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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 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:
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Drug Coverage
The HealthPartners Journey Pace (PPO) plan has an enhanced alternative drug benefit with a $300 deductible. After the deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy you use. For Tier 1, 2, and 3 drugs, you will pay a copay or coinsurance for each prescription. For Tier 4 drugs, you pay 29% coinsurance. 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 comprehensive coverage with a range of benefits, including inpatient hospital stays with a $400 copay for the first 5 days and no copay for the following days. The plan also covers outpatient services, such as primary care, specialist visits, and mental health services, with varying copays for each type of service. Additional benefits include coverage for hearing, vision, and dental services, with specific copays or coinsurance amounts. The plan also covers ambulance services, emergency services, and home health services with no copay.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For days 1-5, there is a $400 copay, and days 6-90 have no copay; there is no coinsurance.
Outpatient Services See details
Outpatient Services with the HealthPartners Journey Pace (PPO) plan includes coverage for outpatient hospital services with a $450 copay, observation services with a $350 copay, ambulatory surgical center services with a $375 copay, outpatient substance abuse services with a $40 copay for both individual and group sessions, and outpatient blood services.
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 and Air Ambulance Services have a $350 copay, with no coinsurance, while Transportation Services to any health-related location 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, Urgently Needed Services have a $50 copay, and Worldwide Emergency Services have a 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, chiropractic services with a $20 copay, occupational therapy with a $40 copay, and physician specialist services with a $40 copay. The plan also covers mental health specialty services, with individual sessions costing a $40 copay and group sessions costing a $20 copay, as well as psychiatric services, with individual sessions costing a $40 copay and group sessions costing a $20 copay. Physical therapy and speech-language pathology services have a $40 copay, and additional telehealth benefits have a copay between $0 and $40.
Preventive Services See details
Preventive Services are covered, including Medicare-covered services, annual physical exams, and additional preventive services; however, health education, in-home safety assessments, personal emergency response systems (PERS), medical nutrition therapy (MNT), post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, in-home support services, support for caregivers of enrollees, enhanced disease management, telemonitoring services, home and bathroom safety devices and modifications, and counseling services are not covered. Also covered are nutritional/dietary benefits, home-based palliative care, additional sessions of smoking and tobacco cessation counseling, fitness benefits, kidney disease education services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, EKG following Welcome Visit, and remote access technologies.
Hearing Services See details
Hearing services are covered, including hearing exams with a $40 copay, as well as fitting/evaluation for hearing aids. Prescription hearing aids (all types) 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, and OTC hearing aids are not covered.
Vision Services See details
Vision Services includes coverage for eye exams with a $40 copay, as well as coverage for eyeglasses, contact lenses, eyeglass lenses, and eyeglass frames. Routine eye exams are covered once per year.
Dental Services See details
The HealthPartners Journey Pace (PPO) plan covers a maximum of $2,000 per year for dental services, including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services, with varying visit limits. Periodontics has a coinsurance of 0% to 50%, while maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the HealthPartners Journey Pace (PPO) plan. Medicare Part B Insulin Drugs have a $35 copay, with a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered with a coinsurance of 20%.
Medical Equipment See details
Medical Equipment is covered under the HealthPartners Journey Pace (PPO) plan, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME and Prosthetic Devices have a 20% coinsurance, and Medical Supplies have a 20% coinsurance; however, 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, with some services requiring prior authorization. Diagnostic Procedures/Tests have a $50 copay, while Lab Services are not covered. Diagnostic Radiological Services have a $250 copay, Therapeutic Radiological Services have 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 under the HealthPartners Journey Pace (PPO) plan. Specifically, Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the HealthPartners Journey Pace (PPO) plan, with a $0 copay for days 1-20 and days 81-100, and a $214 copay for days 21-80; there is no coinsurance. 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 per visit, up to 20 treatments per year. Over-the-counter (OTC) items are covered with a maximum benefit of $50 every three months, including Nicotine Replacement Therapy (NRT) and Naloxone. Other services include US Emergency Travel Logistics, Travel Counseling, and Treatment at the Scene with a $350 copay. Many other services are not covered.
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