What are my costs in 2017 to see a doctor?

Select a plan from the pull-down menu below to see a quick reference of your costs for care from a doctor.

Earl P. - Peoples Health Member

Peoples Health Choices 65 #14 (HMO)

Benefit Description Your Cost

Primary Care Physician Office Visit

$5

Specialist Office Visit (includes podiatry services)

$45

Chiropractic Services

$20

Emergency Care (within the U.S. and outside the U.S. and its territories)

$75, waived if admitted to inpatient hospital care within 24 hours for the same condition ($5,000 combined annual maximum for emergency and urgently needed care outside the U.S. and its territories)

Urgently Needed Care (within the U.S. and outside the U.S. and its territories)

$35 ($5,000 combined annual maximum for emergency and urgently needed care outside the U.S. and its territories)

Vision Care

$45 for routine eye exam (one per year)

$45 for exams and services to diagnose and treat diseases and conditions of the eye

Notes:

Authorization is required for certain services.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. Benefits, premiums, copayments and coinsurance may change on January 1 of each year. The formulary, pharmacy network and provider network may change at any time. You will receive notice when necessary.

Peoples Health Choices 65 #14 (HMO) for St. Tammany Parish

Benefit Description Your Cost

Primary Care Physician Office Visit

$5

Specialist Office Visit (includes podiatry services)

$40

Chiropractic Services

$20

Emergency Care (within the U.S. and outside the U.S. and its territories)

$75, waived if admitted to inpatient hospital care within 24 hours for the same condition ($5,000 combined annual maximum for emergency and urgently needed care outside the U.S. and its territories)

Urgently Needed Care (within the U.S. and outside the U.S. and its territories)

$35 ($5,000 combined annual maximum for emergency and urgently needed care outside the U.S. and its territories)

Vision Care

$40 for routine eye exam (one per year)

$40 for exams and services to diagnose and treat diseases and conditions of the eye

Notes:

Authorization is required for certain services.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. Benefits, premiums, copayments and coinsurance may change on January 1 of each year. The formulary, pharmacy network and provider network may change at any time. You will receive notice when necessary.

Peoples Health Choices Premium (HMO)

Benefit Description Your Cost

Primary Care Physician Office Visit

$0

Specialist Office Visit (includes podiatry services)

$0

Chiropractic Services

$0

Emergency Care (within the U.S. and outside the U.S. and its territories)

$0 ($5,000 combined annual maximum for emergency and urgently needed care outside the U.S. and its territories)

Urgently Needed Care (within the U.S. and outside the U.S. and its territories)

$0 ($5,000 combined annual maximum for emergency and urgently needed care outside the U.S. and its territories)

Vision Care

$35 for routine eye exam (one per year)

$35 for exams and services to diagnose and treat conditions of the eye

Notes:

Authorization is required for certain services.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. Benefits, premiums, copayments and coinsurance may change on January 1 of each year. The formulary, pharmacy network and provider network may change at any time. You will receive notice when necessary.

Peoples Health Choices Platinum #009 (HMO)

Benefit Description Your Cost

Primary Care Physician Office Visit

$0

Specialist Office Visit (includes podiatry services)

$30

Chiropractic Services

$20

Emergency Care (within the U.S. and outside the U.S. and its territories)

$75, waived if admitted to inpatient hospital care within 24 hours for the same condition ($5,000 combined annual maximum for emergency and urgently needed care outside the U.S. and its territories)

Urgently Needed Care (within the U.S. and outside the U.S. and its territories)

$35 ($5,000 combined annual maximum for emergency and urgently needed care outside the U.S. and its territories)

Vision Care

$30 for routine eye exam (one per year)

$30 for exams and services to diagnose and treat diseases and conditions of the eye

Notes:

Authorization is required for certain services.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. Benefits, premiums, copayments and coinsurance may change on January 1 of each year. The formulary, pharmacy network and provider network may change at any time. You will receive notice when necessary.

Peoples Health Secure Choice #011 (HMO SNP)

Benefit Description Your Cost

Primary Care Physician Office Visit

$0

Specialist Office Visit (includes podiatry services)

$0 or $45*

Chiropractic Services

$0 or 20%* coinsurance

Emergency Care (within the U.S. and its territories)

$0 or 20%* coinsurance (up to $75, depending on the service); waived if admitted to inpatient hospital care within three days for the same condition

Urgently Needed Care (within the U.S. and its territories)

$0 or 20%* coinsurance (up to $65, depending on the service); waived if admitted to inpatient hospital care within three days for the same condition

Vision Care

$0 or $45* for exams and services to diagnose and treat diseases and conditions of the eye

Routine eye exams for vision correction are not covered

Notes:

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

Authorization is required for certain services.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. Benefits, premiums, copayments and coinsurance may change on January 1 of each year. The formulary, pharmacy network and provider network may change at any time. You will receive notice when necessary. This plan is available to anyone who has both medical assistance from the state and Medicare.

