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Univera Medicare Freedom (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Univera Medicare Freedom (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Univera Medicare Freedom (HMO-POS) in 2026, please refer to our full plan details page.
Univera Medicare Freedom (HMO-POS) is a HMO-POS plan offered by Lifetime Healthcare, Inc. available for enrollment in 2025 to people living in Western New York. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Univera Medicare Freedom (HMO-POS) 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 Univera Medicare Freedom (HMO-POS).
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 Univera Medicare Freedom (HMO-POS), 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. Additionally, this plan comes with a Part B Premium reduction of $35.00. You must continue to pay paying your reduced 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 $4500.00 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 Univera Medicare Freedom (HMO-POS).
Additional Benefits
The Univera Medicare Freedom (HMO-POS) plan offers comprehensive medical coverage with predictable out-of-pocket costs, including a low $5 copay for primary care visits and a $35 copay for specialist appointments. For hospital care, inpatient stays require a $260 daily copay for the first five days and no copay for days 6 through 90, while emergency room visits carry a $115 copay. Outpatient services and ambulance rides are also covered with fixed copays and no coinsurance, helping you easily manage your healthcare budget. This plan also features robust wellness benefits, offering no copay for annual physicals, routine eye exams, preventive dental care, and home health services. Members receive a $250 annual allowance for eyewear, a $50 quarterly allowance for over-the-counter items, and up to 12 one-way trips per year to health-related locations at no cost. Additional services like hearing aids, diagnostic tests, and durable medical equipment are covered with clear copays or standard coinsurance.
Inpatient Hospital See details
Inpatient hospital benefits are partially covered by Univera Medicare Freedom (HMO-POS), offering no coinsurance with a $260 daily copay for days 1 through 5 and no copay for days 6 through 90. Prior authorization is required, and while unlimited additional acute care days are covered with no copay, psychiatric additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Univera Medicare Freedom (HMO-POS) covers outpatient hospital and ambulatory surgical center services with a $250 copay and no coinsurance, and outpatient blood services with no copay and no coinsurance. Some outpatient substance abuse services are covered with no copay and no coinsurance, but individual and group sessions are not covered.
Partial Hospitalization See details
Partial hospitalization is covered by Univera Medicare Freedom (HMO-POS) with no copay and a 20% coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Univera Medicare Freedom (HMO-POS), featuring a $150 copay and no coinsurance for both ground and air ambulance rides. Additionally, the plan provides up to 12 one-way trips per year to any health-related location with no copay and no coinsurance.
Emergency Services See details
Univera Medicare Freedom (HMO-POS) covers emergency services with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 23 hours. Urgently needed services require a $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no coinsurance and copays of $115, $50, and $150 respectively.
Primary Care See details
Univera Medicare Freedom (HMO-POS) covers primary care visits for a $5 copay and specialist, physical, speech, and occupational therapies for a $35 copay, with no coinsurance. Telehealth services carry a $0 to $35 copay and 20% coinsurance, while podiatry is not covered. Additionally, some chiropractic, mental health, and psychiatric services are covered, but routine chiropractic care, other chiropractic services, and individual or group sessions for mental health and psychiatry are not covered.
Preventive Services See details
Preventive Services are covered under Univera Medicare Freedom (HMO-POS) with no copay and no coinsurance for annual physicals, kidney disease education, and other screenings. Additional preventive services are partially covered, offering memory fitness and remote access technologies, while sub-services like health education, PERS, in-home safety assessments, medical nutrition therapy, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, tobacco cessation, enhanced disease management, telemonitoring, home safety devices, and counseling are not covered.
Hearing Services See details
Univera Medicare Freedom (HMO-POS) covers hearing exams and evaluations with a $35 copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and a copay ranging from $499 to $799, but inner ear, outer ear, and over the ear prescription aids, as well as OTC hearing aids, are not covered.
Vision Services See details
Univera Medicare Freedom (HMO-POS) offers partially covered vision services, including one annual routine eye exam with no copay, no coinsurance, and no deductible. Eyewear is covered up to a $250 yearly limit with no deductible, no coinsurance, and a $35 copay for contact lenses, though other eye exam services, eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Univera Medicare Freedom (HMO-POS) offers partially covered dental services with a $35 copay and no coinsurance for Medicare-covered dental care, and no copay or coinsurance for other covered preventive and comprehensive services. Sub-services that are not covered under this plan include other diagnostic dental services, fluoride treatment, other preventive services, maxillofacial prosthetics, implant services, and orthodontics.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Univera Medicare Freedom (HMO-POS) with no copay, though prior authorization is required. Medicare Part B insulin drugs carry a $35 copay with no coinsurance, while Part B chemotherapy, radiation, and other drugs require a coinsurance of 0% to 20%.
Dialysis Services See details
Dialysis Services are covered by Univera Medicare Freedom (HMO-POS) with no copay and a 20% coinsurance.
Medical Equipment See details
Medical equipment covered by Univera Medicare Freedom (HMO-POS) includes durable medical equipment, prosthetics, and medical supplies, all of which feature no copay and a 20% coinsurance. Diabetic supplies require a $5 copay and no coinsurance, while diabetic therapeutic shoes and inserts have a 20% coinsurance and no copay.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the Univera Medicare Freedom (HMO-POS) plan, with prior authorization required. Diagnostic procedures, tests, and lab services require a $10 copay and no coinsurance, while diagnostic radiological services carry a $150 copay and no coinsurance, outpatient X-rays cost a $40 copay, and therapeutic radiological services require a 20% coinsurance and no copay.
Home Health Services See details
Home health services are covered under the Univera Medicare Freedom (HMO-POS) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Univera Medicare Freedom (HMO-POS) covers some cardiac rehabilitation services with no coinsurance and a $15 copay, though standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Univera Medicare Freedom (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. You will pay no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the standard Medicare benefit are not covered.
Other Services See details
Other Services under the Univera Medicare Freedom (HMO-POS) are partially covered, offering acupuncture with no copay and 50% coinsurance for up to 10 treatments per year. Additionally, over-the-counter items (up to $50 every three months) and chronic illness meal benefits are covered with no copay and no coinsurance, while other miscellaneous services are not covered.
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