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Freedom Medicare Plan Rx (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Freedom Medicare Plan Rx (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Freedom Medicare Plan Rx (HMO) in 2025, please refer to our full plan details page.
Freedom Medicare Plan Rx (HMO) is a HMO plan offered by Elevance Health, Inc. available for enrollment in 2025 to people living in Select Counties in Florida. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Freedom Medicare Plan Rx (HMO) 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 Freedom Medicare Plan Rx (HMO).
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 Medicare Plan Rx (HMO), 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 Maximum Out-Of-Pocket cost of $3000.00 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
The Freedom Medicare Plan Rx (HMO) has an enhanced alternative drug benefit. There is no deductible for prescription drugs. In the initial coverage phase, you will pay a copay for your prescriptions. For preferred generic drugs, the copay is $47, and for standard generic drugs, the copay is $95. For preferred brand drugs, you pay 33% coinsurance. After your yearly out-of-pocket drug costs reach $2000, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Freedom Medicare Plan Rx (HMO) offers a range of benefits with varying costs. Inpatient hospital stays have a copay, while outpatient services have copays depending on the specific service. You'll find no copays for primary care, hearing exams, eye exams, and many dental services. Additional benefits include coverage for ambulance services, emergency services, and some transportation. The plan also covers home health services and skilled nursing facility stays with copays. Other services, such as over-the-counter items and meal benefits, are covered with no copay, up to a certain monthly maximum, but some services like podiatry and certain therapies are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric, are covered. For days 1-7, there is a $225 copay, and for days 8-90, there is no copay.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a $200 copay, Observation Services with a $200 copay, Ambulatory Surgical Center (ASC) Services with a $75 copay, and Outpatient Substance Abuse Services with a copay between $30 and $200 for both individual and group sessions. Outpatient Blood Services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization and a doctor referral. You will have a $55 copay for this benefit.
Ambulance and Transportation Services See details
The Freedom Medicare Plan Rx (HMO) covers ambulance and transportation services, with prior authorization required. Ground ambulance services have a $200 copay, while air ambulance services have a 20% coinsurance. Transportation services to plan-approved health-related locations are covered with no copay for up to 6 one-way trips per year, while 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 under the Freedom Medicare Plan Rx (HMO). Emergency Services have a $120 copay, while Urgently Needed Services have a $10 copay. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have a $500 copay, with a maximum plan benefit coverage of $100,000.
Primary Care See details
Freedom Medicare Plan Rx (HMO) covers primary care physician services with no copay, chiropractic services with a $20 copay (prior authorization and a doctor referral required), and occupational therapy services with a $30 copay (prior authorization and a doctor referral required). The plan also covers physician specialist services with a $30 copay (prior authorization and a doctor referral required), mental health specialty services with a $30 copay, and physical therapy and speech-language pathology services with a $30 copay (prior authorization and a doctor referral required). Podiatry services are not covered.
Preventive Services See details
Preventive Services are covered, including Medicare-covered services with no copay, and additional services such as Fitness Benefit and Remote Access Technologies, which may have a copay. Annual physical exams, Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), 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 Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, and Telemonitoring Services are not covered.
Hearing Services See details
The Freedom Medicare Plan Rx (HMO) offers Hearing Services, including hearing exams and fitting/evaluation for hearing aids with no copay. Routine hearing exams and prescription hearing aids (all types) are covered with no copay. Prescription Hearing Aids have a maximum plan benefit coverage of $500 per year. Prescription Hearing Aids - Inner Ear, Outer Ear, and Over the Ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision Services includes coverage for eye exams with no copay, and eyewear with a $100 combined maximum plan benefit per year, with a $10 copay for contact lenses and eyeglasses, and a $30 copay for upgrades. Eyeglass lenses and frames are not covered.
Dental Services See details
Dental Services include oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and oral and maxillofacial surgery with no copay; however, some services such as restorative services, endodontics, and orthodontics are not covered. Oral exams are limited to 4 visits per year, dental x-rays are limited to 1, prophylaxis is limited to 2, and fluoride treatment and oral and maxillofacial surgery are limited to 2 visits per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. 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 Freedom Medicare Plan Rx (HMO). You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment, with a 20% coinsurance for DME and a coinsurance of 20% for Prosthetic Devices and Medical Supplies. Diabetic Supplies have a coinsurance between 0% and 20%, while Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Freedom Medicare Plan Rx (HMO). Diagnostic Procedures/Tests have a coinsurance of at most 20% and a copay of at most $200.00, while Lab Services have no copay. Diagnostic Radiological Services have a copay of at most $200.00, and Therapeutic Radiological Services have a coinsurance of at most 20%. Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Freedom Medicare Plan Rx (HMO) with a $10 copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization and a doctor's referral are required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization and a doctor's referral. There is no copay for days 1-5, a $20 copay for days 6-20, and a $150 copay for days 21-100, and there is no coinsurance.
Other Services See details
The Freedom Medicare Plan Rx (HMO) covers over-the-counter items with no copay and a maximum benefit of $45.00 per month. Meal benefits are also covered with no copay, but require prior authorization and a doctor referral. Acupuncture, Dual Eligible SNPs, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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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.
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