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

Louisiana Chronic Condition Special Needs C-SNP Plan (2025 Plan)

Monthly Premium

Your Cost
$0
by Peoples Health

Additional Coverage

HearingVisionDental

Overall Government Star Rating

 4.0
out of 5 stars

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Plan Overview

Plan Name
Peoples Health Complete Care LA-5 (HMO-POS C-SNP)
Insurance Carrier
Peoples Health
Plan Type
Chronic Condition Special Needs Plan (C-SNP)
Network Type
HMO

Peoples Health Complete Care LA-5 (HMO-POS C-SNP) is a Chronic Condition Special Needs Plan (C-SNP), which is available in Louisiana and offered by the health insurance company Peoples Health. This plan’s network type is HMO which determines in-network doctors who accept the health plan and whether a referral is needed.

Cost Summary

Monthly Premium
$0
Annual Deductible
$0
Max Out-of-Pocket
$3,900
Primary doctor visit
$0 copay
Specialist visit
$0-10 copay per visit
ER visit
$140 copay per visit (always covered)
Ambulance
$145 copay

Peoples Health Complete Care LA-5 (HMO-POS C-SNP) has a monthly premium cost of $0 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $3,900 In-network. The most common benefit costs which people evaluate when choosing a plan are costs for a primary doctor visit, specialist doctor visit, emergency room visit, and ambulance. These costs are listed in this summary section and a full list of benefit costs for Peoples Health Complete Care LA-5 (HMO-POS C-SNP) are defined below.

Additional Benefits and Coverage

Yes
Part D Prescription Drug Coverage
Yes
Dental
Yes
Vision
Yes
Hearing

Peoples Health Complete Care LA-5 (HMO-POS C-SNP) is a Medicare Advantage plan which does include Medicare Part D Prescription Drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. Peoples Health Complete Care LA-5 (HMO-POS C-SNP) includes coverage for hearing, vision, dental.

Medicare Advantage health plans can offer even more additional benefits. Peoples Health Complete Care LA-5 (HMO-POS C-SNP) includes coverage for the following additional benefits:

Other benefits

Fitness benefit
Limited coverage
Over the counter drug benefits
Limited coverage
In-home support services
Not covered
Home and bathroom safety devices
Limited coverage
Meals for short duration
Limited coverage
Annual physical exams
Limited coverage
Telehealth
Limited coverage

Comparing the Quality Score of Peoples Health Complete Care (HMO-POS C-SNP) to Other Plans in Louisiana

Each year the federal government evaluates the quality of Medicare Advantage and Part D Prescription Drug plans based on a 5-star scoring system. For 2025, Peoples Health Complete Care (HMO-POS C-SNP) received an overall government quality rating of 4.0 stars out of 5 stars.

Peoples Health Complete Care (HMO-POS C-SNP) performed better than Louisiana’s State average overall quality score of 3.8 stars.

This Plan’s 5-star Gov’t Quality Score
Louisiana State Average Score
Overall Government 5 Star Quality Rating
 4.0
 3.8
Summary rating of health plan quality
 4
 4.0
Staying healthy: screenings, tests, & vaccines
 3
 3.2
Managing chronic (long term) conditions
 4
 3.6
Member experience with health plan
 5
 4.2
Member complaints & changes in the health plan's performance
 4
 4.0
Health plan customer service
 3
 3.8
Summary rating of drug plan quality
 3.5
 3.6
Drug plan customer service
 4
 3.9
Member complaints & changes in the drug plan's performance
 3
 3.7
Member experience with the drug plan
 4
 3.8
Drug safety & accuracy of drug pricing
 3
 3.3

The government calculates an “Overall star rating” based on ratings for sub components including “Health plan star rating” and “Drug plan star rating”, which includes further subcomponents of each.

Peoples Health Complete Care (HMO-POS C-SNP) received 4 stars for its health plan quality score which is the same as the Louisiana State average health plan quality score of 4.0 stars.

Peoples Health Complete Care (HMO-POS C-SNP) received 3.5 stars for its drug plan quality score which is worse than the Louisiana State average drug plan quality score of 3.6 stars.

