A non-government entity
HealthPartners Journey Pace (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HealthPartners Journey Pace (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HealthPartners Journey Pace (PPO) in 2025, please refer to our full plan details page.
HealthPartners Journey Pace (PPO) is a PPO plan offered by HealthPartners, Inc. available for enrollment in 2025 to people living in Metro, Central, and Greater MN Counties. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that HealthPartners Journey Pace (PPO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about HealthPartners Journey Pace (PPO).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For HealthPartners Journey Pace (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $300.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $8950.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $8950.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
Sign up for HealthPartners Journey Pace (PPO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The HealthPartners Journey Pace (PPO) plan has an enhanced alternative drug benefit. The plan has a $300 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For example, you'll pay a $12 copay for preferred generic drugs at a standard pharmacy. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The HealthPartners Journey Pace (PPO) plan offers a range of benefits with varying costs. Inpatient hospital stays have a $400 copay for days 1-5, and outpatient services have copays ranging from $40 to $425. This plan also includes coverage for primary care with no copay, hearing and vision services with copays, and dental services with a $2,000 annual maximum. Additionally, services like home health and skilled nursing facilities are covered with no or low copays, and there's coverage for emergency services and ambulance services.
Inpatient Hospital See details
Inpatient Hospital coverage includes acute and psychiatric services, with a $400 copay for days 1-5 and no copay for days 6-90, and additional days are covered with no copay. Non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Outpatient Services, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services, are covered by HealthPartners Journey Pace (PPO). Outpatient Hospital Services have a $425 copay, Observation Services have a $350 copay, Ambulatory Surgical Center (ASC) Services have a $375 copay, and both Individual and Group Sessions for Outpatient Substance Abuse have a copay between $40 and $40.
Partial Hospitalization See details
Partial Hospitalization is covered under the HealthPartners Journey Pace (PPO) plan, with a copay of $55.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the HealthPartners Journey Pace (PPO) plan. Ground Ambulance Services have a $300 copay, while Air Ambulance Services have a 20% coinsurance, and transportation services to health-related locations are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the HealthPartners Journey Pace (PPO) plan. Emergency Services have a $125 copay, while Urgently Needed Services have a $40 copay, and Worldwide Emergency Services have 20% coinsurance for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The HealthPartners Journey Pace (PPO) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy services with a $40 copay, physician specialist services with a $40 copay, mental health specialty services with a $40 copay for individual sessions and a $20 copay for group sessions, other health care professional services with a copay between $0 and $40, psychiatric services with a $40 copay for individual sessions and a $20 copay for group sessions, physical therapy and speech-language pathology services with a $40 copay, additional telehealth benefits with a copay between $0 and $40, and opioid treatment program services with a $40 copay. Podiatry services are not covered.
Preventive Services See details
Preventive Services include coverage for services such as Medicare-covered preventive services, annual physical exams, nutritional/dietary benefits, home-based palliative care, additional sessions of smoking and tobacco cessation counseling, fitness benefits, remote access technologies, kidney disease education, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKGs. However, health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss, weight management programs, alternative therapies, therapeutic massage, adult day health services, in-home support services, support for caregivers, enhanced disease management, telemonitoring services, home and bathroom safety devices, and counseling services are not covered.
Hearing Services See details
Hearing Services include hearing exams with a $40 copay, and routine hearing exams with one visit per year. Prescription hearing aids are covered with a copay between $499 and $999, but prescription hearing aids for the inner ear, outer ear, and over the ear are not covered.
Vision Services See details
Vision Services include coverage for eye exams with a $40 copay, routine eye exams (1 per year), and eyewear including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades. There is no deductible for these services.
Dental Services See details
Dental Services are covered, with a maximum benefit of $2,000 per year for both in and out-of-network services. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), and fluoride treatments are covered, but have limits on the number of visits per year. Periodontics has a coinsurance of 0%-50%, while other services like maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Insulin and other Medicare Part B drugs. For Medicare Part B Insulin Drugs, there is a $35 copay, and a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the HealthPartners Journey Pace (PPO) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
The HealthPartners Journey Pace (PPO) plan covers Durable Medical Equipment, Prosthetic Devices, and Medical Supplies with a 20% coinsurance, and Diabetic Therapeutic Shoes/Inserts with a 20% coinsurance. Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the HealthPartners Journey Pace (PPO) plan. Diagnostic Procedures/Tests have a $50 copay, while Lab Services are not covered. Diagnostic Radiological Services have a $250 copay, Therapeutic Radiological Services have a 20% coinsurance, and Outpatient X-Ray Services have a $25 copay.
Home Health Services See details
Home Health Services are covered by the HealthPartners Journey Pace (PPO) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the HealthPartners Journey Pace (PPO) plan. The plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, with no copay for days 1-20 and days 81-100, and a $214 copay for days 21-80. Additional days beyond Medicare-covered for SNF and Non-Medicare-covered stays for SNF are not covered.
Other Services See details
The HealthPartners Journey Pace (PPO) plan covers acupuncture with a $40 copay, over-the-counter items up to $120 every three months, meal benefits for a chronic illness, US emergency travel logistics, travel counseling, and treatment at the scene with a $300 copay. This plan does not cover Dual Eligible SNPs with Highly Integrated Services, and several other services are also not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved