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Aetna Medicare Freedom Core (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Freedom Core (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Aetna Medicare Freedom Core (PPO) in 2025, please refer to our full plan details page.
Aetna Medicare Freedom Core (PPO) is a PPO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Dallas and Surrounding Counties. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Aetna Medicare Freedom Core (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 Aetna Medicare Freedom Core (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 Aetna Medicare Freedom Core (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $27.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your 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 $590.00 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 $10100.00 (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 $10100.00 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 Aetna Medicare Freedom Core (PPO) plan has a $590 deductible for prescription drugs. After the deductible is met, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For preferred generic drugs, you will pay no copay at preferred pharmacies and mail order, and a $12 copay at standard pharmacies. Standard generic, preferred brand, and non-preferred drugs have a 24% or 25% coinsurance. After your total drug costs reach $2000, you will enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The Aetna Medicare Freedom Core (PPO) plan offers a range of benefits with varying costs. You can expect no copay for primary care visits, routine hearing exams, and vision services, and a $35 copay for mental health and specialist services. Hospital stays have a copay of $395 for the first six days, with no copay for additional days. Additionally, the plan covers outpatient services, emergency services, and home health services, but some services like ambulance, skilled nursing facilities, and diagnostic services have copays or coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, with a copay of $395 for days 1-6 and no copay for days 7-90 for Inpatient Hospital-Acute, and a copay of $300 for days 1-6 and no copay for days 7-90 for Inpatient Hospital Psychiatric. Additional days for Inpatient Hospital-Acute are covered with no copay, while Non-Medicare-covered stay and upgrades for Inpatient Hospital-Acute are not covered, and Additional days and Non-Medicare-covered stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered by the Aetna Medicare Freedom Core (PPO) plan, including all outpatient hospital services, ambulatory surgical center services, and outpatient blood services. The plan has a copay of $0-$350 for outpatient hospital services, a copay of $335 for observation services, and a copay of $0 for ambulatory surgical center services and outpatient blood services. Individual and group sessions for outpatient substance abuse have a copay of $40.
Partial Hospitalization See details
Partial Hospitalization is covered by the Aetna Medicare Freedom Core (PPO) plan, but requires prior authorization. You will have to pay a copay of $85 for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Aetna Medicare Freedom Core (PPO) plan, with prior authorization required for all ambulance services. Ground ambulance services have a $300 copay, and air ambulance services have a 20% coinsurance, while transportation services to any health-related location are not covered.
Emergency Services See details
Emergency services are covered under the Aetna Medicare Freedom Core (PPO) plan, with a $125 copay for emergency and worldwide emergency coverage, a $35 copay for urgently needed services, and a $300 copay for worldwide emergency transportation. There is no coinsurance for any of these services.
Primary Care See details
The Aetna Medicare Freedom Core (PPO) plan covers primary care physician services with no copay, chiropractic services with a $15 copay, occupational therapy services with a $35 copay, physician specialist services with a copay between $0 and $35, and physical therapy and speech-language pathology services with a $35 copay. The plan also covers mental health specialty services, psychiatric services, and opioid treatment program services, all with a $35 copay. The plan also covers additional telehealth benefits with a 20% coinsurance and a copay between $0 and $40. Routine Chiropractic Care and podiatry services are not covered.
Preventive Services See details
Preventive services are covered by Aetna Medicare Freedom Core (PPO), including an annual physical exam with no copay. Other preventive services are covered, but some services have a copay. Kidney Disease Education Services are covered with a 20% coinsurance.
Hearing Services See details
Hearing services include hearing exams with a $35 copay, routine hearing exams with no copay for one visit per year, and fitting/evaluation for hearing aids with no copay for one visit per year. Prescription hearing aids are covered up to $1250 per year, while inner ear, outer ear, and over-the-ear prescription hearing aids are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision services with the Aetna Medicare Freedom Core (PPO) plan include eye exams and eyewear, with no copay for any of the listed services. The plan covers routine eye exams once per year, and provides a combined maximum of $300 per year for eyewear, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades.
Dental Services See details
Dental Services include coverage for Medicare Dental Services with a $35 copay, and other services like oral exams, dental x-rays, and cleaning with no copay, while fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered. Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), and Oral and Maxillofacial Surgery are covered with coinsurance ranging from 20% to 50%. Orthodontic Services have a maximum plan benefit of $2000 per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Freedom Core (PPO) plan, but require prior authorization. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Freedom Core (PPO), with Durable Medical Equipment (DME) subject to a 0-20% coinsurance and requiring prior authorization. Prosthetic devices have a 20% coinsurance, while medical supplies have a 0-20% coinsurance, and diabetic supplies have a 0-20% coinsurance. Diabetic therapeutic shoes/inserts have no copay, while diabetic supplies have a copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, with copays ranging from $0 to $50, and lab services with no copay. Diagnostic Radiological Services have a maximum copay of $250, while Therapeutic Radiological Services have a coinsurance of 20% at a minimum. Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Aetna Medicare Freedom Core (PPO) plan with no copay and no coinsurance, though additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the Aetna Medicare Freedom Core (PPO) plan, but the specific services are not covered. The plan does not specify the copay or coinsurance for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Aetna Medicare Freedom Core (PPO) plan, but require prior authorization. For days 1-20, the copay is $10 per day, and for days 21-100, the copay is $214 per day, while additional days beyond Medicare-covered for SNF and non-Medicare-covered stays are not covered.
Other Services See details
The Aetna Medicare Freedom Core (PPO) plan covers Over-the-Counter (OTC) Items with no copay, up to a maximum of $60 every three months. Other services like acupuncture, meal benefits, and several other services are not covered.
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