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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 2026, 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 and Central MN Counties. This plan received an overall rating of 4.5 out of 5 stars in 2026.
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 $350.00 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:
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Drug Coverage
The HealthPartners Journey Pace (PPO) plan features an annual drug deductible of $350. Under this plan, Tier 1 preferred generic drugs have no copay for one-month and three-month supplies through standard pharmacies and mail-order options. Tier 2 generic medications require an $8 copay for a one-month supply, while a three-month supply costs $16 through preferred mail order and $24 through standard pharmacies and standard mail order. For higher-tier medications, costs are determined by coinsurance rather than flat copays. Tier 3 preferred brands have a 20% coinsurance, and Tier 4 non-preferred drugs require a 38% coinsurance for both one-month and three-month supplies. Tier 5 specialty drugs are covered with a 25% coinsurance for a one-month supply.
Additional Benefits
The HealthPartners Journey Pace (PPO) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care visits, annual physicals, and home health services. Specialist visits, urgent care, and routine eye or hearing exams require a $40 copay with no coinsurance. Inpatient hospital stays require a $400 daily copay for days 1 through 5, with no copay for additional days, while emergency room visits carry a $130 copay. Supplemental benefits include up to $2,000 in annual dental coverage with no copay for preventive care, alongside covered contact lenses and eyeglasses with no copay. Members also receive a $25 quarterly over-the-counter allowance and pay no copay for skilled nursing facility care during days 1 to 20 and days 81 to 100. While select services like dialysis and durable medical equipment require a 20% coinsurance, the plan features no deductible for routine vision and hearing care.
Inpatient Hospital See details
HealthPartners Journey Pace (PPO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $400 daily copay for days 1 through 5 and no copay for days 6 and beyond. This benefit is partially covered, as upgrades and non-Medicare-covered stays are not covered.
Outpatient Services See details
HealthPartners Journey Pace (PPO) covers outpatient services with no coinsurance, including a $450 copay for outpatient hospital services, a $350 daily copay for observation services, and a $375 copay for ambulatory surgical center services. Outpatient substance abuse sessions require a $40 copay with no coinsurance, while outpatient blood services are covered with no copay and no coinsurance.
Partial Hospitalization See details
HealthPartners Journey Pace (PPO) covers partial hospitalization services with a $55.00 copay and no coinsurance.
Ambulance and Transportation Services See details
Ambulance services under HealthPartners Journey Pace (PPO) require prior authorization, costing a $300 copay (no coinsurance) for ground transport and a 20% coinsurance (no copay) for air transport. Additional transportation services to plan-approved or health-related locations are not covered.
Emergency Services See details
HealthPartners Journey Pace (PPO) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and a 20% coinsurance.
Primary Care See details
HealthPartners Journey Pace (PPO) covers primary care physician services with no copay and no coinsurance, while specialists, therapy, and mental health services require a $40 copay and no coinsurance. Routine chiropractic care is covered for a $15 copay and no coinsurance, but other chiropractic and podiatry services are not covered under this benefit.
Preventive Services See details
HealthPartners Journey Pace (PPO) preventive services are partially covered, offering no copay and no coinsurance for annual physicals, kidney disease education, and other routine screenings. Covered supplemental benefits like fitness and remote access technologies have no coinsurance and a $0 to $40 copay, but sub-services such as health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, in-home support, caregiver support, enhanced disease management, telemonitoring, home/bathroom safety devices, and counseling are not covered.
Hearing Services See details
HealthPartners Journey Pace (PPO) covers hearing services, including one annual routine hearing exam for a $40 copay and no coinsurance, with no deductible. Prescription hearing aids are partially covered with no coinsurance and a copay between $499 and $999 for up to two aids per year, though inner ear, outer ear, over the ear, and over-the-counter hearing aids are not covered.
Vision Services See details
Vision services are partially covered by HealthPartners Journey Pace (PPO), featuring one routine eye exam per year for a $40 copay and no coinsurance, with no deductible. Covered eyewear includes contact lenses and combined eyeglasses (lenses and frames) with no copay and no coinsurance, though other eye exam services, individual eyeglass lenses, and individual eyeglass frames are not covered.
Dental Services See details
Dental services are partially covered by HealthPartners Journey Pace (PPO), providing up to $2,000 in annual benefits with no copay and no coinsurance for preventive care. Restorative and periodontic services have no copay and 0% to 75% coinsurance, but orthodontics and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
HealthPartners Journey Pace (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Covered Medicare Part B chemotherapy, radiation, and other drugs have no copay and coinsurance ranging from no coinsurance to 20%, while Part B insulin has a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis services are covered under the HealthPartners Journey Pace (PPO) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Medical equipment is covered by HealthPartners Journey Pace (PPO) with no copay, though a 20% coinsurance applies to durable medical equipment, prosthetics, and diabetic shoes. Diabetic supplies also have no copay and range from no coinsurance to 20% coinsurance, with prior authorization required for all medical equipment categories.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are partially covered by HealthPartners Journey Pace (PPO), as lab services are not covered and prior authorization is required for all other services. Diagnostic tests require a $50 copay with no coinsurance, while radiological services carry a $25 copay for outpatient X-rays, a minimum $250 copay for diagnostic radiology, and a 20% minimum coinsurance for therapeutic radiology.
Home Health Services See details
Home Health Services are covered under the HealthPartners Journey Pace (PPO) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the HealthPartners Journey Pace (PPO) plan, as all sub-services, including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation, are excluded from coverage.
Skilled Nursing Facility (SNF) See details
HealthPartners Journey Pace (PPO) covers skilled nursing facility (SNF) care with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 to 20 and days 81 to 100, a $218 daily copay for days 21 to 80, and additional days beyond the standard 100-day limit are not covered.
Other Services See details
HealthPartners Journey Pace (PPO) provides additional benefits including acupuncture with a $40 copay and no coinsurance for up to 20 treatments per year, and a $25 quarterly over-the-counter allowance with no copay and no coinsurance. Chronic illness meals, emergency travel logistics, and travel counseling are covered with no copay and no coinsurance, while treatment at the scene requires a $300 copay and no coinsurance.
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