Health Partners Medicare Special (2020)
Health Partners Medicare Special is the perfect choice if you have Medicare and full Medicaid health coverage. You get medical and prescription drug coverage plus extra benefits not covered by Original Medicare. Cost sharing depends on your Medicaid category and level of Extra Help. Most members will pay no monthly premium, but those without Extra Help may pay up to $35.60.
|Benefit/Service||Health Partners Medicare Special (HMO-SNP)||Original Medicare|
|Primary Care Provider (PCP) Visit||0% or 20%||20%|
|Specialist Visit (No referrals)||0% or 20%||20%|
|Prescription Drugs (for each 30-day supply during initial coverage period)||20% coinsurance for Part B drugs. Part D depends on level of Extra Help.
Generic: $0/$1.30/$3.60 or 25%
|Not covered (standalone Part D plan required)|
|Diagnostic Testing and Lab Services||0% or 20%||20%|
|Emergency Room||0% or 20% (Max. $120, waived if admitted)||20%|
|Urgent Care||0% or 20% (Max.$65)||20%|
|Routine Transportation||85 one-way trips||Not covered|
|Fitness||Access to any of the over 15,000 Silver Sneakers® fitness centers or reimbursement of up to $50 for an out-of-network center.||Not Included|
|Dental Care||$0 copay for two routine exams and cleanings; $3,000 supplemental allowance||Routine services not covered|
|Hearing||$0 copay for routine annual exam and $1,500 toward hearing aids every year||Routine services not covered|
|Vision||$0 copay for one routine exam yearly, plus eyeglasses or contact lenses (up to $200/year)||Routine services not covered|
|Over-the-Counter Items||$300 quarterly allowance (no rollover)||Not covered|
|Worldwide Emergency Care||Up to $5,000 per year||Not covered|
|Maxiumum Out-of-Pocket||$3,400 per year (medical care)||N/A|
Ready to talk with a licensed benefit advisor?
We’re happy to explain plan benefits in detail. Just call us at 1-833-477-4773 (TTY 1-877-454-8477). You can call 8 a.m. – 8 p.m., seven days a week, from October 1 through March 31. Call 8 a.m. – 8 p.m., Monday – Friday, the rest of the year.
Or if it’s more convenient, use the links below to schedule a home visit or phone call:
- Request a home visit to discuss Health Partners Medicare options
- Request a phone call to discuss Health Partners Medicare options
Want to kick the tires a bit more before we talk? Get more details using the information and tools linked below.