HealthPartners Birch (PPO)

HEALTHPARTNERS INSURANCE COMPANY · 2027 plan year

Plan ID H6309-001-000

Local PPO
MOOP (in-network)
$6,750
MOOP (combined)
$10,000
Monthly premium
$0/mo
Part C $0 + Part D $0
Prescription drugs
Included

This plan in 2026

Plan information

Contract / Plan / Segment
H6309-001-000
Medical deductible
$0 — no deductible
Part D premium
$0/mo (part of the monthly premium above)
Part D deductible
$700/yr
Also owed
Your Medicare Part B premium, paid separately

More HEALTHPARTNERS INSURANCE COMPANY plans in WI

Benefits & cost sharing

Hospital

BenefitIn-network
Inpatient Hospital — Acute$550/day for days 1–5, $0 after
Inpatient Hospital — Additional Days (Acute)No charge
Inpatient Hospital — Psychiatric$470/day for days 1–5, $0 after
Inpatient Hospital — Additional Days (Psychiatric)No charge
Worldwide Urgent Care Coverage$50

Pharmacy

BenefitIn-network
Part B DrugsSee plan details
Chemotherapy & Radiation Drugs (Part B)0%-20% coinsurance
Other Part B Drugs0%-20% coinsurance

Mental Health

BenefitIn-network
Mental Health Specialty ServicesSee plan details
Mental Health — Individual Sessions$55
Mental Health — Group Sessions$55
Supplemental Health BenefitsSee plan details

Other

BenefitIn-network
Skilled Nursing Facility (SNF)$0/day for days 1–20, $221/day for days 21–100
Cardiac & Pulmonary RehabilitationSee plan details
Cardiac Rehabilitation — Additional Sessions$40
Intensive Cardiac Rehabilitation — Additional Sessions$40
Pulmonary Rehabilitation — Additional Sessions$30
Supervised Exercise Therapy (SET)$25
Emergency Services$130
Urgently Needed Services$50
Worldwide Emergency & Urgent CoverageSee plan details
Worldwide Emergency Coverage$130
Worldwide Emergency Transportation$300
Partial Hospitalization Program$55
Intensive Outpatient Program (IOP)$55
Home Health ServicesNo charge
Primary Care Physician ServicesNo charge
Chiropractic Services$15
Occupational Therapy Services$50
Physician Specialist Services$0-$55
Podiatry Services$55
Other Health Care Professional Services$0-$55
Psychiatric Services — Individual Sessions$55
Psychiatric Services — Group Sessions$55
Physical Therapy & Speech-Language Pathology$50
Opioid Treatment Program ServicesNo charge
Diagnostic Tests & Lab ServicesSee plan details
Diagnostic Procedures & Tests$75
Laboratory Services10% coinsurance
Radiological ServicesSee plan details
Diagnostic Radiology$0-$500
Therapeutic Radiology20% coinsurance
X-Ray Services$100
Outpatient Hospital Services$600
Hospital Observation Services$550/day
Ambulatory Surgical Center (ASC)$500
Outpatient Substance Abuse ServicesSee plan details
Substance Abuse — Individual Sessions$55
Substance Abuse — Group Sessions$55
Outpatient Blood ServicesNo charge
Ambulance ServicesSee plan details
Ground Ambulance$300
Air Ambulance$300
Durable Medical Equipment (DME)20% coinsurance
Prosthetics & OrthoticsSee plan details
Prosthetic Devices20% coinsurance
Medical Supplies20% coinsurance
Diabetic Supplies & ServicesSee plan details
Diabetic Supplies0%-20% coinsurance
Diabetic Therapeutic Shoes & Inserts20% coinsurance
Diabetic Monitors0%-20% coinsurance
Dialysis Services20% coinsurance
Other Supplemental BenefitNo charge
Other Supplemental Benefit$300
Medicare-Covered Preventive ServicesSee plan details
Annual Physical ExamNo charge
Nutritional & Dietary BenefitNo charge
Smoking & Tobacco Cessation CounselingNo charge
Fitness BenefitNo charge
Remote Access TechnologiesNurse hotline: No charge; Web/phone-based technologies: $0-$55
Kidney Disease Education ServicesNo charge
Glaucoma ScreeningNo charge
Diabetes Self-Management TrainingNo charge
Digital Rectal ExamsNo charge
Welcome to Medicare EKGNo charge
Insulin (Part B)0%-20% coinsurance (max $35)
Dental — Medicare-Covered Services$55
Dental — PreventiveSee plan details
Dental — Oral Exams25% coinsurance
Dental — X-Rays25% coinsurance
Dental — Prophylaxis (Cleaning)25% coinsurance
Dental — Other Preventive Services25% coinsurance
Dental — ComprehensiveSee plan details
Dental — Periodontics (Gum Care)25% coinsurance
Vision — Eye Exams$55
Vision — Eye ExamsSee plan details
Vision — Routine Eye ExamsNo charge
Vision — EyewearNo charge
Vision — EyewearSee plan details
Hearing — ExamsSee plan details
Hearing — Routine ExamsNo charge
Psychiatric ServicesSee plan details
Vision — Contact LensesNo charge
Vision — Eyeglasses (Lenses & Frames)No charge
Vision — Eyewear UpgradesNo charge
Hearing — Exams$55

Service area

  • WI: 12 counties

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