Plan Benefits and Coverage Details

Monthly Premium
$0
Health Portion of Premium
$0
Drug Portion of Premium
$0
Health Plan Deductible
$0
Health Plan Max Out-of-Pocket
$3,900 In-network
Nationwide Coverage included
No
Hearing Coverage included
Yes
Vision Coverage included
Yes
Dental Coverage included
Yes
Doctor Lookup Link
http://peopleshealth.com/physicians
Plan Link
http://peopleshealth.com

Medical Benefits

Doctor Services

Primary doctor visit
In-network: $0 copay
Specialist visit
In-network: $0-10 copay per visit

Tests, labs, & imaging

Diagnostic tests & procedures
In-network: $25 copay
Lab services
In-network: $0 copay
Diagnostic radiology services (like MRI)
In-network: $0-150 copay
Outpatient x-rays
In-network: $15 copay
Emergency care
$140 copay per visit (always covered)
Urgent care
$0-65 copay per visit (always covered)

Hospital Services

Inpatient hospital coverage
In-network: $95 per day for days 1 through 10
$0 per day for days 11 through 90
$0 per day for days 91 and beyond
Out-of-network: Not Applicable
Outpatient hospital coverage
In-network: $0-125 copay per visit

Skilled nursing facility

Skilled nursing facility
In-network: $0 per day for days 1 through 20
$203 per day for days 21 through 100
Out-of-network: Not Applicable

Preventive services

Preventive services
In-network: $0 copay

Ambulance

Ground ambulance
In-network: $145 copay

Therapy services

Occupational therapy visit
In-network: $0-10 copay
Physical therapy & speech & language therapy visit
In-network: $0-10 copay

Mental health services

Outpatient group therapy with a psychiatrist
In-network: $15 copay
Outpatient individual therapy with a psychiatrist
In-network: $0-25 copay
Outpatient group therapy visit
In-network: $15 copay
Outpatient individual therapy visit
In-network: $0-25 copay

Opioid treatment services

Opioid treatment services
Covered

Other services

Durable medical equipment (like wheelchairs & oxygen)
In-network: 20% coinsurance per item
Prosthetics (like braces, artificial limbs)
In-network: 20% coinsurance per item
Diabetes supplies
In-network: $0 copay

Prescription Drug Benefits

Tier drug costs for: Standard retail pharmacy drug cost for 1-month

TiersInitial coverage phaseCatastrophic coverage phase
Preferred Generic$0.00 copay$0 copay
Generic$5.00 copay$0 copay
Preferred Brand$47.00 copay$0 copay
Non-Preferred Drug$100.00 copay$0 copay
Specialty Tier30% coinsurance$0 copay

Part B Drugs

Chemotherapy drugs
In-network: 0-20% coinsurance
Other Part B drugs
In-network: 0-20% coinsurance

Extra Benefits

Hearing

Hearing exam
In-network: $0 copay
Fitting/evaluation
Not covered
Hearing aids - All types
In-network: $199-1,249 copay

Preventive Dental

Oral exam
In-network: $0 copay
Out-of-network: $0 copay
Cleaning
In-network: $0 copay
Out-of-network: $0 copay
Fluoride treatment
In-network: $0 copay
Out-of-network: $0 copay
Dental x-rays
In-network: $0 copay
Out-of-network: $0 copay

Comprehensive dental

Restorative services
In-network: $0 copay
Out-of-network: $0 copay
Endodontics
In-network: $0 copay
Out-of-network: $0 copay
Periodontics
In-network: $0 copay
Out-of-network: $0 copay
Prosthodontics, removable
In-network: 0%-50% coinsurance
Out-of-network: 0%-50% coinsurance
Prosthodontics, fixed
In-network: 0%-50% coinsurance
Out-of-network: 0%-50% coinsurance
Maxillofacial prosthetics
In-network: $0 copay
Out-of-network: $0 copay
Implant services
Not covered
Oral and maxillofacial surgery
In-network: $0 copay
Out-of-network: $0 copay
Orthodontics
Not covered
Adjunctive general services
In-network: $0 copay
Out-of-network: $0 copay

Vision

Routine eye exam
In-network: $0 copay
Contact lenses
In-network: $0 copay
Eyeglasses (frames & lenses)
Not covered
Eyeglass frames (only)
In-network: $0 copay
Eyeglass lenses (only)
In-network: $0-153 copay
Upgrades
Not covered

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