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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 Rural Oklahoma. This plan received an overall rating of 3.5 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 $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 $250.00 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 $250 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 a $10 copay at preferred pharmacies and $12 at standard pharmacies. For other tiers, you will pay coinsurance that ranges from 25% to 30% of the drug cost. Once your total drug costs reach $2,000, you will enter the catastrophic coverage phase, where you will pay nothing for covered drugs.
Additional Benefits
The Aetna Medicare Freedom Core (PPO) plan offers a range of benefits with varying costs. Hospital stays have a copay, while outpatient services, including primary care, have copays ranging from $0 to $350. Emergency services have a copay, while preventive services like annual exams have no copay. The plan includes coverage for hearing, vision, and dental services, such as hearing exams, eye exams, and oral exams with no copay. Other services, such as ambulance, home health, and skilled nursing facilities have copays or coinsurance. However, the plan does not cover some services, including cardiac rehabilitation and certain other specialized treatments.
Inpatient Hospital See details
Inpatient Hospital coverage includes Inpatient Hospital-Acute, with a copay of $445 for days 1-6 and no copay for days 7-90, and Inpatient Hospital Psychiatric, with a copay of $325 for days 1-6 and no copay for days 7-90. Additional Days for Inpatient Hospital-Acute are covered with no copay, while Non-Medicare-covered Stay for Inpatient Hospital-Acute and Upgrades for Inpatient Hospital-Acute are not covered. Additional Days for Inpatient Hospital Psychiatric and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are also 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 services have a copay between $0 and $350, observation services have a $325 copay, and ASC services have no copay. Individual and group sessions for outpatient substance abuse have a copay of $45.00, and outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Aetna Medicare Freedom Core (PPO) plan, but requires prior authorization. The copay for this benefit is $85.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Aetna Medicare Freedom Core (PPO) plan. Ground ambulance services have a $290 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, Urgently Needed Services, and Worldwide Emergency Services are covered by the Aetna Medicare Freedom Core (PPO) plan. Emergency Services have a $125 copay, Urgently Needed Services have a $55 copay, and Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $125 copay, while Worldwide Emergency Transportation has a $290 copay. There is no coinsurance for any of these services.
Primary Care See details
Primary Care benefits include coverage for Primary Care Physician Services with no copay, Chiropractic Services with a $15 copay, Occupational Therapy Services with a $40 copay, Physician Specialist Services with a copay between $0 and $45, and Physical Therapy and Speech-Language Pathology Services with a $40 copay. Mental Health Specialty and Psychiatric Services, as well as Opioid Treatment Program Services, are covered with a $40 copay, and Additional Telehealth Benefits are covered with a 20% coinsurance and a copay between $0 and $55. Podiatry Services are not covered.
Preventive Services See details
Preventive services include no copay for annual physical exams, Medicare-covered services, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit. Additional preventive services, including health education, additional sessions of smoking and tobacco cessation counseling, and fitness benefits, may have a copay. Kidney disease education services have a 20% coinsurance.
Hearing Services See details
Hearing exams are covered with a $40 copay, and routine hearing exams and fitting/evaluation for hearing aids have no copay. Prescription hearing aids are covered with a maximum plan benefit of $500 per ear every year, and Prescription Hearing Aids (all types) are covered with no copay, while inner ear, outer ear, and over the ear prescription hearing aids are not covered. OTC hearing aids are not covered.
Vision Services See details
Vision services, including eye exams and eyewear, are covered under the Aetna Medicare Freedom Core (PPO) plan. Eye exams and eyewear have no copay, and eyewear has a combined maximum plan benefit of $150 per year.
Dental Services See details
The Aetna Medicare Freedom Core (PPO) plan covers dental services, including oral exams with no copay, dental x-rays with no copay, and prophylaxis (cleaning) with no copay. Fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered. Orthodontic services have a maximum benefit of $1000 per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay, while 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 by the Aetna Medicare Freedom Core (PPO) plan, but require prior authorization. There is a 20% coinsurance for these services.
Medical Equipment See details
Medical equipment is covered by the Aetna Medicare Freedom Core (PPO) plan, including Durable Medical Equipment (DME) with a coinsurance of 0-20%, Prosthetic Devices with a 20% coinsurance, and Medical Supplies with a 0-20% coinsurance. Diabetic Equipment is covered, with the cost sharing including coinsurance for Medicare-covered Diabetic Therapeutic Shoes or Inserts and copays for Medicare-covered Diabetes Supplies.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, diagnostic procedures/tests with a copay between $0 and $50, lab services with no copay, and outpatient X-ray services with no copay. Therapeutic Radiological Services have a 20% coinsurance, and Diagnostic Radiological Services have a copay of at most $375.
Home Health Services See details
Home Health Services are covered by the Aetna Medicare Freedom Core (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 not covered by the Aetna Medicare Freedom Core (PPO) plan. This includes 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.
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, there is a $10 copay, and for days 21-100, the copay is $170. Additional days beyond Medicare-covered and non-Medicare-covered SNF stays are not covered.
Other Services See details
The Aetna Medicare Freedom Core (PPO) plan does not cover acupuncture, 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, or Self-Directed Personal Assistance Services. Over-the-counter items and "Other 1" and "Other 2" services are covered with no copay.
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