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Out-of-Area Coverage

As a Health Partners Medicare member, you must receive your care from a network provider.

In most cases, care you receive from an out-of-network provider (a provider who is not part of our plan's network) will not be covered. Here are three exceptions:

  • The plan covers emergency care or urgently needed care that you get from an out-of-network provider.
  • If you need medical care that Medicare requires our plan to cover and the providers in our network cannot provide this care, you can get this care from an out-of-network provider. You or your doctor must get prior authorization (approval for these services in advance) from Health Partners Medicare. In this situation, you will pay the same as you would pay if you got the care from a network provider.
  • Kidney dialysis services that you get at a Medicare-certified dialysis facility when you are temporarily outside the plan's service area.

For more information, call Member Relations at 1-866-901-8000 (TTY 711) or see the Evidence of Coverage for your plan.

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