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Special (2023) - Pennsylvania

Health Partners Medicare Special (SNP HMO) is the perfect choice if you have Medicare and full Medicaid health coverage. Special is offered in Pennsylvania.

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
  • $305 quarterly benefit for over-the-counter health items and food
  • 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 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

$500 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 and Food Benefit

$305 quarterly allowance; includess OTC items and food

Not covered
Maximum Out-of-Pocket $8,300 per year (medical care) No annual limit

Call Today to Learn More and Enroll

Call 1-833-477-4773 (TTY 1-877-454-8477) to speak with a licensed benefits advisor.

Hours of operation
8 a.m.–8 p.m., seven days a week, October 1 through March 31
8 a.m.–8 p.m., Monday–Friday, 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