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| Preventative Care | |
| Immunizations, routine hearing, vision screenings and exams | You pay nothing |
| Deductiblea specified amount of money that the insured must pay before an insurance company will pay a claim. | Individual: $1,000
Family: $2,000 |
| Out-of-Pocket MaximumAn out-of-pocket maximum is the most you'll have to pay during a policy period (usually a year) for health care services | Individual: $5,000
Family: $10,000 |
| Preventative Dental Care | All charges |
| Office and Online Visits | |
| Illness or Injury
Convenience Clinics Mental/Chemical Health outpatient Urgent Care |
Three visits free per member, per year*, then 20% after deductible |
| Chiropractic Services | 20% after deductible |
| virtuwell.com | Three free visits per member, per year |
| Maternity Care | You pay nothing for routine prenatal care, postnatal care and delivery |
| Prescriptions – GENERICS ADVANTAGE Rx | |
| Filled at Contracted Pharmacy | ·$5 copay for low-cost preferred generics
·$25 copay for high-cost preferred generics ·$45 copay for brand name formulary after deductible ·$90 copay for non-formulary after deductible |
| Specialty Medicines | 20% after deductible |
| Mail order (90-day supply) | ·$10 copay for low-cost preferred generics
·$50 copay for high-cost preferred generics ·$90 copay for brand name formulary after deductible ·$180 copay for non-formulary after deductible |
| Lab and Diagnostic Services | |
| MRI/CT (Scheduled outpatient or office) | 20% after deductible |
| Other than MRI/CT | 20% after deductible |
| Hospital Care | |
| Inpatient Care | 20% after deductible |
| Outpatient Care | 20% after deductible |
| Mental/Chemical Health inpatient | 20% after deductible |
| Emergency Services | |
| Emergency Room | 20% after deductible |
| Worldwide Emergency Care while traveling | 20% after deductible |
| Biweekly Rates | |
| Non-Postal Employee pays | Individual: $49.16
Family: $119.77 |
| Postal Employee (Category 1) | Individual: $42.77
Family: $104.20 |
| Postal Employee (Category 2) | Individual: $40.81
Family: $99.41 |
| Preventative Care | |
| Immunizations, routine hearing, vision screenings and exams | You pay nothing |
| Deductiblea specified amount of money that the insured must pay before an insurance company will pay a claim. | Individual: $1,000
Family: $2,000 |
| Out-of-Pocket MaximumAn out-of-pocket maximum is the most you'll have to pay during a policy period (usually a year) for health care services | Individual: $5,000
Family: $10,000 |
| Preventative Dental Care | All charges |
| Office and Online Visits | |
| Illness or Injury
Convenience Clinics Mental/Chemical Health outpatient Urgent Care |
Three visits free per member, per year*, then 20% after deductible |
| Chiropractic Services | 20% after deductible |
| virtuwell.com | Three free visits per member, per year |
| Maternity Care | You pay nothing for routine prenatal care, postnatal care and delivery |
| Prescriptions – GENERICS ADVANTAGE Rx | |
| Filled at Contracted Pharmacy | • $5 copay for low-cost preferred generics
• $25 copay for high-cost preferred generics • $45 copay for brand name formulary after deductible • $90 copay for non-formulary after deductible |
| Specialty Medicines | 20% after deductible |
| Mail order (90-day supply) | • $10 copay for low-cost preferred generics
• $50 copay for high-cost preferred generics • $90 copay for brand name formulary after deductible • $180 copay for non-formulary after deductible |
| Lab and Diagnostic Services | |
| MRI/CT (Scheduled outpatient or office) | 20% after deductible |
| Other than MRI/CT | 20% after deductible |
| Hospital Care | |
| Inpatient Care | 20% after deductible |
| Outpatient Care | 20% after deductible |
| Mental/Chemical Health inpatient | 20% after deductible |
| Emergency Services | |
| Emergency Room | 20% after deductible |
| Worldwide Emergency Care while traveling | 20% after deductible |
| Biweekly Rates | |
| Non-postal Employee | Individual: $49.16
Family: $119.77 |
| Postal Employee (Category 1) | Individual: $42.77
Family: $104.20 |
| Postal Employee (Category 2) | Individual: $40.81
Family: $99.41 |
| Atlas $6850 Plus Bronze | Atlas $7150 Bronze | |
| Deductiblea specified amount of money that the insured must pay before an insurance company will pay a claim. | $6,850 per person
$13,700 family maximum Out of network: $10,000 per person, $20,000 family maximum |
