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HealthPartners Review

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Eric Stauffer is a former insurance agent and banker turned consumer advocate. His priority is to help educate individuals and families about the different types of insurance they need, and assist them in finding the best...

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UPDATED: Nov 30, 2018

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Minnesota-based HealthPartners is a not-for-profit health insurance plan and complete health care system. HealthPartners is the largest consumer-governed non-profit health organization in the country, according to their website, with 1.8 million members.

About HealthPartners

HealthPartners started out as Group Health in 1957, formed with a board of directors made up of members and patients as a cooperative health system. In 1992, Group Health’s merger with MedCenters Health Plan resulted in the official creation of HealthPartners.

The group further expanded in 2013 when they again merged, this time with Park Nicollet Health Services. The resulting health system runs a multi-specialty group of clinics and hospitals with more than 1,800 physicians. HealthPartners headquarters is located in Bloomington, Minnesota.

The HealthPartners health plan features a regional network across Minnesota, Wisconsin, and the Dakotas. They partner with major insurer Cigna to provide a nationwide network of approximately 950,000 doctors. HealthPartners also offers a dental plan with a limited regional network in the HealthPartners Dental Group.

Health plans include individual, group, and Medicare. Currently, individual health plans are only offered in Minnesota and Wisconsin, and plans can be purchased directly or through the healthcare exchange. Other plans, available through the Cigna partnership, are not listed on the website and are under the Cigna umbrella.

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HealthPartners Plans

HealthPartners offers a range of PPO plans at all levels. Plan availability varies by state; Minnesota plans feature the Peak network, while in Wisconsin the Atlas network is offered. All plans include out-of-network care options. Outside of these states, HealthPartners plans are offered through Cigna – these plans offer a broader network of care.

A review of the Peak and Atlas plans found they offer the same coverage and the same choices are available in both states. The only difference is the network of care, which is localized.

Individual Plans (Peak and Atlas)

These plans are offered at Catastrophic, Bronze, Silver, and Gold levels, with an HSA option available as well at the Bronze and Silver levels.

The Peak Catastrophic plan has a $7,350 individual deductible and $14,3000 family deductible, both of which are also the out of pocket limit. The plan allows three primary care office visits per year, with a $30 copay for a regular office visit and $15 copay for convenience care (described as visits to quick clinics such as those found in pharmacies). After these three visits, the deductible applies, and when the deductible is paid in full all services are then fully covered, in-network, including prescriptions.

The Peak Bronze plan is offered with or without an HSA. The HSA plan has a $6,600 individual deductible (family is doubled), after which all in-network services are covered in full, including prescriptions.

The non-HSA plan has a $6,000 individual deductible, doubled for a family. Three office visits are covered per year with the same copays and rules as the catastrophic plan. After the deductible is met, services are covered with a 20% coinsurance. Prescriptions start with a $5 copay for Tier 1.

There are three Silver plan options, one of which is the HSA plan. That plan has a $3,000 individual and $6,000 family deductible, with higher out of pocket limits.  After the deductible is met, services are covered with a 15% coinsurance amount, including prescriptions.

The other two Silver plans are similar but have different deductible and coinsurance amounts. Both plans have $30 primary care copays, $15 for convenience care, and $30 for urgent care for the first three visits. The $2,300 individual deductible plan then has a 25% coinsurance, while the $3,500 individual deductible plan has 15% coinsurance. On both plans, prescription drugs start at $12 for Tier 1.

There is one Gold plan, which has a $1,000 individual and $2,000 family deductible. Primary care visits are unlimited with a $10 copay, as are specialist visits with a $30 copay. Convenience care has a $5 copay. Prescription drug coverage starts at $5 for Tier 1 drugs.

Dental Plans

HealthPartners Dental Group offers a selection of dental plans to choose from. Plans can include only the Dental Group network, or the wider Open Access network.

