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 |
20% |
| 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 |
Hearing aids: $0 copay Up to $1,500 every year |
Hearing aids not covered |
| Vision |
$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:
|
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:
- Request a home visit to discuss Health Partners Medicare options
- Request a phone call to discuss Health Partners Medicare options
More Information
- View our Medicare Star Rating
- Learn more about Health Partners Plans
- For a personalized plan evaluation, visit our online enrollment site and enter your ZIP code. Then click the “View plans” button. To see the details of our Special plan, you must click "Add all Special Needs Plans (SNP)" near the top of the box.