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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 $2400.00 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 a $0 deductible for prescription drugs. In the initial coverage phase, you'll pay a copay or coinsurance depending on the drug tier and the pharmacy you use. For example, preferred generic drugs have a $47 copay, while preferred brand drugs have 33% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for 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 of $150 for days 1-7 and no copay for days 8-90, while outpatient services can have copays ranging from $35 to $250. The plan also covers ambulance services, emergency services, and a variety of primary care services like primary care visits, chiropractic services, and mental health specialty services all with copays. Preventive services, hearing exams, routine eye exams, and dental services have no copay. The plan also offers coverage for prescription hearing aids with a plan-specified amount of $500 per year, and eyewear with a $10 copay. Other benefits include home health services, skilled nursing facility (SNF) services, and various diagnostic and radiological services, with costs varying by service.
Inpatient Hospital See details
Inpatient Hospital coverage requires prior authorization and a doctor referral, with a copay of $150 for days 1-7 and no copay for days 8-90. Additional days for inpatient hospital acute and psychiatric, as well as non-Medicare-covered stays and upgrades, are not covered.
Outpatient Services See details
Outpatient Services includes coverage for all outpatient hospital services with a $250 copay, observation services with a $250 copay, and ambulatory surgical center services with a $75 copay. The plan also covers outpatient substance abuse services with copays between $35 and $250 for individual and group sessions, and outpatient blood services with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the Freedom Medicare Plan Rx (HMO) with prior authorization and a doctor referral required. You will pay a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services includes coverage for ground ambulance services with a $200 copay, and air ambulance services with 20% coinsurance. Transportation Services to a plan-approved health-related location is covered with no copay for 6 one-way trips per year, but transportation services to any other health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Freedom Medicare Plan Rx (HMO). Emergency Services have a $120 copay, and Urgently Needed Services have a $10 copay. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation each have a $500 copay.
Primary Care See details
The Freedom Medicare Plan Rx (HMO) offers primary care services with no copay, chiropractic services with a $20 copay, occupational therapy services with a $35 copay, physician specialist services with a $35 copay, and mental health specialty services with a $35 copay. Additionally, physical therapy and speech-language pathology services have a $35 copay, and opioid treatment program services have a copay between $0 and $250. Podiatry services are not covered.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services, with the exception of the annual physical exam. Additional preventive services, including Fitness Benefit and Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline), are covered with no copay.
Hearing Services See details
Hearing Services include hearing exams, routine hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids. Hearing exams have no copay, while routine hearing exams and fitting/evaluation for hearing aids also have no copay for one visit per year. Prescription hearing aids have a plan-specified amount of $500 per year, and there is no copay for two visits per year for all types of prescription hearing aids, but prescription hearing aids for the inner ear, outer ear, and over the ear are not covered. OTC hearing aids are not covered.
Vision Services See details
The Freedom Medicare Plan Rx (HMO) covers vision services, including routine eye exams and eyewear. Routine eye exams and eyewear have no copay, and contact lenses and eyeglasses have a $10 copay, with a combined maximum plan benefit of $100 every year. Eyeglass lenses and frames are not covered.
Dental Services See details
The Freedom Medicare Plan Rx (HMO) offers dental services with no copay for Medicare Dental Services, Oral Exams, Dental X-Rays, Prophylaxis (Cleaning), Fluoride Treatment, and Oral and Maxillofacial Surgery. However, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), Maxillofacial Prosthetics, Implant Services, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay. 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), with a coinsurance between 20% and 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, and Durable Medical Equipment for use outside the home is not covered. Prosthetics and Medical Supplies have a 20% coinsurance, and Diabetic Supplies have between 0% and 20% coinsurance while Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Freedom Medicare Plan Rx (HMO), with Diagnostic Procedures/Tests subject to a 20% coinsurance and a copay of up to $250, and Lab Services with no copay. Diagnostic Radiological Services have a copay of at most $250, while Therapeutic Radiological Services have a coinsurance of at most 20%, and 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 $20 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 the copay for the services. Prior authorization and a doctor 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, with no coinsurance. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include coverage for Over-the-Counter (OTC) Items and a Meal Benefit, both with no copay; however, acupuncture, Dual Eligible SNPs with Highly Integrated Services, 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. The OTC benefit has a maximum coverage amount of $50.00 per month.
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