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Medicare Blue Choice Freedom (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Medicare Blue Choice Freedom (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Medicare Blue Choice Freedom (HMO-POS) in 2025, please refer to our full plan details page.
Medicare Blue Choice Freedom (HMO-POS) is a HMO-POS plan offered by Lifetime Healthcare, Inc. available for enrollment in 2025 to people living in Metro Rochester Area. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Medicare Blue Choice 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 Medicare Blue Choice 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 Medicare Blue Choice 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 Medicare Blue Choice Freedom (HMO-POS).
Additional Benefits
The Medicare Blue Choice Freedom (HMO-POS) plan offers a range of benefits, including coverage for inpatient hospital stays, outpatient services, and emergency care, each with varying copays. The plan also provides coverage for primary care visits with a $5 copay, and specialist visits with a $35 copay. Additional benefits include vision, hearing, and dental services with copays ranging from $35 to $40, and coverage for ambulance services, home health, and skilled nursing facilities. The plan also covers diagnostic and radiological services, and offers a meal benefit, along with coverage for over-the-counter items up to $50 every three months.
Inpatient Hospital See details
Inpatient Hospital benefits include coverage for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services, both requiring prior authorization. For Inpatient Hospital-Acute, there is a $260 copay for days 1-5, and no copay for days 6-90, and for Inpatient Hospital Psychiatric, there is a $260 copay for days 1-5, and no copay for days 6-90. Additional Days for Inpatient Hospital-Acute benefits are covered, but Non-Medicare-covered Stay for Inpatient Hospital-Acute and Upgrades for Inpatient Hospital-Acute are not covered, and Additional Days for Inpatient Hospital Psychiatric and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient services include coverage for outpatient hospital services, observation services, and ambulatory surgical center services, each with a $250 copay. Outpatient substance abuse services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered under the plan, but requires prior authorization. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Medicare Blue Choice Freedom (HMO-POS) plan. Ground and air ambulance services have a $150 copay, with no coinsurance. Transportation services to any health-related location are covered for 12 one-way trips per year. Transportation services to plan-approved health-related locations are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency services have a $110 copay, urgently needed services have a $50 copay, and worldwide emergency coverage has a $110 copay, worldwide urgent coverage has a $50 copay, and worldwide emergency transportation has a $150 copay.
Primary Care See details
Primary Care Physician Services have a $5 copay, Chiropractic Services have a $15 copay, and Occupational Therapy Services have a $35 copay. Physician Specialist Services and Physical Therapy and Speech-Language Pathology Services have a $35 copay, while Other Health Care Professional and Opioid Treatment Program Services have a 50% coinsurance. Additional Telehealth Benefits have a $0-$35 copay and 20% coinsurance. However, Routine Chiropractic Care, Individual and Group Sessions for Mental Health Specialty Services, Individual and Group Sessions for Psychiatric Services, and Podiatry Services are not covered.
Preventive Services See details
The Medicare Blue Choice Freedom (HMO-POS) plan covers a variety of preventive services, including Medicare-covered preventive services with prior authorization, annual physical exams, health education, fitness benefits, enhanced disease management, remote access technologies, kidney disease education services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit. However, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers, additional sessions of smoking and tobacco cessation counseling, telemonitoring services, home and bathroom safety devices, and counseling services are not covered.
Hearing Services See details
Hearing Services include hearing exams with a $35 copay, and routine hearing exams once per year. Prescription hearing aids (all types) are covered with a copay between $499 and $799 for 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 are covered, including eye exams and eyewear. Eye exams have a $40 copay, and eyewear has a $35 copay. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services include coverage for oral exams, dental x-rays, prophylaxis (cleaning), restorative services, adjunctive general services, endodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery, with a $35 copay for Medicare dental services; however, fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered. Orthodontic services have a maximum benefit of $1,000 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 under the Medicare Blue Choice Freedom (HMO-POS) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and prior authorization required, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment. Diabetic Supplies have a $5 copay, and Diabetic Therapeutic Shoes/Inserts have 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests with a $10 copay, Lab Services with a $10 copay, Diagnostic Radiological Services with a $150 copay, Therapeutic Radiological Services with 20% coinsurance, and Outpatient X-Ray Services with a $40 copay. All services require prior authorization.
Home Health Services See details
Home Health Services are covered by the Medicare Blue Choice Freedom (HMO-POS) plan with no copay and no coinsurance, but authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the Medicare Blue Choice Freedom (HMO-POS) plan, but no specific services are covered. There is a copay for some services, but the details are not provided.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the Medicare Blue Choice Freedom (HMO-POS) plan. For days 1-20, there is no copay, and for days 21-100, the copay is $214.
Other Services See details
Other Services include acupuncture, over-the-counter (OTC) items, and a meal benefit. Acupuncture has a 50% coinsurance, over-the-counter items have a maximum benefit of $50 every three months, and the meal benefit is for a chronic illness. Additional services such as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, and others are not covered.
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