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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 $2600.00 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 with no deductible. In the initial coverage phase, you will pay a copay for drugs in tiers 1 and 2, and 33% coinsurance for drugs in tier 3. During the initial coverage phase, the copay for preferred and standard generic drugs is $30 and $75/$80 respectively. 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 with varying costs. Hospital stays have a $75 copay for days 1-7, and no copay for days 8-90, while outpatient services have copays ranging from $0 to $150. Emergency services have a $120 copay, and transportation services to a plan-approved health-related location are covered with no copay for up to 12 one-way trips per year. This plan includes coverage for primary care with no copay, and specialist visits with a $15 copay. It also provides hearing, vision, and dental services with no copays, as well as home health services, and over-the-counter items. However, some services like ambulance, dialysis, and medical equipment have coinsurance requirements, and some services require prior authorization.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered with a $75 copay for days 1-7, and no copay for days 8-90. Additional days and non-Medicare covered stays are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a $150 copay, Observation Services with a $150 copay, Ambulatory Surgical Center (ASC) Services with a $25 copay, and Outpatient Substance Abuse Services with a copay between $15 and $150 for individual and group sessions. Outpatient Blood Services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the Freedom Platinum Plan Rx (HMO), but requires prior authorization and a doctor referral. You will pay a $55 copay for this benefit.
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. 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 Platinum Plan Rx (HMO). Emergency Services have a $120 copay, Urgently Needed Services have a $10 copay, and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation each have a $500 copay.
Primary Care See details
The Freedom Platinum Plan Rx (HMO) covers primary care physician services with no copay, and chiropractic, occupational therapy, physician specialist, mental health specialty, psychiatric, physical therapy and speech-language pathology services with a $15 copay. Podiatry services are not covered, and other health care professional services have a copay between $0 and $15.
Preventive Services See details
Preventive Services include coverage for Medicare-covered preventive services with prior authorization and referral, and also additional preventive services, with the copay depending on the service. The plan also covers kidney disease education services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a welcome visit, all 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, but prescription hearing aids for the inner ear, outer ear, and over the ear are not covered.
Vision Services See details
The Freedom Platinum Plan Rx (HMO) covers vision services, including eye exams and eyewear, with no copay. Routine eye exams are limited to one per year, and eyewear has a combined maximum benefit of $400 per year. Contact lenses are covered up to two pairs per year, while eyeglass lenses are not covered.
Dental Services See details
The Freedom Platinum Plan Rx (HMO) covers dental services including oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, periodontics, and oral and maxillofacial surgery with no copay, although some services have a limit on the number of visits per year. 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, including Medicare Part B Insulin Drugs with a $35 copay. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs are covered with 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 is covered, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance. Diabetic Supplies have a coinsurance between 0% and 20%, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including all diagnostic services and radiological services. Diagnostic Procedures/Tests have a coinsurance of at most 20% with a copay of at most $150, while Lab Services have no copay. Diagnostic Radiological Services have a copay of at most $150, and Therapeutic Radiological Services have a coinsurance of at most 20%, while 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 generally covered, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. A referral and prior authorization from your doctor are required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, requiring prior authorization and a doctor's referral. There is no copay for days 1-20, and a $150 copay for days 21-100; additional days beyond Medicare-covered and non-Medicare-covered stays 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 coverage amount of $85 per month. The plan also covers a meal benefit with no copay, but requires prior authorization and a doctor referral. However, acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and many other 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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