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HealthPartners Freedom Vital WI (Cost)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HealthPartners Freedom Vital WI (Cost). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HealthPartners Freedom Vital WI (Cost) in 2025, please refer to our full plan details page.
HealthPartners Freedom Vital WI (Cost) is a Cost plan offered by HealthPartners, Inc. available for enrollment in 2025 to people living in Select Counties in Western WI. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that HealthPartners Freedom Vital WI (Cost) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about HealthPartners Freedom Vital WI (Cost).
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 HealthPartners Freedom Vital WI (Cost), 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.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $3400.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
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
Prescription drugs are not covered by HealthPartners Freedom Vital WI (Cost).
Additional Benefits
The HealthPartners Freedom Vital WI (Cost) plan offers coverage for inpatient hospital stays with a $400 copay, as well as outpatient services, including substance abuse, with copays ranging from $40 to $150. Emergency services have a $140 copay, and primary care visits cost $15. Preventive services are covered, with some subject to a copay, and there are also benefits for hearing and vision services, with copays for exams and partial coverage for hearing aids. This plan also covers ambulance services, home infusion, and dialysis with varying cost-sharing structures. Other covered services include acupuncture, and medical equipment. However, some services, such as skilled nursing facility stays, certain dental and vision services, and some types of rehabilitation, are not covered.
Inpatient Hospital See details
Inpatient hospital services are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, there is a $400 copay for a Medicare-covered stay, but Non-Medicare-covered stays and Upgrades are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, observation services, Ambulatory Surgical Center (ASC) services, outpatient substance abuse services, and outpatient blood services. Outpatient Hospital and ASC services have a $150 copay, while individual and group sessions for outpatient substance abuse have a copay between $40 and $40.
Partial Hospitalization See details
Partial Hospitalization benefits are covered by the HealthPartners Freedom Vital WI (Cost) plan.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by HealthPartners Freedom Vital WI (Cost). Ground ambulance services have a $200 copay, while air ambulance services have a 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 HealthPartners Freedom Vital WI (Cost). Emergency services have a $140 copay and no coinsurance, while urgently needed services have a $40 copay and no coinsurance. Worldwide emergency services have a 20% coinsurance for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
Primary Care benefits include a $15 copay for primary care physician services and chiropractic services, a $40 copay for occupational therapy services, a $40 copay for physician specialist services, and a $40 copay for individual mental health sessions and a $20 copay for group mental health sessions. Physical therapy and speech-language pathology services have a $40 copay, while routine chiropractic care, podiatry services, additional telehealth benefits, and are not covered.
Preventive Services See details
The HealthPartners Freedom Vital WI (Cost) plan covers a variety of preventive services, including annual physical exams, with additional preventive services subject to a copay, including Remote Access Technologies with a copay ranging from $0 to $40. Some preventive services, such as Health Education, In-Home Safety Assessment, and others, are not covered.
Hearing Services See details
Hearing Services include coverage for hearing exams with a $40 copay, as well as fitting/evaluation for hearing aids. Prescription hearing aids are covered, with a copay between $499 and $999, depending on the type of hearing aid. OTC hearing aids, and prescription hearing aids for the inner ear, outer ear, and over the ear are not covered.
Vision Services See details
Vision Services include coverage for eye exams with a $40 copay, and routine eye exams are covered once per year. Eyewear is partially covered, but contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental Services are partially covered under the HealthPartners Freedom Vital WI (Cost) plan. Medicare Dental Services are covered, while Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), Maxillofacial Prosthetics, Implant Services, Oral and Maxillofacial Surgery, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and between 0-20% coinsurance. For Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs, there is between 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered with no copay and no coinsurance.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a coinsurance of 0-20%, while Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests have no copay, while Lab Services are not covered. Diagnostic Radiological Services have a 20% coinsurance, Therapeutic Radiological Services have a $60 copay, and Outpatient X-Ray Services have a $10 copay.
Home Health Services See details
Home Health Services are covered by HealthPartners Freedom Vital WI (Cost) with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are technically covered, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are not covered by the HealthPartners Freedom Vital WI (Cost) plan. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are also not covered.
Other Services See details
Other Services include acupuncture with a $40 copay, limited to 20 treatments per year, and other services including US Emergency Travel Logistics, Travel Counseling, and Treatment at the Scene, with a $200 copay. Over-the-counter items, meal benefits, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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