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HealthPartners Journey Smart (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HealthPartners Journey Smart (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HealthPartners Journey Smart (PPO) in 2026, please refer to our full plan details page.
HealthPartners Journey Smart (PPO) is a PPO plan offered by HealthPartners, Inc. available for enrollment in 2026 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 Smart (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 Smart (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 Smart (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. Additionally, this plan comes with a Part B Premium reduction of $50.80. You must continue to pay paying your reduced 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 $400.00 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 Smart (PPO) prescription drug plan features an annual drug deductible of $400. For Tier 1 preferred generic drugs, there is no copay for a 1-month or 3-month supply filled at standard pharmacies or via mail order. Tier 2 generic medications cost a $5 copay for a 1-month supply, while a 3-month supply is $10 through preferred mail order and $15 at standard pharmacies or standard mail order. For higher-tier medications, costs are based on coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 20% coinsurance, and Tier 4 non-preferred drugs carry a 38% coinsurance for both 1-month and 3-month fills. Tier 5 specialty drugs require a 25% coinsurance for a 1-month supply across standard pharmacies and mail-order channels.
Additional Benefits
The HealthPartners Journey Smart (PPO) plan offers affordable coverage for your everyday healthcare needs, featuring no copay and no coinsurance for primary care visits and routine preventive services. Specialist visits, physical therapy sessions, and urgent care services require a $50 copay, while emergency room visits carry a $130 copay. If you require hospitalization, inpatient stays cost a $450 daily copay for days one through five with no copay for subsequent days, while outpatient hospital services have a $500 copay. Beyond medical care, the plan provides dental coverage with no copay or coinsurance up to a $2,000 yearly maximum for preventive care, periodontics, and implants. Routine vision and hearing exams are available for a $50 copay, which includes a $250 annual eyewear allowance and prescription hearing aid copays between $499 and $999. Additionally, durable medical equipment, prosthetic devices, and dialysis services are covered with no copay and a 20% coinsurance.
Inpatient Hospital See details
HealthPartners Journey Smart (PPO) covers inpatient acute and psychiatric hospital stays with no coinsurance and a copay of $450 per day for days 1 through 5, followed by no copay for day 6 and beyond. This benefit is partially covered, as upgrades and non-Medicare-covered stays are not covered, and prior authorization is required for acute hospital stays.
Outpatient Services See details
HealthPartners Journey Smart (PPO) covers outpatient hospital services with a $500 copay and no coinsurance, observation services at $350 per day with no coinsurance, and ambulatory surgical center services with a $400 copay and no coinsurance. Outpatient substance abuse sessions carry a $50 copay and no coinsurance, while outpatient blood services are covered with no copay, no coinsurance, and no deductible.
Partial Hospitalization See details
Partial hospitalization services are covered under the HealthPartners Journey Smart (PPO) plan with a $55.00 copay and no coinsurance.
Ambulance and Transportation Services See details
HealthPartners Journey Smart (PPO) covers ambulance services with prior authorization, requiring a $350 copay and no coinsurance for ground transport, and a 20% coinsurance with no copay for air transport. While some transportation services are covered, transportation to plan-approved locations or any other health-related locations is not covered.
Emergency Services See details
HealthPartners Journey Smart (PPO) covers emergency services with a $130 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours, and urgently needed services with a $50 copay and no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with no copay and a 20% coinsurance.
Primary Care See details
HealthPartners Journey Smart (PPO) covers primary care physician services with no copay and no coinsurance, while specialist visits, physical therapy, and mental health services require a $50 copay and no coinsurance. Chiropractic services are partially covered with routine and other chiropractic services not covered, whereas podiatry services are not covered.
Preventive Services See details
Preventive services are covered by HealthPartners Journey Smart (PPO) with no copay and no coinsurance for annual physical exams, kidney disease education, and other preventive screenings. Additional preventive services are partially covered with no coinsurance and a $0 to $50 copay for remote access, but do not cover health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, 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 devices, and counseling.
Hearing Services See details
Hearing services are covered under HealthPartners Journey Smart (PPO), featuring a $50 copay and no coinsurance for one routine hearing exam per year. Prescription hearing aids are partially covered with no coinsurance and a copay ranging from $499 to $999 for up to two devices annually, but over-the-counter (OTC) hearing aids and specific inner, outer, or over-the-ear prescription models are not covered.
Vision Services See details
Vision Services are partially covered by HealthPartners Journey Smart (PPO), excluding other eye exam services, eyeglass lenses, and eyeglass frames. Routine eye exams are covered once per year with a $50 copay and no coinsurance, while eligible eyewear has no copay, no coinsurance, and a $250 annual maximum benefit with no deductibles.
Dental Services See details
HealthPartners Journey Smart (PPO) offers partially covered dental services with no copay and no coinsurance for covered benefits, up to a $2,000 yearly maximum for combined in-network and out-of-network care. Covered services include preventive care, periodontics, and implants, while orthodontics and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by HealthPartners Journey Smart (PPO) with no copay, though prior authorization and step therapy may apply. Associated Medicare Part B chemotherapy, insulin, and other drugs are covered with coinsurance ranging from no coinsurance to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
HealthPartners Journey Smart (PPO) covers Dialysis Services with no copay and a 20% coinsurance.
Medical Equipment See details
Medical equipment is covered under HealthPartners Journey Smart (PPO) with no copay and a 20% coinsurance for durable medical equipment, prosthetic devices, and diabetic therapeutic shoes. Diabetic supplies are also covered with no copay and range from no coinsurance to 20% coinsurance, with prior authorization required for these services.
Diagnostic and Radiological Services See details
HealthPartners Journey Smart (PPO) covers diagnostic and radiological services, though prior authorization is required. Under this plan, diagnostic procedures and outpatient X-rays have a $50 copay, diagnostic radiological services carry a $275 copay, and lab services and therapeutic radiological services require 10% and 20% coinsurance, respectively.
Home Health Services See details
Home Health Services are covered by HealthPartners Journey Smart (PPO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under the HealthPartners Journey Smart (PPO) plan with no coinsurance, though some services are covered while cardiac rehabilitation ($40 copay), intensive cardiac rehabilitation ($40 copay), pulmonary rehabilitation ($30 copay), and supervised exercise therapy for peripheral artery disease (SET for PAD) services ($25 copay) are not covered.
Skilled Nursing Facility (SNF) See details
HealthPartners Journey Smart (PPO) partially covers Skilled Nursing Facility (SNF) services, with no coverage for additional days beyond the standard Medicare-covered limit. For covered days, there is no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100.
Other Services See details
HealthPartners Journey Smart (PPO) partially covers other services, excluding over-the-counter (OTC) items, meal benefits, and dual-eligible SNPs. Covered benefits include up to 20 acupuncture treatments per year for a $50 copay and no coinsurance, emergency travel logistics and travel counseling with no copay and no coinsurance, and treatment at the scene for a $350 copay and no coinsurance.
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