$7,150 per person
$14,300 family maximum Out of network: $10,000 per person, $20,000 family maximum |
| CoinsuranceWhat % you pay after your deductible has been met and before your out of pocket max | You pay 40%
Out of network: You pay 50% |
You pay nothing
Out of network: you pay 50% |
| Out-of-Pocket MaximumAn out-of-pocket maximum is the most you'll have to pay during a policy period (usually a year) for health care services | $7,150 per person
$14,300 family maximum Out of network: no maximum |
$7,150 per person
$14,300 family maximum Out of network: No maximum |
| Preventative Care | You pay nothing | You pay nothing |
| Convenience Care and Office Visits* | First three visits per person, per year have a copay. **
$50 office visits $25 convenience care $50 urgent care Then you pay 40% after deductible |
You pay nothing after deductible |
| Behavioral Health | First three visits per person, per year have a copay. **
$50 office visits Then you pay 40% after deductible |
You pay nothing after deductible |
| virtuwell | Unlimited free visits | Unlimited free visits |
| Emergency Room Visits | You pay 40% after deductible | You pay nothing after deductible |
| Prescription Medicines | $25 generic formulary
You pay 40% after deductible for Brand formulary You pay 50% after deductible for non-formulary |
You pay nothing after deductible |
| Laboratory Services | You pay 40% after deductible | You pay nothing after deductible |
| Inpatient and outpatient hospital care
Outpatient MRI and CT Durable medical equipment |
You pay 40% after deductible | You pay nothing after deductible |
| Maternity | You pay 40% after deductible | You pay nothing after deductible |
| Atlas $2200 Plus Silver | Atlas $3500 Plus Silver | |
| Deductiblea specified amount of money that the insured must pay before an insurance company will pay a claim. | $2,200 per person
$4,400 family maximum Out of network: $10,000 per person, $20,000 family maximum |
$3,500 per person
$7,000 family maximum Out of network: $10,000 per person, $20,000 family maximum |
| CoinsuranceWhat % you pay after your deductible has been met and before your out of pocket max | You pay 25%
Out of network: You pay 50% |
You pay 20%
Out of network: you pay 50% |
| Out-of-Pocket MaximumAn out-of-pocket maximum is the most you'll have to pay during a policy period (usually a year) for health care services | $7,150 per person
$14,300 family maximum Out of network: no maximum |
$7,150 per person
$14,300 family maximum Out of network: No maximum |
| Preventative Care | You pay nothing | You pay nothing |
| Convenience Care and Office Visits* | First three visits per person, per year have a copay. ***
$30 office visits $15 convenience care $30 urgent care Then you pay 25% after deductible |
$30 office visit for primary care
$65 office visit for specialty care $15 convenience care $75 urgent care |
| Behavioral Health | First three visits per person, per year have a copay. ***
$30 office visits Then you pay 25% after deductible |
$30 office visits |
| virtuwell | Unlimited free visits | Unlimited free visits |
| Emergency Room Visits | You pay $250 for your first visit each year* Then you pay 25% after deductible for additional visits | You pay $400 copay after deductible |
| Prescription Medicines | $12 generic formulary
You pay 25% after deductible for Brand formulary You pay 50% after deductible for non-formulary |
$15 generic formulary
$50 Brand formulary $100 non-formulary |
| Laboratory Services | You pay 25% after deductible | You pay 20% after deductible |
| Inpatient and outpatient hospital care
Outpatient MRI and CT Durable medical equipment |
You pay 25% after deductible | You pay 20% after deductible |
| Maternity | You pay 25% after deductible | You pay 20% after deductible |
| Atlas $500 w/Copay Gold | |
| Deductiblea specified amount of money that the insured must pay before an insurance company will pay a claim. | $500 per person
$1,000 family maximum Out of network: $10,000 per person, $20,000 family maximum |
| CoinsuranceWhat % you pay after your deductible has been met and before your out of pocket max | You pay 20%
Out of network: You pay 50% |
| Out-of-Pocket MaximumAn out-of-pocket maximum is the most you'll have to pay during a policy period (usually a year) for health care services | $7,000 per person
$14,000 family maximum Out of network: no maximum |
| Preventative Care | You pay nothing |
