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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 2026, 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 4.5 out of 5 stars in 2026.
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 $4200.00 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) features a $0 drug deductible, meaning your prescription drug coverage begins immediately. Under this plan, you will pay no copay for Tier 1 preferred generic drugs at preferred, standard, and standard mail-order pharmacies. For Tier 2 preferred brand drugs, the plan requires a copayment of $47 for a one-month supply at both preferred and standard pharmacies. Tier 3 non-preferred drugs cost a $95 copay for a one-month supply at preferred pharmacies and standard mail order, while standard pharmacies charge a $100 copay. Specialty medications in Tier 4 require a 33% coinsurance for a one-month supply across preferred, standard, and standard mail-order services. This straightforward copay and coinsurance structure helps you easily estimate your out-of-pocket prescription costs.
Additional Benefits
The Freedom Medicare Plan Rx (HMO) offers affordable healthcare coverage with no copay for primary care doctor visits and a $35 copay for specialist visits and mental health services. Inpatient hospital stays require a $150 daily copay for days 1 through 7, with no copay for days 8 through 90, and emergency room visits feature a $150 copay that is waived if you are admitted. Outpatient services and ambulatory surgical center visits are also covered with copays ranging from $75 to $250 and no coinsurance. This plan also covers routine dental, vision, and hearing exams with no copay or coinsurance. Additional perks include a $40 monthly allowance for over-the-counter items, partial coverage for hearing aids and eyewear, and up to six free one-way transportation trips per year to plan-approved locations. Medical equipment, prosthetics, and dialysis services are also covered, generally requiring a 20% coinsurance and no copay.
Inpatient Hospital See details
Freedom Medicare Plan Rx (HMO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $150 daily copay for days 1 through 7 and no copay for days 8 through 90. Prior authorization and referrals are required, and additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Freedom Medicare Plan Rx (HMO) covers outpatient services with no coinsurance, featuring a $250 copay for outpatient hospital and observation services, and a $75 copay for ambulatory surgical center services. Outpatient substance abuse sessions require a copay ranging from $35 to $250 with no coinsurance, while outpatient blood services are provided with no copay and no coinsurance.
Partial Hospitalization See details
Freedom Medicare Plan Rx (HMO) covers partial hospitalization services with a $55.00 copay and no coinsurance. Both prior authorization and a referral are required to access this covered benefit.
Ambulance and Transportation Services See details
Freedom Medicare Plan Rx (HMO) covers ground ambulance services with a $200 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered, providing up to 6 one-way trips per year to plan-approved locations with no copay or coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
Freedom Medicare Plan Rx (HMO) covers emergency services with a $150 copay, which is waived if admitted to the hospital within 72 hours, and urgently needed services with a $10 copay, with no coinsurance required for either service. Worldwide emergency, urgent, and transportation services are also covered up to a $100,000 maximum limit with a $500 copay and no coinsurance per service.
Primary Care See details
Freedom Medicare Plan Rx (HMO) covers primary care physician services with no copay and no coinsurance, while specialist visits, physical therapy, occupational therapy, and mental health services require a $35 copay and no coinsurance. Podiatry and chiropractic services are not covered, but telehealth and opioid treatment are available with no coinsurance and copays ranging from $0 to $50.
Preventive Services See details
Freedom Medicare Plan Rx (HMO) provides partial coverage for preventive services with no copay and no coinsurance for covered benefits, including Medicare-covered zero-dollar preventive services, kidney disease education, memory fitness, and remote access technologies. However, certain services are not covered, including annual physical exams, health education, in-home safety assessments, and nutritional or dietary benefits.
Hearing Services See details
Hearing services are covered by the Freedom Medicare Plan Rx (HMO) with no copay and no coinsurance for routine exams and fitting evaluations. Prescription hearing aids are partially covered with no copay or coinsurance up to an annual maximum of $500 per ear, though OTC hearing aids and inner ear, outer ear, or over the ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by the Freedom Medicare Plan Rx (HMO), featuring one routine eye exam per year with no copay and no coinsurance, though other eye exam services are not covered. Covered eyewear includes contact lenses or eyeglasses (lenses and frames) for a $10 copay and no coinsurance up to a $100 annual maximum, while individual eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
Dental services are partially covered by the Freedom Medicare Plan Rx (HMO) with no copay and no coinsurance for covered benefits, which include oral exams, cleanings, fluoride treatments, x-rays, and oral surgery. However, this plan does not cover restorative services, endodontics, periodontics, prosthodontics, implants, orthodontics, adjunctive general services, maxillofacial prosthetics, and other diagnostic or preventive dental services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Freedom Medicare Plan Rx (HMO) with no copay, though prior authorization is required. Under this coverage, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by the Freedom Medicare Plan Rx (HMO) with no copay and a 20% coinsurance.
Medical Equipment See details
Freedom Medicare Plan Rx (HMO) covers medical equipment, prosthetics, and diabetic supplies with no copay, though prior authorization is required. A 20% coinsurance applies to durable medical equipment, prosthetics, and diabetic shoes, while diabetic supplies have a coinsurance ranging from no coinsurance to 20%.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the Freedom Medicare Plan Rx (HMO) with required referrals and prior authorizations, featuring no copay for lab services and outpatient X-rays, though coinsurance applies. Diagnostic procedures and therapeutic radiology incur a 20% coinsurance alongside varying copays, while diagnostic radiology copays start at $25.
Home Health Services See details
Home Health Services are covered by Freedom Medicare Plan Rx (HMO) with a $20.00 copay and no coinsurance. Prior authorization and a referral are required to access this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Freedom Medicare Plan Rx (HMO) with no coinsurance, meaning some services are covered, but standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered. Prior authorization and a referral are required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by Freedom Medicare Plan Rx (HMO) with no coinsurance, requiring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100 per stay. Prior authorization and referrals are required for these services, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Freedom Medicare Plan Rx (HMO) partially covers other services, featuring no copay and no coinsurance for over-the-counter (OTC) items up to $40 per month and meal benefits for chronic illnesses. Acupuncture is not covered under this plan.
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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.
* 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.
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