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Aetna Medicare Freedom Plus (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Freedom Plus (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 Plus (PPO) in 2025, please refer to our full plan details page.
Aetna Medicare Freedom Plus (PPO) is a PPO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Select Counties in GA. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Aetna Medicare Freedom Plus (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 Plus (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 Plus (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. 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 $14000.00 (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 $14000.00 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 Plus (PPO) plan has an enhanced alternative drug benefit. The plan has a $590 deductible. Once the deductible is met, you will pay a copay or coinsurance for your prescriptions. For preferred generic drugs, you will have no copay at preferred or mail-order pharmacies, and a $12 copay at standard pharmacies. For standard generic drugs, you will pay 22% coinsurance at all pharmacies. For preferred brand and non-preferred drugs, you will pay 25% coinsurance at all pharmacies.
Additional Benefits
The Aetna Medicare Freedom Plus (PPO) plan offers a range of benefits with varying costs. Hospital stays have copays, with no copay for longer stays, while outpatient services can have copays depending on the service. Emergency, primary care, and preventive services are covered, with some services having no copay, and others having a copay or coinsurance. This plan also covers hearing, vision, and dental services, with no copays for routine exams and some other services. Home health, dialysis, and medical equipment are included, with copays or coinsurance depending on the service. The plan also includes coverage for home infusion, diagnostic and radiological services, and skilled nursing facilities, and has other services with no copay.
Inpatient Hospital See details
Inpatient Hospital benefits for Aetna Medicare Freedom Plus (PPO) include Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both requiring prior authorization. For Inpatient Hospital-Acute, there is a $380 copay for days 1-7, and no copay for days 8-90. For Inpatient Hospital Psychiatric, there is a $407 copay for days 1-5, and no copay for days 6-90. Additional days for Inpatient Hospital-Acute are covered with no copay. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, and Additional days and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered by the Aetna Medicare Freedom Plus (PPO) plan. Outpatient Hospital Services have a copay between $0 and $380, while Observation Services have a $380 copay; Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay, and Individual and Group Sessions for Outpatient Substance Abuse have a $40 copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Aetna Medicare Freedom Plus (PPO) plan, with a copay of $80. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by Aetna Medicare Freedom Plus (PPO), with prior authorization required for all ambulance services. Ground ambulance services have a $295 copay, while air ambulance services have 20% coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including Urgently Needed Services and Worldwide Emergency Services, are covered by the Aetna Medicare Freedom Plus (PPO) plan. Emergency Services and Worldwide Emergency Coverage have a $110 copay, Urgently Needed Services have a $40 copay, and Worldwide Emergency Transportation has a $295 copay; all services have no coinsurance.
Primary Care See details
Under the Aetna Medicare Freedom Plus (PPO) plan, primary care physician services have no copay, chiropractic services have a $15 copay, and occupational therapy services have a $35 copay. Physician specialist services and other health care professional visits have copays ranging from $0 to $45, while physical therapy and speech-language pathology services have a $35 copay. Mental health and psychiatric services have a $40 copay for individual and group sessions. Additional telehealth benefits have a 20% coinsurance and a copay ranging from $0 to $45, and opioid treatment program services have a $40 copay. Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
Preventive Services include no copay for annual physical exams, Medicare-covered preventive services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit. Kidney disease education services have 20% coinsurance. Other services such as in-home safety assessments, personal emergency response systems, medical nutrition therapy, and more are not covered.
Hearing Services See details
Hearing exams are covered under the Aetna Medicare Freedom Plus (PPO) plan with a $45 copay, and routine hearing exams, and fitting/evaluation for hearing aids have no copay. Prescription hearing aids are covered with a $500 maximum plan benefit per year, and OTC hearing aids are not covered.
Vision Services See details
Vision services include eye exams and eyewear, with routine eye exams and other eye exam services having no copay. Eyewear has a combined maximum plan benefit of $130 per year, and includes no copay for contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades.
Dental Services See details
Dental Services are covered, including oral exams, dental x-rays, and other diagnostic and preventive services with no copay. This plan has a maximum plan benefit coverage of $1,000 per year for both in-network and out-of-network services. Restorative services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery are covered with no copay. However, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required.
Dialysis Services See details
Dialysis services are covered under the Aetna Medicare Freedom Plus (PPO) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Under the Aetna Medicare Freedom Plus (PPO) plan, Durable Medical Equipment (DME) is covered with 20% coinsurance and requires authorization, but Durable Medical Equipment for use outside the home is not covered. Prosthetics/Medical Supplies and Medical Supplies are covered with 20% coinsurance, while Diabetic Supplies have a 0-20% coinsurance, and Diabetic Therapeutic Shoes/Inserts have a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with prior authorization required. Diagnostic Procedures/Tests have a copay between $0 and $95, while Lab Services have no copay. Diagnostic Radiological Services have a copay up to $300, and Therapeutic Radiological Services have a coinsurance of 20%. Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Aetna Medicare Freedom Plus (PPO) plan with no copay and no coinsurance, but 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 Plus (PPO) plan, but the specific services of Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services are not covered. There is a copay for some services, but the specific amount is not listed.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered by the Aetna Medicare Freedom Plus (PPO) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214.
Other Services See details
The Aetna Medicare Freedom Plus (PPO) plan covers Over-the-Counter (OTC) Items and Meal Benefit with no copay. The plan also covers "Other 1" and "Other 2" services with no copay. However, acupuncture, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, and many other services are not covered.
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