| Convenience Care and Office Visits* | Unlimited number of visits per person, per year have a copay:
$10 office visits primary care $30 specialty care $5 convenience care $30 urgent care |
| Behavioral Health | Unlimited number of visits per person, per year have a copay:
$10 office visit |
| virtuwell | Unlimited free visits |
| Emergency Room Visits | You pay 20% after deductible |
| Prescription Medicines | $5 low cost generic formulary
$25 high cost generic formulary You pay 20% after deductible for Brand formulary You pay 50% after deductible for non-formulary |
| Laboratory Services | You pay nothing |
| Inpatient and outpatient hospital care
Outpatient MRI and CT Durable medical equipment |
You pay 20% after deductible |
| Maternity | You pay 20% after deductible |
| Atlas $7150 Catastrophic | |
| Deductiblea specified amount of money that the insured must pay before an insurance company will pay a claim. | $7,150 per person
$14,300 family maximum Out of network: $10,000 per person, $20,000 family maximum |
| CoinsuranceWhat % you pay after your deductible has been met and before your out of pocket max | You pay 20%
Out of network: You pay 50% |
| Out-of-Pocket MaximumAn out-of-pocket maximum is the most you'll have to pay during a policy period (usually a year) for health care services | You pay nothing
Out of network: You pay 50% |
| Preventative Care | You pay nothing |
| Convenience Care and Office Visits* | First three primary care visits per person, per year have a copay:
$30 office visits $15 convenience care then you pay nothing after deductible You pay nothing after deductible for urgent care |
| Behavioral Health | You pay nothing after deductible |
| virtuwell | Your first three visits are free
Then you pay nothing after deductible |
| Emergency Room Visits | You pay nothing after deductible |
| Prescription Medicines | You pay nothing after deductible |
| Laboratory Services | You pay nothing after deductible |
| Inpatient and outpatient hospital care
Outpatient MRI and CT Durable medical equipment |
You pay nothing after deductible |
| Maternity | You pay nothing after deductible |
| Atlas $3000 HSA Silver | Atlas $6550 HSA Bronze | |
| Deductiblea specified amount of money that the insured must pay before an insurance company will pay a claim. | $3,000 per person
$6,000 family maximum Out of network: $10,000 per person, $20,000 family maximum |
$6,550 per person
$13,100 family maximum Out of network: $10,000 per person, $20,000 family maximum |
| CoinsuranceWhat % you pay after your deductible has been met and before your out of pocket max | You pay 15%
Out of network: You pay 50% |
You pay nothing
Out of network: You pay 50% |
| Out-of-Pocket MaximumAn out-of-pocket maximum is the most you'll have to pay during a policy period (usually a year) for health care services | $6,550 per person
$13,100 family maximum Out of network: No maximum |
$6,550 per person
$13,100 family maximum Out of network: No maximum |
| Preventative Care | You pay nothing | You pay nothing |
| Convenience Care and Office Visits | You pay 15% after deductible | You pay nothing after deductible |
| Behavioral Health | You pay 15% after deductible | You pay nothing after deductible |
| virtuwell | Unlimited free visits after deductible | Unlimited free visits after deductible |
| Emergency Room Visits | You pay 15% after deductible | You pay nothing after deductible |
| Prescription Medicines | You pay 15% after deductible | You pay nothing after deductible |
| Laboratory Services | You pay 15% after deductible | You pay nothing after deductible |
| Inpatient and outpatient hospital care
Outpatient MRI and CT Durable medical equipment |
You pay 15% after deductible | You pay nothing after deductible |
| Maternity | You pay 15% after deductible | You pay nothing after deductible |
Dental Plans
| Maintenance Plan | Major Plan | Comprehensive Plan | ||||
| In-Network | Out-of-network | In-network | Out-of-network | In-network | Out-of-network | |
| Preventive (check-ups and X-rays) | 100% | 80% | 0% | 0% | 100% | 80% |
| Sealants | 100% | 80% | 100% | 80% | 100% | 80% |
| Fillings | 80% | 50% | 80% | 50% | 80% | 50% |
| White fillings on back teeth | 50% | 50% | 50% | 50% | 50% | 50% |
| Basic Services | 0% | 0% | 50-80% | 50% | 50-80% | 50% |
| Surgical Services | 0% | 0% | After Six Months | |||
| 50% | 50% | 50% | 50% | |||
| Major restorative (crowns, bridges, etc.) | 0% | 0% | After 12 Months | |||
