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HealthPartners Cedar (PPO)

Wisconsin Medicare Advantage Plan (2026 Plan)

Monthly Premium

Your Cost
$0
by HealthPartners

Additional Coverage

HearingVisionDental

Overall Government Star Rating

(coming soon)

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Plan Overview

Plan Name
HealthPartners Cedar (PPO)
Insurance Carrier
HealthPartners
Plan Type
Medicare Advantage Plan With Part D Prescription Drug Coverage
Network Type
PPO

HealthPartners Cedar (PPO) is a Medicare Advantage Plan With Part D Prescription Drug Coverage, which is available in Wisconsin and offered by the health insurance company HealthPartners. This plan’s network type is PPO which determines in-network doctors who accept the health plan and whether a referral is needed.

Cost Summary

Monthly Premium
$0
Annual Deductible
$0
Max Out-of-Pocket
$6,000
Primary doctor visit
$0 copay
Specialist visit
$60 copay
ER visit
No Data
Ambulance
$300 copay

HealthPartners Cedar (PPO) has a monthly premium cost of $0 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $10,000 In and Out-of-network $6,000 In-network. The most common benefit costs which people evaluate when choosing a plan are costs for a primary doctor visit, specialist doctor visit, emergency room visit, and ambulance. These costs are listed in this summary section and a full list of benefit costs for HealthPartners Cedar (PPO) are defined below.

Additional Benefits and Coverage

Yes
Part D Prescription Drug Coverage
Yes
Dental
Yes
Vision
Yes
Hearing

HealthPartners Cedar (PPO) is a Medicare Advantage plan which does include Medicare Part D Prescription Drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. HealthPartners Cedar (PPO) includes coverage for hearing, vision, dental.

Medicare Advantage health plans can offer even more additional benefits. HealthPartners Cedar (PPO) includes coverage for the following additional benefits:

Other benefits

Fitness benefit
Limited coverage
Over the counter drug benefits
Not covered
In-home support services
Not covered
Home and bathroom safety devices
Not covered
Meals for short duration
Not covered
Annual physical exams
Limited coverage
Telehealth
Limited coverage

Plan Benefits and Coverage Details

Monthly Premium
$0
Health Portion of Premium
$0
Drug Portion of Premium
$0
Health Plan Deductible
$0
Health Plan Max Out-of-Pocket
$10,000 In and Out-of-network
$6,000 In-network
Nationwide Coverage included
No
Hearing Coverage included
Yes
Vision Coverage included
Yes
Dental Coverage included
Yes
Doctor Lookup Link
http://healthpartners.com/MedicareDocs
Plan Link
http://healthpartners.com/ExploreMedicare

Medical Benefits

Doctor Services

Primary doctor visit
In-network: $0 copay
Out-of-network: $0 copay
Specialist visit
In-network: $60 copay
Out-of-network: $60 copay

Tests, labs, & imaging

Diagnostic tests & procedures
In-network: $90 copay
Out-of-network: $90 copay
Lab services
In-network: 10% coinsurance
Out-of-network: 10% coinsurance
Diagnostic radiology services (like MRI)
In-network: $350 copay
Out-of-network: $350 copay
Outpatient x-rays
In-network: $90 copay
Out-of-network: $90 copay
Emergency care
In-network: No Data
Out-of-network: No Data
Urgent care
In-network: No Data
Out-of-network: No Data

Hospital Services

Inpatient hospital coverage
In-network: No Data
Out-of-network: No Data
Outpatient hospital coverage
In-network: $500 copay
Out-of-network: $500 copay

Skilled nursing facility

Skilled nursing facility
In-network: No Data
Out-of-network: No Data

Preventive services

Preventive services
In-network: $0 copay
Out-of-network: $0 copay

Ambulance

Ground ambulance
In-network: $300 copay
Out-of-network: $300 copay

Therapy services

Occupational therapy visit
In-network: $50 copay
Out-of-network: $50 copay
Physical therapy & speech & language therapy visit
In-network: $50 copay
Out-of-network: $50 copay

Mental health services

Outpatient group therapy with a psychiatrist
In-network: $60 copay
Out-of-network: $60 copay
Outpatient individual therapy with a psychiatrist
In-network: $60 copay
Out-of-network: $60 copay
Outpatient group therapy visit
In-network: $60 copay
Out-of-network: $60 copay
Outpatient individual therapy visit
In-network: $60 copay
Out-of-network: $60 copay

Opioid treatment services

Opioid treatment services
Covered

Other services

Durable medical equipment (like wheelchairs & oxygen)
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Prosthetics (like braces, artificial limbs)
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Diabetes supplies
In-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance

Prescription Drug Benefits

Tier drug costs for: Standard retail pharmacy drug cost for 1-month

TiersInitial coverage phaseCatastrophic coverage phase
Preferred Generic$0.00 copay$0 copay
Generic$0.00 copay$0 copay
Preferred Brand20% coinsurance$0 copay
Non-Preferred Drug38% coinsurance$0 copay
Specialty Tier26% coinsurance$0 copay

Part B Drugs

Chemotherapy drugs
In-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance
Other Part B drugs
In-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance

Extra Benefits

Hearing

Hearing exam
In-network: $0 copay
Out-of-network: $0 copay
Fitting/evaluation
In-network: $0 copay
Out-of-network: $0 copay
Hearing aids - prescription
In-network: $499-$999 copay
Out-of-network: $499-$999 copay
Hearing aids - over the counter
Not covered

Preventive Dental

Oral exam
In-network: $0 copay
Out-of-network: $0 copay
Cleaning
In-network: $0 copay
Out-of-network: $0 copay
Fluoride treatment
In-network: $0 copay
Out-of-network: $0 copay
Dental x-rays
In-network: $0 copay
Out-of-network: $0 copay

Comprehensive dental

Restorative services
In-network: $0 copay
Out-of-network: $0 copay
Endodontics
Not covered
Periodontics
In-network: $0 copay
Out-of-network: $0 copay
Prosthodontics, removable
Not covered
Prosthodontics, fixed
Not covered
Maxillofacial prosthetics
Not covered
Implant services
Not covered
Oral and maxillofacial surgery
Not covered
Orthodontics
Not covered
Adjunctive general services
Not covered

Vision

Routine eye exam
In-network: $0 copay
Out-of-network: $0 copay
Contact lenses
Not covered
Eyeglasses (frames & lenses)
Not covered
Eyeglass frames (only)
Not covered
Eyeglass lenses (only)
Not covered
Upgrades
Not covered

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