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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 Tulsa and Surrounding Counties. 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 you meet the deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy you use. For preferred generic drugs, you will pay a $10 copay at preferred pharmacies and a $12 copay at standard pharmacies. For standard generic drugs, you will pay 25% coinsurance. After your total drug costs reach $2000, you will enter the catastrophic coverage phase and pay nothing for covered drugs.
Additional Benefits
The Aetna Medicare Freedom Core (PPO) plan offers a range of benefits with varying costs. For inpatient hospital stays, you'll pay a copay, with the amount depending on the type of service and the length of your stay. Outpatient services, including primary care, have no copay, but some services like specialist visits and therapies have copays. The plan includes coverage for emergency services, ambulance services, and home health services, with copays or coinsurance applying in some cases. Preventive services, hearing, vision, and dental services are also covered, with specific copays, coinsurance, and maximum benefit amounts for certain services. Additionally, the plan covers services like home infusion, dialysis, and medical equipment with associated costs.
Inpatient Hospital See details
The Aetna Medicare Freedom Core (PPO) plan covers inpatient hospital services, with a copay of $375 for days 1-6, and no copay for days 7-90 for Inpatient Hospital-Acute. Inpatient Hospital Psychiatric services have 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. 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, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services, are covered. Outpatient hospital services have a copay between $0 and $350, observation services have a $325 copay, ambulatory surgical center services have no copay, and outpatient blood services have no copay. Individual and group sessions for outpatient substance abuse both have a copay of $45.
Partial Hospitalization See details
Partial Hospitalization is covered by the Aetna Medicare Freedom Core (PPO) plan, but requires prior authorization. You will have a $70 copay for this benefit.
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 and Worldwide Emergency Coverage have a $125 copay, Worldwide Urgent Coverage has a $125 copay, Worldwide Emergency Transportation has a $290 copay, and Urgently Needed Services have a $55 copay; there is no coinsurance for any of these services.
Primary Care See details
Under the Aetna Medicare Freedom Core (PPO) plan, primary care physician services are covered with no copay, while chiropractic services have a $15 copay, occupational therapy services have a $40 copay, and physical therapy and speech-language pathology services have a $40 copay. Physician specialist services have a copay between $0 and $45, mental health specialty services and psychiatric services have a $40 copay, and additional telehealth benefits have a 20% coinsurance and a copay between $0 and $55. Opioid treatment program services also have a $40 copay. Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
Preventive Services include Medicare-covered services with no copay, an annual physical exam with no copay, and additional preventive services with a copay for some services. Kidney Disease Education Services have a 20% coinsurance, while Glaucoma Screenings, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visits have no copay.
Hearing Services See details
Hearing exams have a $40 copay, while routine hearing exams and fitting/evaluation for hearing aids have no copay. Prescription hearing aids are covered with a maximum benefit of $500 per ear every year, while OTC hearing aids and some types of prescription hearing aids are not covered.
Vision Services See details
Vision services are covered, including eye exams and eyewear. Eye exams and eyewear have no copay, and there is a combined maximum plan benefit coverage amount of $165.00 per year for eyewear.
Dental Services See details
Dental Services include coverage for Medicare Dental Services with a $40 copay, Oral Exams with no copay, Dental X-Rays with no copay, Prophylaxis (Cleaning) with no copay, Orthodontic Services with a $1,000 maximum benefit, Restorative Services with 20% - 50% coinsurance, Adjunctive General Services with 20% - 50% coinsurance, Endodontics with 20% coinsurance, Periodontics with 20% - 50% coinsurance, Prosthodontics (removable) with 50% coinsurance, and Prosthodontics (fixed) with 50% coinsurance; Fluoride Treatment, Maxillofacial Prosthetics, Implant Services, and Orthodontics are not covered.
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. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, the coinsurance ranges from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered with a coinsurance of 20%. Prior authorization is required.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), Prosthetics, Medical Supplies, and Diabetic Equipment, are covered under the Aetna Medicare Freedom Core (PPO) plan. DME has a coinsurance between 0% and 20%, while Prosthetic Devices have a 20% coinsurance, and Medical Supplies have a coinsurance between 0% and 20%. Diabetic Supplies have a coinsurance between 0% and 20%, and Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including all diagnostic services, diagnostic procedures/tests, and lab services. Diagnostic procedures/tests have a copay between $0 and $50, lab services have no copay, and diagnostic radiological services have a copay up to $375. Therapeutic radiological services have 20% coinsurance, and 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. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are technically covered, but Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. There is a copay for some Cardiac and Pulmonary Rehabilitation Services, but the details are not specified.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Aetna Medicare Freedom Core (PPO) plan with prior authorization. For days 1-20, the copay is $10, and for days 21-100, the copay is $214; additional days beyond Medicare-covered 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, and provides a maximum benefit of $30 every three months. Other services such as acupuncture, meal benefits, Dual Eligible SNPs with Highly Integrated Services, and other services are not covered.
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