| 50% | 25% | 50% | 25% | |||
| Annual benefit | $1,250 | $750 | $1,250 | $750 | $1,250 | $750 |
| Annual deductible | $50 | $75 | $50 | $75 | $50 | $75 |
| Rates* | |||||
| Maintenance Plan | Major Plan | Comprehensive Plan | |||
| HealthPartners Dental Group | HealthPartners Dental Group | HealthPartners Dental Group | |||
| Under age 50 | $28.21 | Under age 50 | $21.43 | Under age 50 | $38.46 |
| Age 50 and over | $33.81 | Age 50 and over | $25.74 | Age 50 and over | $46.17 |
| Dependent Rates | Dependent Rates | Dependent Rates | |||
| 1 child | $26.80 | 1 child | $20.36 | 1 child | $36.56 |
| 2 children | $53.62 | 2 children | $40.74 | 2 children | $73.12 |
| 3 or more children | $80.43 | 3 or more children | $61.11 | 3 or more children | $109.68 |
| Open Access | Open Access | Open Access | |||
| Under age 50 | $34.51 | Under age 50 | $28.38 | Under age 50 | $47.16 |
| Age 50 and over | $40.05 | Age 50 and over | $34.08 | Age 50 and over | $56.60 |
| Dependent Rates | Dependent Rates | Dependent Rates | |||
| 1 Child | $32.79 | 1 Child | $26.96 | 1 Child | $44.80 |
| 2 Children | $65.60 | 2 Children | $53.92 | 2 Children | $89.60 |
| 3 or More Children | $98.40 | 3 or More Children | $80.88 | 3 or More Children | $134.43 |
When you begin shopping for a Marketplace health plan, you’ll see plan options with different metal tiers such as Gold, Silver and Bronze plans. But the only difference between these plans is how much premium you’ll pay each month and how much you’ll pay for certain medical services. A Bronze plan typically gives you lower monthly premium payments, but potentially higher out-of-pocket costs – if you end up needing a lot of care. And a Gold plan may have higher monthly premiums, but that helps you limit your out-of-pocket costs later. If you’re looking for a balance on your monthly premium payments and your out-of-pocket costs, Silver plans provide just that. And, Silver plans are the only plans with additional out-of-pocket payment reductions (cost sharing reductions)! This helps lower the costs of your copays, deductibles and coinsurance. So, if you are eligible for a subsidy and cost sharing, Silver plans offer the highest value.
The in-network hospitals include:
Capitol View Transitional Care
HealthPartners Central Minnesota Clinic
Perks and Benefits
Work out 12 times or more in a month, and get reimbursed $20. Just show your insurance card at the front desk of your gym. They’ll get you signed up and will track your workouts. It’s that easy.
Healthy Discounts
Get discounts for fitness classes and exercise equipment. Save money on groceries and diapers. And find savings for skin care products, recovery programs and more. There are more than 80 places to save.
Discounts on contacts and glasses
When you get HealthPartners insurance, you also get discounts on contacts, glasses and eye exams. As a HealthPartners member, you get discounts on eye care through EyeMed Vision Care. You can get savings at thousands of independent eye clinics, as well as optical retailers like LensCrafters, Pearle Vision and Target Optical. Your discounts include:
- 35 percent savings on glasses frames
- $50 for standard plastic lenses
- 15 percent savings on contact lens materials
Help when I’m traveling
Traveling should be fun. And although unexpected trouble can quickly make a trip stressful, one phone call can bring you peace of mind. Assist America is available to anyone who has HealthPartners, and it doesn’t cost you anything. If you’re more than 100 miles from home, call Assist America 24/7 to get free help with:
- Filling lost prescriptions
- Finding good doctors
- Getting admitted to a qualified hospital
- Tracking down lost luggage
- Finding a translator
Help with the tough stuff
Don’t you wish there was someone to help with the tough stuff? Now there is. With the Assistance Program, you get 24/7, unlimited access to helpful resources. Don’t worry; it’s all confidential. Nothing is shared with your employer or your insurance plan.
Counselors are available 24/7 to help with:
- Divorce and marital challenges
- Grief and loss
- Job stress
- Mental and emotional health
- Parenting
- Legal issues
Staff is available 24/7 to help with:
- Finding a car
- Finding the right child care
- Finding a good elder care center
- Finding an apartment
- Developing your career
- Saving money
Apply Online Now
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