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Freedom Platinum Plan Rx (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Freedom Platinum 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 Platinum Plan Rx (HMO) in 2025, please refer to our full plan details page.
Freedom Platinum Plan Rx (HMO) is a HMO plan offered by Elevance Health, Inc. available for enrollment in 2025 to people living in Select Counties in FL. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Freedom Platinum 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 Platinum 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 Platinum 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 $2000.00 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 Platinum Plan Rx (HMO) has an enhanced alternative drug benefit. This plan has no deductible for prescription drugs. During the initial coverage phase, you will pay a copay for your prescriptions. For example, a preferred generic drug has a $30 copay, while a standard generic drug has a $75 copay at a preferred pharmacy. After 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 Platinum Plan Rx (HMO) offers a range of benefits, including inpatient hospital stays with a copay, outpatient services with varying copays, and ambulance services with copays and coinsurance. This plan covers emergency and urgent care services, as well as primary care physician services, and offers no copay for many services like hearing exams, vision exams, and dental cleanings. Additional benefits include preventive services, hearing aids, vision care, and dental services with no or low copays. The plan also covers home health services, diagnostic and radiological services, and skilled nursing facility stays with specific cost-sharing structures. This plan also includes coverage for over-the-counter items and meal benefits with no copay.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered, but require prior authorization and a doctor's referral. For days 1-7, there is a $25 copay, and days 8-90 have no copay.
Outpatient Services See details
Outpatient services include coverage for all outpatient hospital services with a $100 copay, observation services with a $100 copay, ambulatory surgical center (ASC) services with a $25 copay, outpatient substance abuse services with a copay between $0 and $100 for individual and group sessions, and outpatient blood services with no copay. Prior authorization and a doctor referral are required for most services.
Partial Hospitalization See details
Partial Hospitalization is covered under the Freedom Platinum Plan Rx (HMO) with a $55 copay, and requires prior authorization and a doctor referral.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered. Ground ambulance services have a $200 copay, while air ambulance services have a 20% coinsurance. Transportation Services to a plan-approved health-related location are covered with no copay for up to 12 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Freedom Platinum Plan Rx (HMO). Emergency Services have a $120 copay, Urgently Needed Services have a $10 copay, and Worldwide Emergency Services have a $500 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The Freedom Platinum Plan Rx (HMO) covers primary care physician services, chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Primary care physician services, chiropractic services, physician specialist services, individual and group mental health and psychiatric sessions, and physical therapy and speech-language pathology services have no copay, while occupational therapy services, other health care professional services, and opioid treatment program services have a copay of $0.00-$100.00. Podiatry services are not covered.
Preventive Services See details
Preventive Services are covered, including Medicare-covered services with no copay and additional preventive services that may have a copay. Fitness benefits and remote access technologies have no copay, while annual physical exams, health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, readmission prevention, wigs for hair loss, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, home and bathroom safety devices and modifications, and counseling services are not covered. Other preventive services, including glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit, are covered with no copay.
Hearing Services See details
The Freedom Platinum Plan Rx (HMO) covers hearing exams and routine hearing exams with no copay, as well as fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered up to a maximum of $750 per year, with no copay for prescription hearing aids of all types. This plan does not cover prescription hearing aids for inner ear, outer ear, or over the ear, and it does not cover OTC hearing aids.
Vision Services See details
The Freedom Platinum Plan Rx (HMO) covers vision services, including eye exams and eyewear. Eye exams and eyewear have no copay, and contact lenses, eyeglasses (lenses and frames), and upgrades are covered, with a $30 copay for upgrades and a combined maximum of $300 for eyewear.
Dental Services See details
Dental Services are covered by the Freedom Platinum Plan Rx (HMO), with no copay for oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, periodontics, and oral and maxillofacial surgery. Adjunctive general services, endodontics, 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, with prior authorization required. 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 Platinum Plan Rx (HMO), with a coinsurance of 20%.
Medical Equipment See details
Medical Equipment benefits are covered, with a 20% coinsurance for Durable Medical Equipment (DME), Prosthetic Devices, and Medical Supplies, and no copay. Diabetic Supplies have a coinsurance between 0% and 20%, while Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance, with no copay for either. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with a doctor referral required. Diagnostic Procedures/Tests have a copay of up to $100 and a coinsurance of at least 20%, while Lab Services have no copay. Diagnostic Radiological Services have a copay of at most $100.00, and Therapeutic Radiological Services have a coinsurance of at least 20%. Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Freedom Platinum Plan Rx (HMO) with no 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 none of the sub-services are covered, including Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services. Prior authorization and a doctor's referral are required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Freedom Platinum Plan Rx (HMO) with a doctor referral and prior authorization required. You will have no copay for days 1-20, and a $150 copay for days 21-100, and additional days beyond Medicare-covered for SNF, as well as non-Medicare-covered stays for SNF are not covered.
Other Services See details
The Freedom Platinum Plan Rx (HMO) covers Over-the-Counter (OTC) Items with no copay and a maximum benefit of $85.00 per month, and also covers Meal Benefits with no copay, prior authorization, and a doctor referral. 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.
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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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