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Special (2022)

Health Partners Medicare Special (SNP HMO) 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 like an over-the-counter health items allowance, transportation and a fitness center membership through SilverSneakers®. Cost sharing depends on your Medicaid category and level of Extra Help. Most members will pay no monthly premium!

The Special plan has a $0 monthly premium and no costs for most medical coverage, as well as other great benefits including:

  • $0 copay for PCP visits and no referrals to see specialists
  • $0 copay for covered prescription drugs
  • Unlimited transportation to medical appointments + pharmacies
  • Telehealth coverage and access to doctors 24/7 through Teladoc®
  • $300 quarterly allowance for over-the-counter health items
  • $300 produce and healthy food allowance for eligible members*
  • No medical or prescription drug deductibles
  • Vision care, dental and hearing benefits with generous allowances
  • Fitness center membership through SilverSneakers, or a membership to the Salvation Army Kroc Center in Philadelphia
Benefit/Service Health Partners Medicare Special (HMO-SNP) Original Medicare
Primary Care Provider (PCP) Visit $0 20%
Specialist Visit (no referrals) $0 20%
Prescription Drugs (for each 30-day supply during initial coverage period)

$0 deductible

$0 copay

Not covered (standalone Part D plan required)
Diagnostic Testing and Lab Services

$0 coinsurance for lab & Medicare-covered diagnostic tests and procedures

0% coinsurance for X-ray

0% coinsurance for advanced radiology services like MRI/CT/PET

Emergency Room 0% coinsurance 20%
Urgent Care 0% coinsurance 20%
Routine Transportation Unlimited one-way trips Not covered
Fitness $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 $3,500 a year toward supplemental comprehensive dental services

Routine services not covered

Hearing aids: $0 copay

Up to $1,500 every year

Hearing aids not covered

$0 for routine annual vision exam

$0 for exam to diagnose and treat diseases and conditions of the eye

$0 for Medicare-covered eyewear after cataract surgery

$300 for one of the following:

  • One pair of eyeglasses (lenses and frames)
  • Contact lenses
20% for Medicare-covered services; routine services not covered
Over-the-Counter Items

$300 quarterly allowance

Not covered
Produce & Food Benefit*

$300 quarterly allowance for produce and food items. Eligibility requirements apply.

Not covered
Maximum Out-of-Pocket $3,450 per year (medical care) No annual limit

*Produce and food benefit are a part of special supplemental benefits. Not all members will qualify. Eligibility is based on claims data.

Call Today to Learn More and Enroll

Our licensed benefit advisors can provide more details about the great benefits in our Special plan. To speak to a licensed benefits advisor, call 1-833-477-4773 (TTY 1-877-454-8477). Our benefit advisors are available 8 a.m. – 8 p.m., seven days a week from October 1 through March 31 (8 a.m. – 8 p.m., Monday – Friday from April 1 through September 30).

You can also request a home visit or phone call from one of Health Partners Medicare's licensed benefits advisors:

More Information