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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 $20.00. 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) prescription drug plan features an annual drug deductible of $350. You will pay no copay for Tier 1 preferred generic drugs, whether you use standard retail pharmacies or mail-order services. Tier 2 generic drugs carry a standard $8 copay for a 1-month supply, though you can save on a 3-month supply by using preferred mail order for a $16 copay. For higher-tier medications, your costs are determined by coinsurance. Tier 3 preferred brands require a 20% coinsurance, while Tier 4 non-preferred drugs carry a 38% coinsurance. Tier 5 specialty drugs are covered with a 25% coinsurance for a 1-month supply through standard pharmacies and mail-order options.
Additional Benefits
The HealthPartners Journey Pace (PPO) plan offers robust coverage for everyday health needs, featuring no copay and no coinsurance for primary care visits and standard preventive care. For emergency services, members face a $130 copay, which is waived upon hospital admission, while inpatient hospital stays require a $400 copay for the first five days and no copay thereafter. Outpatient hospital services are covered with a $450 copay and no coinsurance, ensuring manageable out-of-pocket costs for major medical events. Additionally, the plan features comprehensive dental coverage with no copay for diagnostic or preventive care and an annual maximum benefit of $2,000. Vision and hearing benefits include routine annual exams for a $40 copay, alongside coverage for eyewear with no copay and up to two hearing aids per year. Other valuable benefits include home health services with no copay, home infusion services, and a $25 quarterly allowance for over-the-counter items.
Inpatient Hospital See details
HealthPartners Journey Pace (PPO) covers inpatient acute and psychiatric hospital services with no coinsurance, requiring a $400 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, featuring a $450 copay for outpatient hospital services and a $375 copay for ambulatory surgical center services, both requiring prior authorization. Observation services require a $350 daily copay, outpatient substance abuse sessions have a $40 copay with no coinsurance, and outpatient blood services are fully covered with no copay, coinsurance, or deductible.
Partial Hospitalization See details
Partial hospitalization services are covered by HealthPartners Journey Pace (PPO) with a $55.00 copay and no coinsurance.
Ambulance and Transportation Services See details
HealthPartners Journey Pace (PPO) covers ground ambulance services with a $300 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required. Transportation services to health-related locations are not covered under this plan.
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 specialist visits, mental health, and therapy services require a $40 copay and no coinsurance. Routine chiropractic care is covered for a $15 copay with no coinsurance, but other chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive Services are partially covered by HealthPartners Journey Pace (PPO), offering no copay and no coinsurance for annual physical exams, kidney disease education, and standard Medicare-covered services. While fitness, nutritional, and remote access technologies (with a $0 to $40 copay and no coinsurance) are covered, the plan does not cover 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, disease management, telemonitoring, home safety modifications, or counseling.
Hearing Services See details
Hearing services are partially covered under HealthPartners Journey Pace (PPO), which offers one routine annual hearing exam for a $40 copay and no coinsurance, with no deductible. Up to two prescription hearing aids are covered per year with no coinsurance and a copay ranging from $499 to $999, though OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Vision services are partially covered by HealthPartners Journey Pace (PPO) with no deductibles, featuring a $40 copay and no coinsurance for one routine eye exam annually, while other eye exams are not covered. Eyewear is covered with no copay and no coinsurance for contact lenses, upgrades, and eyeglasses (lenses and frames), though individual eyeglass lenses and frames are not covered.
Dental Services See details
HealthPartners Journey Pace (PPO) provides partially covered dental services with an annual maximum benefit of $2,000 for both in-network and out-of-network care. Diagnostic and preventive care options require no copay and no coinsurance, while other covered treatments feature no copay and coinsurance ranging from 0% to 75%, though orthodontics and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by HealthPartners Journey Pace (PPO) with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs carry no copay and a 0% to 20% coinsurance, while Part B insulin has a $35 copay and a 0% to 20% coinsurance.
Dialysis Services See details
HealthPartners Journey Pace (PPO) covers dialysis services with no copay and a 20% coinsurance.
Medical Equipment See details
HealthPartners Journey Pace (PPO) covers medical equipment, prosthetics, and diabetic shoes with no copay and 20% coinsurance, subject to prior authorization. Diabetic supplies are also covered with no copay and coinsurance ranging from no coinsurance to 20%, limited to specified manufacturers.
Diagnostic and Radiological Services See details
HealthPartners Journey Pace (PPO) diagnostic and radiological services are partially covered and require prior authorization, though lab services are not covered under this benefit. Covered diagnostic procedures have a $50 copay with no coinsurance, while radiological services require a $25 copay for X-rays, a minimum $250 copay for diagnostic radiology, and a minimum 20% 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, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the HealthPartners Journey Pace (PPO) plan. This non-coverage applies to all related sub-services, including standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation.
Skilled Nursing Facility (SNF) See details
HealthPartners Journey Pace (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no copay for days 1 to 20 and days 81 to 100, and a $218 daily copay for days 21 to 80. Prior authorization is required, a prior three-day hospital stay is not required, and additional days beyond the standard 100-day Medicare benefit are not covered.
Other Services See details
HealthPartners Journey Pace (PPO) covers various other services, including acupuncture with a $40 copay and no coinsurance for up to 20 treatments annually, and over-the-counter items up to $25 every three months 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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