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Medicare Enrollment Requirements

There are four types of Medicare Advantage plans offered by Peoples Health. Each type has different medicare enrollment requirements for plan eligibility.

Health Maintenance Organization (HMO) Plans

If you meet the following Medicare enrollment requirements, you’re eligible to become an HMO plan member:

  • Be enrolled in Medicare Part A and Medicare Part B
  • Continue to pay your Medicare Part B premium
  • Do 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 (for 2020 plans); note that for 2021, you MAY enroll in a Medicare Advantage plan even if you have end-stage renal disease
  • Live in the plan service area (a service area varies by plan and may vary by year)

Preferred Provider Organization (PPO)

If you meet the following Medicare enrollment requirements, you’re eligible to become a PPO plan member:

  • Be enrolled in Medicare Part A and Medicare Part B
  • Continue to pay your Medicare Part B premium
  • Live in the plan service area (a service area varies by plan and may vary by year)

Dual Eligible Special Needs Plans (D-SNPs)

If you meet the following Medicare enrollment requirements, you’re eligible to become a D-SNP member:

  • Have medical assistance from the state or Louisiana Medicaid; for some of our D-SNPs, you must have full Medicaid benefits
  • Be enrolled in Medicare Part A and Medicare Part B
  • Continue to pay your Medicare Part B premium, unless paid for you by the state or another third party
  • Do 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 (for 2020 plans); note that for 2021, you MAY enroll in a Medicare Advantage plan even if you have end-stage renal disease
  • Live in the plan service area (service area varies by plan and may vary by year)

Employer and Retiree Group Plans

If you meet the following enrollment requirements, you’re eligible to become an employer or retiree group plan member:

  • Be a member of a participating employer or retiree group and meet any requirements determined by the group
  • Be enrolled in Medicare Part A and Medicare Part B
  • Do 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 (for 2020 plans); note that for 2021, you MAY enroll in a Medicare Advantage plan even if you have end-stage renal disease
  • Live in the service area determined individually by each employer or retiree group (contact the group benefits administrator for more information)

Have Medicare and Medicaid?

Get the extra benefits you need. Learn more about our dual-eligible plans.

Peoples Health Medicare Advantage member
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