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2023 Plans

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Plan Details

Complete
(HMO-POS)
Prime
(HMO-POS)
Special
(HMO-SNP)
Monthly Premium $0 $41.10 $0
Primary Care Visits $0 $0 $0
Specialist Visits $25 (20% coinsurance out-of-network) $20 (20% coinsurance out-of-network) $0
Referrals Not required Not required Not required
Urgent Care $55 copay $55 copay $0
Emergency Room $90 copay (waived if admitted within 24 hours) $90 copay (waived if admitted within 24 hours) $0 copay
Inpatient Hospital Days 1-5: $230/day
Days 6-90: $0/day
Days 1-5: $235/day
Days 6-90: $0/day
$0 copay
Outpatient Surgery Surgery center: $200 copay
Outpatient hospital visit: $300 copay
Surgery center: $200 copay
Outpatient hospital visit: $300 copay
$0 copay
Prescription Drugs
(30-day supply)
Preferred Generic: $0
Generic: $10
Preferred Brand: $47
Non-preferred drug: $100
Specialty: 33%
Preferred Generic: $0
Generic: $10
Preferred Brand: $47
Non-preferred drug: $100
Specialty: 33%
$0 copay on all prescription drugs

Additional Benefits

Complete
(HMO-POS)
Prime
(HMO-POS)
Special
(HMO-SNP)
Part D Senior Savings $10 copay for insulin (30 day supply) $10 copay for insulin (30 day supply) N/A
Over-the-Counter Benefit $150 per quarter $165 per quarter $305 per quarter; includes OTC and eligible food items
Dental Exams $0 copay; 2 per year and annual X-rays $0 copay; 2 per year and annual X-rays $0 copay; 2 per year and annual X-rays
Dental Allowance $1,200 $2,000 $3,500
Annual Vision Exam $0 copay $0 copay $0 copay
Vision Allowance $250 for one pair of eyeglasses (lenses and frames) or contact lenses $300 for one pair of eyeglasses (lenses and frames) or contact lenses $500 for one pair of eyeglasses (lenses and frames) or contact lenses
Annual Hearing Exam $0 copay $0 copay $0 copay
Hearing Aid Allowance $1,000 (every 2 years) $1,500 (every 2 years) $1,500 (every year)
Transportation 22 one-way rides 50 one-way rides Unlimited one-way rides
SilverSneakers / Kroc Center Membership Included Included Included
Teladoc Included Included Included

2023 Coverage Area

Hpp Pennsylvania
  • Berks
  • Bucks
  • Carbon
  • Chester
  • Cumberland
  • Dauphin
  • Delaware
  • Lancaster
  • Lebanon
  • Lehigh
  • Montgomery
  • Northampton
  • Perry
  • Philadelphia
  • Schuylkill

This is not a full description of benefits; benefits, copays, limits and periodicity vary by plan. 

Health Partners Medicare is an HMO plan with Medicare and Pennsylvania State Medicaid program contracts. Enrollment in Health Partners Medicare depends on contract renewal.

Plan Details

Silver
(HMO-POS)
Platinum
(HMO-POS)
Monthly Premium $0 $20
Primary Care Visits $0 $0
Specialist Visits $30 (20% coinsurance out-of-network) $0 (20% coinsurance out-of-network)
Referrals Not required Not required
Urgent Care $55 copay $55 copay
Emergency Room $90 copay (waived if admitted within 24 hours) $90 copay (waived if admitted within 24 hours)
Inpatient Hospital Days 1-5: $290/day
Days 6-90: $0/day
Days 1-5: $275/day
Days 6-90: $0/day
Outpatient Surgery Surgery center: $200 copay
Outpatient hospital visit: $300 copay
Surgery center: $200 copay
Outpatient hospital visit: $300 copay
Prescription Drugs
(30-day supply)
Preferred Generic: $0
Generic: $10
Preferred Brand: $47
Non-preferred drug: $100
Specialty: 33%
Preferred Generic: $0
Generic: $10
Preferred Brand: $47
Non-preferred drug: $100
Specialty: 33%

Additional Benefits

Silver
(HMO-POS)
Platinum
(HMO-POS)
Part D Senior Savings $10 copay for insulin (30-day supply) $10 copay for insulin (30-day supply)
Over-the-Counter Benefit $60 per quarter $60 per quarter
Dental Exams $0 copay; 2 per year and annual X-rays $0 copay; 2 per year and annual X-rays
Dental Allowance $1,000 $1,000
Annual Vision Exam $0 copay $0 copay
Vision Allowance $200 for one pair of eyeglasses (lenses and frames) or contact lenses $200 for one pair of eyeglasses (lenses and frames) or contact lenses
Annual Hearing Exam $0 copay $0 copay
Hearing Aid Allowance $1,000 (every 2 years) $1,500 (every 2 years)
SilverSneakers / Kroc Center Membership Included Included
Teladoc Included Included

2023 Coverage Area

Hpp Newjersey
  • Burlington
  • Camden
  • Gloucester

This is not a full description of benefits; benefits, copays, limits and periodicity vary by plan.

Health Partners Medicare is an HMO plan with Medicare and Pennsylvania State Medicaid program contracts. Enrollment in Health Partners Medicare depends on contract renewal.