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HealthPartners Freedom Balance WI (Cost)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HealthPartners Freedom Balance 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 Balance WI (Cost) in 2025, please refer to our full plan details page.
HealthPartners Freedom Balance 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 Balance 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 Balance 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 Balance 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 Balance WI (Cost).
Additional Benefits
The HealthPartners Freedom Balance WI (Cost) plan offers a variety of benefits, including inpatient and outpatient services, ambulance and emergency services, and primary care. You'll have a $200 copay for inpatient hospital stays, and copays range from $15 to $140 for other services like doctor visits, urgent care, and specialist visits. Preventive services have no copay, and home health services and dialysis services are covered at no cost to you. This plan also provides coverage for hearing, vision, and dental services, with copays for exams and partial coverage for hearing aids and eyewear. Diagnostic and radiological services have copays that vary by service type. Additionally, you can receive acupuncture and home infusion services.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For both, there is a $200 copay for a Medicare-covered stay, while additional days have no copay. Non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a $100 copay, Observation Services, Ambulatory Surgical Center (ASC) Services with a $100 copay, Outpatient Substance Abuse Services with a $15 copay for both individual and group sessions, and Outpatient Blood Services. Prior authorization is required for Outpatient Hospital Services and Ambulatory Surgical Center (ASC) Services.
Partial Hospitalization See details
Partial Hospitalization is covered by this plan. There is no specific cost information provided for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the HealthPartners Freedom Balance WI (Cost) plan. Ground and Air Ambulance Services each have a $100 copay, and there is no coinsurance, while Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the HealthPartners Freedom Balance WI (Cost) plan. Emergency Services have a $140 copay, and Urgently Needed Services have a $15 copay, while Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have a 20% coinsurance.
Primary Care See details
The HealthPartners Freedom Balance WI (Cost) plan covers primary care physician services, chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, and opioid treatment program services. Primary care physician services, chiropractic services, physician specialist services, and physical therapy and speech-language pathology services have a $15 copay, while the maximum copay for individual and group mental health and psychiatric sessions ranges from $7.50 to $15.00. Podiatry services and additional telehealth benefits are not covered.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services with no copay, annual physical exams, additional preventive services, kidney disease education, and other preventive services. Additional preventive services include a copay, and some services like health education, in-home safety assessments, and others are not covered. Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline) has a copay between $0 and $15.
Hearing Services See details
Hearing services include hearing exams with a $15 copay, and routine hearing exams limited to 1 visit per year. Prescription hearing aids are partially covered, with a copay between $499 and $999 for all types, limited to 2 visits per year, but inner ear, outer ear, and over-the-ear hearing aids are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision Services include coverage for eye exams with a $15 copay, and routine eye exams once per year. Eyewear benefits are 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 by HealthPartners Freedom Balance WI (Cost), with Medicare Dental Services covered, but 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, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered with this plan. There is no copay or coinsurance for this benefit.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a coinsurance between 0% and 20%, and there is no copay. Prosthetic Devices, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the HealthPartners Freedom Balance WI (Cost) plan. Diagnostic procedures, tests, and lab services are not covered, while Diagnostic Radiological Services have a copay of at most $200, Therapeutic Radiological Services have a copay of at most $60, and Outpatient X-Ray Services have a $10 copay.
Home Health Services See details
Home Health Services are covered by the HealthPartners Freedom Balance WI (Cost) plan with no copay and no coinsurance, although additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are generally covered, but this 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) benefits are partially covered by the HealthPartners Freedom Balance WI (Cost) plan. Additional days beyond Medicare-covered for SNF are covered, but non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include acupuncture, with a $15 copay, as well as US Emergency Travel Logistics, Travel Counseling, and Treatment at the Scene, which has a $100 copay. Over-the-counter items, meal benefits, Dual Eligible SNPs with Highly Integrated Services, 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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