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Compare Health Partners Medicare Prime and Simple (2020)

Health Partners Medicare Prime gives you medical and prescription drug coverage, competitive copays for a wide array of services, plus extra benefits like fitness and over-the-counter items. All for just $35.60/month. (PACE participants may pay $0.)

Health Partners Medicare Simple is a plan for those who want basic health and prescription drug coverage with a $0 premium.

No matter which plan you choose, you'll benefit from a $0 medical deductible, the peace of mind that comes with a maximum out-of-pocket limit for medical care and, of course, our friendly 24/7 customer service. 

Benefit or Service Health Partners Medicare Prime
(HMO-POS)
Health Partners Medicare Simple
(HMO-POS)
Original Medicare
Primary Care Provider (PCP) Visit $0 $5 20%
Specialist Visit (No referrals) $45 in-network, 20% out-of-network* $50 in-network, 20% out-of-network* 20%
Prescription Drugs (for each 30-day supply during initial coverage period)

$350 deductible on Brand, Non-Preferred Drug and Specialty tiers only

$0 Select Care
$7 Preferred Generic
$20 Generic 
$47 Preferred brand 
25% Non-Preferred Drug 
26% Specialty

$350 deductible on Brand, Non-Preferred Drug and Specialty tiers only

$7 Preferred Generic
$20 Generic
$47 Preferred brand
25% Non-Preferred Drug
26% 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
20% 20%
Emergency Room $90 copay (waived if admitted) 20% (max. $90/visit) 20%
Urgent Care $55/visit 20% (max. $65/visit) 20%
Routine Transportation 30 one-way trips Not included Not included
Fitness Access to any of the over 15,000 Silver Sneakers® fitness centers or reimbursement of up to $25 for an out-of-network center. Not included Not included
Dental Care $0 copay for two routine exams and cleanings; $1,000 supplemental allowance  $0 copay for two routine exams and cleanings (no supplemental allowance) Routine services not covered
Hearing $0 copay for routine annual exam and $1,000 toward hearing aids every three years $0 copay for routine annual exam and $500 toward hearing aids every three years Routine services not covered
Vision $0 copay for one routine exam yearly, plus eyeglasses or contact lenses (up to $120/year) $0 copay for one routine exam yearly, plus eyeglasses or contact lenses (up to $100/year) Routine services not covered
Over-the-Counter Items $25 monthly allowance (no rollover) Not covered Not covered
Worldwide Emergency Care Up to $5,000 per year Not covered Not covered
Maxiumum Out-of-Pocket $6,700 per year (medical care) $6,700 per year (medical care) N/A

*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:

Want to kick the tires a bit more before we talk? Get more details using the information and tools below.