Skip navigation

Sub-navFull Medicaid? Explore Health Partners Medicare Special (2020)

print page

Full Medicaid? Explore Health Partners Medicare Special (2020)

Health Partners Medicare Special 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. Cost sharing depends on your Medicaid category and level of Extra Help. Most members will pay no monthly premium, but those without Extra Help may pay up to $35.60.

Benefit/Service Health Partners Medicare Special (HMO-SNP) Original Medicare
Primary Care Provider (PCP) Visit 0% or 20% 20%
Specialist Visit (No referrals) 0% or 20% 20%
Prescription Drugs (for each 30-day supply during initial coverage period) 20% coinsurance for Part B drugs. Part D depends on level of Extra Help.

Generic: $0/$1.30/$3.60 or 25%
Other drugs: $0/$3.90/$8.95 or 25%

Not covered (standalone Part D plan required)
Diagnostic Testing and Lab Services 0% or 20% 20%
Emergency Room 0% or 20% (Max. $120, waived if admitted) 20%
Urgent Care 0% or 20% (Max.$65) 20%
Routine Transportation 85 one-way trips Not covered
Fitness Access to any of the over 15,000 Silver Sneakers® fitness centers or reimbursement of up to $50 for an out-of-network center. Not Included
Dental Care $0 copay for two routine exams and cleanings; $3,000 supplemental allowance Routine services not covered
Hearing $0 copay for routine annual exam and $1,500 toward hearing aids every year Routine services not covered
Vision $0 copay for one routine exam yearly, plus eyeglasses or contact lenses (up to $200/year) Routine services not covered
Over-the-Counter Items $300 quarterly allowance (no rollover) Not covered
Worldwide Emergency Care Up to $5,000 per year Not covered
Maxiumum Out-of-Pocket $3,400 per year (medical care) N/A

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 linked below.