A non-government entity
Freedom Blue PPO Valor (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Freedom Blue PPO Valor (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Freedom Blue PPO Valor (PPO) in 2026, please refer to our full plan details page.
Freedom Blue PPO Valor (PPO) is a PPO plan offered by Highmark Health available for enrollment in 2025 to people living in Southeastern, PA. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Freedom Blue PPO Valor (PPO) 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 Freedom Blue PPO Valor (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 Freedom Blue PPO Valor (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. Additionally, this plan comes with a Part B Premium reduction of $60.00. 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 combined Maximum Out-Of-Pocket cost of $8950.00 (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 $8950.00 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:
Sign up for Freedom Blue PPO Valor (PPO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
Prescription drugs are not covered by Freedom Blue PPO Valor (PPO).
Additional Benefits
The Freedom Blue PPO Valor (PPO) plan offers affordable medical coverage featuring no copay and no coinsurance for primary care visits and preventive services. Specialist office visits require a low $10 copay, while inpatient hospital stays incur a $300 copay per stay with no coinsurance. Outpatient hospital services have a $250 copay, and emergency room visits require a $130 copay that is waived if you are admitted. Supplemental benefits include dental care with up to a $3,000 annual maximum and no copay for routine services, as well as a $400 annual eyewear allowance with no copay. Routine annual vision and hearing exams are highly affordable with a $10 copay and no coinsurance. Members also receive extra perks like up to 24 one-way transportation trips with no copay and a $100 over-the-counter allowance every three months with no copay.
Inpatient Hospital See details
Freedom Blue PPO Valor (PPO) partially covers inpatient hospital services with no coinsurance, featuring a $300 copay per stay for acute care and a $325 daily copay for days 1 through 3 of psychiatric care, with no copay for days 4 through 90. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Freedom Blue PPO Valor (PPO) covers outpatient hospital and daily observation services with a $250 copay and no coinsurance, and ambulatory surgical center services with a $200 copay and no coinsurance. Outpatient substance abuse sessions require a $5 copay with no coinsurance, while outpatient blood services are covered with no copay and no coinsurance.
Partial Hospitalization See details
Freedom Blue PPO Valor (PPO) covers partial hospitalization services with no copay and no coinsurance.
Ambulance and Transportation Services See details
Freedom Blue PPO Valor (PPO) covers ground and air ambulance services with a $310 copay and no coinsurance, requiring prior authorization. Transportation services are partially covered, offering up to 24 one-way trips per year to plan-approved locations with no copay and no coinsurance, while trips to any health-related location are not covered.
Emergency Services See details
Emergency services are covered by Freedom Blue PPO Valor (PPO) with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within three days. Urgently needed services require a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no coinsurance and copays of $130, $40, and $310 respectively.
Primary Care See details
Freedom Blue PPO Valor (PPO) covers primary care physician visits with no copay and no coinsurance, and specialist visits with a $10 copay and no coinsurance. Other services like physical therapy, mental health, and podiatry require copays ranging from $5 to $15 with no coinsurance, while chiropractic benefits are only partially covered because other chiropractic services are not covered.
Preventive Services See details
Freedom Blue PPO Valor (PPO) covers preventive services, including annual physical exams and kidney disease education, with no copay and no coinsurance. Additional benefits are partially covered, featuring remote access technologies with a $0 (no copay) to $10 copay and home safety devices with a 20% coinsurance, while services like health education, nutritional training, and personal emergency response systems are not covered.
Hearing Services See details
Hearing services under Freedom Blue PPO Valor (PPO) are partially covered, featuring annual routine hearing exams for a $10 copay and no coinsurance, and prescription hearing aids with a $699 to $999 copay and no coinsurance. Fitting and evaluation, OTC hearing aids, and inner ear, outer ear, or over-the-ear prescription hearing aids are not covered.
Vision Services See details
Vision Services are partially covered by Freedom Blue PPO Valor (PPO), offering one routine annual eye exam for a $10 copay and no coinsurance, though other eye exam services are not covered. Eyewear is covered with no copay and no coinsurance, providing up to a $400 annual combined maximum benefit for contacts, lenses, frames, and upgrades.
Dental Services See details
Freedom Blue PPO Valor (PPO) partially covers dental services up to a $3,000 annual maximum for both in- and out-of-network care. Medicare-covered dental services require a $10 copay and no coinsurance, while other covered preventive and comprehensive services have no copay and no coinsurance. Non-covered services include other diagnostic, other preventive, maxillofacial prosthetics, implant services, and orthodontics.
Home Infusion bundled Services See details
Freedom Blue PPO Valor (PPO) covers Home Infusion bundled services with no copay, though prior authorization is required. Medicare Part B drugs, including chemotherapy, radiation, and insulin, feature no copay (except for a $35 copay on insulin) and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered under the Freedom Blue PPO Valor (PPO) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Freedom Blue PPO Valor (PPO) covers medical equipment with no copays, though prior authorization is required. Durable medical equipment incurs a coinsurance ranging from no coinsurance to 50%, diabetic supplies range from no coinsurance to 20% coinsurance, and prosthetic devices, medical supplies, and diabetic shoes require a 20% coinsurance.
Diagnostic and Radiological Services See details
Freedom Blue PPO Valor (PPO) covers diagnostic and radiological services with no coinsurance, though prior authorization is required. Outpatient lab services have no copay, diagnostic tests have a $0 to $10 copay, X-rays have a $20 copay, and diagnostic and therapeutic radiological services require minimum copays of $225 and $60, respectively.
Home Health Services See details
Freedom Blue PPO Valor (PPO) covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Freedom Blue PPO Valor (PPO) covers some Cardiac Rehabilitation Services with no copay and no coinsurance, but Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by Freedom Blue PPO Valor (PPO) with no coinsurance, as additional days beyond the Medicare-covered limit are not covered. Covered days require prior authorization but no prior three-day hospital stay, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100.
Other Services See details
Other services are partially covered by Freedom Blue PPO Valor (PPO), which offers an over-the-counter (OTC) benefit of up to $100 every three months with no copay and no coinsurance. Acupuncture, meal benefits, nicotine replacement therapy, and naloxone are not covered under this benefit.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved