2021 Health Partners Medicare Prime and Complete
Health Partners Medicare Prime is a competitive low-cost plan that costs just $37.50 per month, with medical and prescription coverage, plus lots of extra benefits.
Health Partners Medicare Complete is a plan with a $0 plan premium with all the benefits of Original Medicare plus extra benefits!
No matter which plan you choose, you'll get:
- $0 copay for PCP visits + no referrals
- Comprehensive Part D prescription drug coverage
- Transportation to medical appointments + pharmacies
- Healthcare at home with telehealth + Teladoc®
- $150 quarterly allowance for over-the-counter health items
- No medical or Rx deductibles
- Vision care, dental + hearing benefits with generous allowances
- SilverSneakers® or Salvation Army Kroc Center of Philadelphia membership
Benefit or Service |
Health Partners Medicare Prime (HMO-POS) |
Health Partners Medicare Complete (HMO-POS) |
Original Medicare |
Primary Care Provider (PCP) Visit | $0 | $0 | 20% |
Specialist Visit (No referrals) | $30 in-network, 20% out-of-network* |
$45 in-network, 20% out-of-network* |
20% |
Prescription Drugs (for each 30-day supply during initial coverage period) |
$0 Deductible $0 Preferred Generic |
$0 Deductible $0 Preferred Generic |
Not covered (standalone Part D plan required) |
Diagnostic Testing and Lab Services |
$0 copay for lab & Medicare-covered diagnostic tests and procedures $250 copay for advanced radiology services like MRI/CT/PET |
$0 copay for lab & Medicare-covered diagnostic tests and procedures $250 copay for advanced radiology services like MRI/CT/PET |
20% |
Emergency Room | $90 copay (waived if admitted) | $90 copay (waived if admitted) | 20% |
Urgent Care | $55 | $55 | 20% |
Routine Transportation | 50 one-way trips | 24 one-way trips | Not included |
Fitness | $0 copay for SilverSneakers® membership or membership in the Salvation Army Kroc Center of Philadelphia | $0 copay for SilverSneakers® membership or membership in the Salvation Army Kroc Center of Philadelphia | Not included |
Dental Care |
$0 for 2 exams and cleanings, plus X-rays (limits apply) Plan pays $1,500 a year toward supplemental comprehensive dental services |
$0 for 2 exams and cleanings, plus X-rays (limits apply) Plan pays $1,200 a year toward supplemental comprehensive dental services |
Routine services not covered |
Hearing |
Hearing aids: $0 copay Up to $1,500 every two years
|
Hearing aids: $0 copay Up to $1,000 every two years |
Routine services not covered |
Vision |
$0 for routine annual vision exam $40 for exam to diagnose and treat diseases and conditions of the eye $0 for Medicare-covered eyewear after cataract surgery $0 for one of the following:
|
$0 for routine annual vision exam $45 for exam to diagnose and treat diseases and conditions of the eye $0 for Medicare-covered eyewear after cataract surgery $0 for one of the following:
|
Routine services not covered |
Over-the-Counter Items |
$150 quarterly allowance, plus rollover Must be used by December 31, 2021 |
$150 quarterly allowance, plus rollover Must be used by December 31, 2021 |
Not covered |
Maxiumum Out-of-Pocket | $7,550 per year (medical care) | $7,550 per year (medical care) | No annual limit |
*Out-of-Network specialists must accept Original Medicare. Out-of-network services do not count toward maximum out-of-pocket for medical care.
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
Get more details about our Prime and Complete plans using the information and tools linked below.
- 2021 Summary of Benefits
- View our Medicare Star Rating
- Learn more about Health Partners Plans
- For a personalized 2021 plan evaluation, visit our online enrollment site and click the “Compare Plans” button.