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Perennial Advantage Freedom (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Perennial Advantage Freedom (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Perennial Advantage Freedom (HMO-POS) in 2026, please refer to our full plan details page.
Perennial Advantage Freedom (HMO-POS) is a HMO-POS plan offered by Perennial Consortium, LLC available for enrollment in 2025 to people living in Colorado (partial). The overall rating for this plan is not yet available for 2026.
It's important to know that Perennial Advantage Freedom (HMO-POS) 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 Perennial Advantage 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 Perennial Advantage 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.
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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $3500.00 (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 $3500.00 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 Perennial Advantage Freedom (HMO-POS) plan offers a budget-friendly prescription drug benefit with a $0 drug deductible, meaning your coverage starts on day one. Members enjoy no copay for Tier 1 preferred generic drugs for one-, two-, or three-month supplies at standard pharmacies and through standard mail order. For Tier 2 generic medications, standard pharmacy and mail order costs are also low, requiring a $10 copay for a one-month supply, $20 for two months, and $30 for three months. For higher-tier medications, costs are structured predictably across standard pharmacy and mail order channels. Tier 3 preferred brand drugs carry a $45 copay for a one-month supply, while Tier 4 non-preferred drugs cost $95 for a one-month supply, with both tiers offering proportional increases for longer supplies. Specialty medications in Tier 5 require a 33% coinsurance for a one-month supply, with multi-month options unavailable for this tier.
Additional Benefits
Perennial Advantage Freedom (HMO-POS) provides affordable access to essential medical care, featuring no copays or coinsurance for primary care visits, home health services, and skilled nursing facility stays. Specialist visits require a low $5 copay, while emergency room visits carry a $90 copay. For hospital stays, members pay a $225 copay for days one through five, with no copay for additional days up to day 90. The plan also includes valuable supplemental benefits, such as dental care with no copay or coinsurance up to a $2,600 annual limit. Prescription hearing aids are covered with no copay up to a $1,350 annual maximum, and routine vision care is available with no copay and a 20% coinsurance. Additionally, members receive up to 24 one-way transportation trips per year and over-the-counter items with no copay.
Inpatient Hospital See details
Perennial Advantage Freedom (HMO-POS) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $225 copay for days 1 through 5 and no copay for days 6 through 90. Prior authorization is required, and while unlimited additional acute days are covered, hospital upgrades and additional psychiatric days are not covered.
Outpatient Services See details
Perennial Advantage Freedom (HMO-POS) covers outpatient hospital services with a $0 to $250 copay and no coinsurance, and observation services with a $100 copay per stay and no coinsurance. Ambulatory surgical center, outpatient substance abuse, and outpatient blood services are covered with no copay and a 20% coinsurance.
Partial Hospitalization See details
Perennial Advantage Freedom (HMO-POS) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Perennial Advantage Freedom (HMO-POS) covers ambulance services with prior authorization, charging a $250 copay and no coinsurance for ground transport, and a 20% coinsurance and no copay for air transport. Transportation services are partially covered with no copay and no coinsurance for up to 24 one-way trips per year to any health-related location, though trips to plan-approved health-related locations are not covered.
Emergency Services See details
Perennial Advantage Freedom (HMO-POS) covers emergency services with a $90.00 copay and urgently needed services with a $20.00 to $55.00 copay, with no coinsurance for either service and copays waived if admitted to the hospital within three days. While some worldwide emergency services are covered, worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation are not covered in practice.
Primary Care See details
Perennial Advantage Freedom (HMO-POS) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $5 copay and no coinsurance. Chiropractic services are partially covered—excluding other chiropractic services—with routine care requiring a $35 copay and 20% coinsurance. Therapy and mental health services range from no copay to a $25 copay with no coinsurance, while psychiatric care requires no copay and 20% coinsurance.
Preventive Services See details
Perennial Advantage Freedom (HMO-POS) covers Medicare-covered preventive services, kidney disease education, and select screenings with no copay and no coinsurance. Additional preventive benefits are only partially covered, as services such as the annual physical exam, health education, personal emergency response systems, and weight management programs are not covered.
Hearing Services See details
Perennial Advantage Freedom (HMO-POS) covers hearing exams with no copay, though routine exams require 20% coinsurance. Prescription hearing aids are covered with no copay or coinsurance up to a $1,350 annual maximum, but inner ear, outer ear, and over the ear models are not covered. OTC hearing aids are fully covered with no copay and no coinsurance.
Vision Services See details
Perennial Advantage Freedom (HMO-POS) partially covers vision services with no copays, no deductibles, and a 20% coinsurance for covered routine eye exams and eyewear. One routine exam is covered per year, and eyeglasses, frames, and upgrades are covered up to a $250 annual maximum, while other eye exams and contact lenses are not covered.
Dental Services See details
Dental services are partially covered by Perennial Advantage Freedom (HMO-POS), offering no copay and no coinsurance for most preventive and comprehensive care up to a $2,600 annual limit, while Medicare-covered dental services require a 20% coinsurance and no copay. However, other preventive dental services, maxillofacial prosthetics, and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Perennial Advantage Freedom (HMO-POS) with no copay, though prior authorization is required. Covered Medicare Part B drugs, including chemotherapy, radiation, and insulin, are subject to coinsurance ranging from no coinsurance to 20%, with insulin drugs requiring a $35 copay.
Dialysis Services See details
Dialysis Services are covered by Perennial Advantage Freedom (HMO-POS) with no copay and a 20% coinsurance.
Medical Equipment See details
Perennial Advantage Freedom (HMO-POS) covers medical equipment with no copays, though prior authorization and a 20% coinsurance apply to durable medical equipment, prosthetics, and medical supplies. Diabetic supplies are covered with no copay and no coinsurance, while diabetic therapeutic shoes and inserts carry no copay and a coinsurance ranging from no coinsurance to 20%.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are partially covered by Perennial Advantage Freedom (HMO-POS), requiring prior authorization and featuring no copay alongside a 20% coinsurance for covered diagnostic procedures, diagnostic radiology, and therapeutic radiology. However, lab services and outpatient X-ray services are not covered under this plan.
Home Health Services See details
Perennial Advantage Freedom (HMO-POS) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by Perennial Advantage Freedom (HMO-POS) with no copay and require prior authorization, though in practice some services are covered while cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Perennial Advantage Freedom (HMO-POS) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, although prior authorization is required. This benefit does not require a prior three-day inpatient hospital stay, but additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Perennial Advantage Freedom (HMO-POS) provides partial coverage for other services, offering over-the-counter (OTC) items with no copay and no coinsurance. Under this benefit, acupuncture, meal benefits, and other additional services are not covered.
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