Peoples Health Choices Select (HMO)

Benefit Description Your Cost

Primary Care Physician Office Visit

$5

Specialist Office Visit (includes podiatry services)

$40

Chiropractic Services

$15

Emergency Care (within the U.S. and outside the U.S. and its territories)

$75, waived if admitted to inpatient hospital care within 24 hours for the same condition ($5,000 combined annual maximum for emergency and urgently needed care outside the U.S. and its territories)

Urgently Needed Care (within the U.S. and outside the U.S. and its territories)

$25 ($5,000 combined annual maximum for emergency and urgently needed care outside the U.S. and its territories)

Vision Care

$40 for routine eye exam (one per year)

$40 for exams and services to diagnose and treat diseases and conditions of the eye

Notes:

Authorization is required for certain services.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. Benefits, premiums, copayments and coinsurance may change on January 1 of each year. The formulary, pharmacy network and provider network may change at any time. You will receive notice when necessary.

Peoples Health Secure Health (HMO SNP)

Benefit Description Your Cost

Primary Care Physician Office Visit

$0

Specialist Office Visit (includes chiropractic and podiatry services)

$0

Emergency Care (within the U.S. and its territories)

$0 or $50*, waived if admitted to inpatient hospital care within 24 hours for the same condition

Emergency Care (outside the U.S. and its territories)

$50, waived if admitted to inpatient hospital care within 24 hours for the same condition ($5,000 combined annual maximum for emergency and urgently needed care outside the U.S. and its territories)

Urgently Needed Care (within the U.S. and outside the U.S. and its territories)

$0 ($5,000 combined annual maximum for emergency and urgently needed care outside the U.S. and its territories)

Vision Care

$0 for routine eye exam (one per year)

$0 for exams and services to diagnose and treat disease and conditions of the eye

Notes:

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

Authorization is required for certain services.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. Benefits, premiums, copayments and coinsurance may change on January 1 of each year. The formulary, pharmacy network and provider network may change at any time. You will receive notice when necessary. This plan is available to anyone who has both medical assistance from the state and Medicare.

Peoples Health Choices Gold (HMO)

Benefit Description Your Cost

Primary Care Physician Office Visit

$10

Specialist Office Visit (includes podiatry services)

$40

Chiropractic Services

$20

Emergency Care (within the U.S. and outside the U.S. and its territories)

$75, waived if admitted to inpatient hospital care within 24 hours for the same condition ($5,000 combined annual maximum for emergency and urgently needed care outside the U.S. and its territories)

Urgently Needed Care (within the U.S. and outside the U.S. and its territories)

$25 ($5,000 combined annual maximum for emergency and urgently needed care outside the U.S. and its territories)

Vision Care

$0 for routine eye exam (one per year)

$40 for exams and services to diagnose and treat diseases and conditions of the eye

Notes:

Authorization is required for certain services.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. Benefits, premiums, copayments and coinsurance may change on January 1 of each year. The formulary, pharmacy network and provider network may change at any time. You will receive notice when necessary.

Peoples Health Group Medicare (HMO-POS)

Benefit Description Your Cost Costs for PLan-covered Services from out-of-Network Providers

Primary Care Physician Office Visit

$5

20% coinsurance

Specialist Office Visit (includes chiropractic and podiatry services)

$10

20% coinsurance

Emergency Care (within the U.S. and outside the U.S. and its territories)

$50, waived if admitted to inpatient hospital care within 24 hours for the same condition ($5,000 combined annual maximum for emergency and urgently needed care outside the U.S. and its territories)

$50, waived if admitted to inpatient hospital care within 24 hours for the same condition ($5,000 combined annual maximum for emergency and urgently needed care outside the U.S. and its territories)

Urgently Needed Care (within the U.S. and its territories)

$10

$10

Vision Care

$15 for routine eye exam (one per year)
$15 for exams and services to diagnose and treat diseases and conditions of the eye

Routine eye exams for routine vision correction are not covered
20% coinsurance for exams and services to diagnose and treat diseases and conditions of the eye

Notes:

Authorization is required for certain services.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. Benefits, premiums, copayments and coinsurance may change on January 1 of each year. The formulary, pharmacy network and provider network may change at any time. You will receive notice when necessary.

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

Benefit Description Your Cost Costs for PLan-covered Services from out-of-Network Providers

Primary Care Physician Office Visit

$5

20% coinsurance

Specialist Office Visit (includes chiropractic and podiatry services)

$10

20% coinsurance

Emergency Care (within the U.S. and outside the U.S. and its territories)

$50, waived if admitted to inpatient hospital care within 24 hours for the same condition ($5,000 combined annual maximum for emergency and urgently needed care outside the U.S. and its territories)

$50, waived if admitted to inpatient hospital care within 24 hours for the same condition ($5,000 combined annual maximum for emergency and urgently needed care outside the U.S. and its territories)

Urgently Needed Care (within the U.S. and its territories)

$10

$10

Vision Care

$15 for routine eye exam (one per year)
$15 for exams and services to diagnose and treat diseases and conditions of the eye

Routine eye exams for routine vision correction are not covered
20% coinsurance for exams and services to diagnose and treat diseases and conditions of the eye

Notes:

Authorization is required for certain services.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. Benefits, premiums, copayments and coinsurance may change on January 1 of each year. The formulary, pharmacy network and provider network may change at any time. You will receive notice when necessary.