Peoples Health Extras (HMO-POS)
Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS)
Peoples Health Medicare Advantage Patriot No Rx LA (HMO-POS)
Peoples Health Complete Care LA-5 (HMO-POS C-SNP) 
Peoples Health Complete Care LA-6 (HMO-POS C-SNP) 
Peoples Health Complete Care LA-7 (HMO-POS C-SNP) Southland
Peoples Health Complete Care LA-7 (HMO-POS C-SNP) River Areas
Peoples Health Complete Care Support (HMO-POS C-SNP) Greater New Orleans, Baton Rouge and River Areas
Peoples Health Complete Care Support (HMO-POS C-SNP) South, Northshore and Upland Areas
Peoples Health Secure Health (HMO-POS D-SNP) Greater New Orleans, Baton Rouge and River Areas
Peoples Health Secure Complete (HMO-POS D-SNP) Greater New Orleans, Baton Rouge and River Areas
Peoples Health Dual Complete LA-S5 (HMO-POS D-SNP) Greater New Orleans, Baton Rouge and River Areas
Peoples Health Secure Health (HMO-POS D-SNP) South, Northshore and Upland Areas
Peoples Health Secure Complete (HMO-POS D-SNP) South, Northshore and Upland Areas
Peoples Health Dual Complete LA-S5 (HMO-POS D-SNP) South, Northshore and Upland Areas

 

Notice of Privacy Practices – Description of how your medical information may be used and disclosed and how you can get access to this information

Prior authorization metrics

Peoples Health Prior Authorization – FY 2025 – The following prior authorization data is being reported consistent with the CMS Final Rule and includes certain prior authorization and appeal information for members enrolled in Peoples Health Medicare Advantage (MA) H-Contracts from January 1, 2025 to December 31, 2025, including prior authorization requests for transitions to post-acute care and submitted to capitated-delegated providers, behavioral health delegates, physical health delegates and dental delegates (where applicable). The reports do not include any reporting related to prescription drugs (when not under the medical benefit).

Access the current prior authorization requirements for MA medical items and services here. Historical prior authorization requirements are available here and are listed by the MA plan type. Information is current as of the date of posting.

Note: Peoples Health does not extend the timeframe to review prior authorization requests. As a result, Peoples Health is not reporting information related to extensions.