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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 $10 Generic $47 Preferred Brand $100 Non-Preferred Drug 33% Specialty	$0 Deductible $0 Preferred Generic $10 Generic $47 Preferred Brand $100 Non-Preferred Drug 33% Specialty	Not covered (standalone Part D plan required)
Diagnostic Testing and Lab Services	$0 copay for lab & Medicare-covered diagnostic tests and procedures $30 copay for X-ray $250 copay for advanced radiology services like MRI/CT/PET	$0 copay for lab & Medicare-covered diagnostic tests and procedures $30 copay for X-ray $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: one pair of eyeglasses (lenses and up to $150 for frame) one pair of eyeglass lenses up to $150 for one eyeglass frame up to $200 for contact lenses	$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: one pair of eyeglasses (lenses and up to $150 for frame) one pair of eyeglass lenses up to $150 for one eyeglass frame up to $200 for contact lenses	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:

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.