There are three levels. Maintenance covers preventative care and basic services but does not offer coverage for things like surgery. Major covers a variety of services including some coverage for surgery and other major restorative work but has no preventative care coverage. Comprehensive is a combination of both of these plans.

Medicare Advantage

HealthPartners has Medicare Advantage plans available throughout Minnesota and in specific counties in the Dakotas, Wisconsin, Iowa, and Illinois. For the purpose of this review, we looked at the Minnesota plans.

The Minnesota Freedom plan is available throughout the state and is offered at five levels. Basic has a 20% coinsurance and does not include Part D coverage. The rest offer the option to add Part D coverage to the plan.

The Vital plan has a $15 copay for primary care visits and specialists have a $40 copay. Part D coverage can be added with a $195 deductible and copays starting at $6.

The Freedom Active plan has a $20 copay for both primary care and specialist visits. Part D can be added with a $180 deductible and prescriptions starting at $6.

Freedom Balance has a $15 copay for both primary care and specialist visits. Again, Part D is an option, with a $175 deductible, and prescription copays starting at $5.

Finally, the Freedom Ultimate plan offers $0 copays for either primary care or specialist visits in return for the highest monthly cost. Part D coverage can be added with a $115 deductible and prescriptions starting at a $5 copay.

There is one other plan available, the Journey Stride, which has a limited regional network. This plan has a $15 copay for primary care and a $40 copay for specialist visits. Part D can be added with the same deductible and coverage as the Vital plan.

Rates

We ran a rate quote for a 30-year-old male living in the Twin Cities area of Minnesota. The results did not return an option for the Catastrophic plan; the least expensive plan offered is the Bronze HSA at $250.36 per month. At $365.53, the Gold plan was the most expensive plan listed.

These rates are well in line with what we have seen elsewhere for this type of coverage, even on the low side given that these are PPO plans and not HMO. The Gold plan was surprisingly lower in price than some plans we have seen with higher deductibles and higher copays. Of course, these plans are for a specific regional area, which makes it difficult to provide a nationwide comparison.

The Medicare plans start at $32.90 per month – on top of the regular Medicare premium, and go up to $164.80 for the Ultimate Plan. The addition of Part D brings that rate up to $232.90, or $375.90 for their Part D enhanced coverage.

Overall, the Medicare rates are in line with other Advantage providers, although it is worth noting that none of the base rates include Part D. Surprisingly, HealthPartners does not offer a $0 added premium Advantage option, which most major insurance companies do.

Claims

As with most health insurance companies, claims are handled directly by providers, although there are some claims forms available on the website that appear to be mainly for group benefits.

Claims through Cigna partner plans are handled through Cigna’s claims department, but again they are billed directly by providers.

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Ratings and Consumer Reviews

HealthPartners’ Better Business Bureau (BBB) page appears under the original name, Group Health, and they currently have an A+ rating. There are 21 complaints on file in the past three years, seven of which have been closed in the past 12 months.

The National Committee for Quality Assurance ranks HealthPartners at an overall 4.5, out of 5, which places it among the top health plans in the nation, and at the top of the rankings for the state of Minnesota. They have held high rankings here for many years.

Many of the reviews we found focused not on the health plan, but on specific services from providers or clinics, which is not unusual with a health system whose plan has the same name as their clinics. Pissed Consumer, for example, has 47 reviews, but few of them focus on issues related to the health plan or coverage. There are a few complaints regarding billing and services that were not covered.

Overall, HealthPartners appears to have a good reputation.

The Bottom Line

HealthPartners has a good selection of plans and reasonable rates for PPO coverage as well as for Medicare Advantage plans. They are well worth considering for those who live in the coverage area and like the idea of a comprehensive health care system that offers the option of an extended coverage network.

For a list of companies that we recommend, visit our Best Insurance Companies page.

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About Eric Stauffer

Author: Eric StaufferI am a former insurance agent and banker turned consumer advocate. My priority is to help educate individuals and families about the different types of insurance they need, and assist them in finding the best place to get it.

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