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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 2026, 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 4.5 out of 5 stars in 2026.
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 $2750.00 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) features a $0 drug deductible, meaning your prescription drug coverage begins immediately. For Tier 1 preferred generic drugs, you will pay no copay for a one-, two-, or three-month supply at preferred and standard pharmacies, as well as through standard mail order. Tier 2 preferred brand drugs require a low $10 copay for a one-month supply at retail pharmacies, while standard mail order offers a discounted $20 copay for a three-month supply. Tier 3 non-preferred drugs carry a $50 copay at preferred pharmacies and standard mail order, or a $55 copay at standard pharmacies for a one-month supply. For a three-month supply of Tier 3 drugs, standard mail order provides savings with a $100 copay compared to up to $165 at standard pharmacies. High-cost Tier 4 specialty drugs require a 33% coinsurance for a one-month supply across preferred, standard, and mail-order options.
Additional Benefits
The Freedom Platinum Plan Rx (HMO) offers comprehensive medical coverage designed to minimize your out-of-pocket costs through low copays and no coinsurance on many key services. Members enjoy no copay and no coinsurance for primary care doctor visits, routine preventive care, and home health services. For more specialized care, inpatient hospital stays require a $75 daily copay for the first seven days with no copay thereafter, while specialist visits require a low $15 copay. This plan also features robust supplemental benefits, including no copays or coinsurance for routine dental cleanings, annual eye exams, and routine hearing tests. You will receive up to $400 annually for eyewear, a $750 annual allowance per ear for prescription hearing aids, and an $80 monthly allowance for over-the-counter items with no copay. Other essential needs like durable medical equipment are covered with no copay and a 20% coinsurance, ensuring affordable access to necessary medical supplies.
Inpatient Hospital See details
Freedom Platinum Plan Rx (HMO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $75 daily copay for days 1 through 7 and no copay for days 8 through 90. Prior authorization and referrals are required, and certain services such as additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services under the Freedom Platinum Plan Rx (HMO) are covered with no coinsurance, featuring a $150 copay for outpatient hospital and observation services and a $25 copay for ambulatory surgical center services. Outpatient substance abuse sessions require a $15 to $150 copay with no coinsurance, while outpatient blood services have no copay, no coinsurance, and no deductible.
Partial Hospitalization See details
Partial hospitalization is covered by the Freedom Platinum Plan Rx (HMO) with a $55 copay and no coinsurance. This benefit requires both a referral and prior authorization.
Ambulance and Transportation Services See details
Freedom Platinum 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, with prior authorization required. Transportation services are partially covered with prior authorization, offering up to 12 one-way trips per year to plan-approved locations with no copay and no coinsurance, though trips to any health-related location are not covered.
Emergency Services See details
Freedom Platinum Plan Rx (HMO) covers emergency services with a $150 copay (waived if admitted within 72 hours) and urgent care with a $10 copay, both with no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with a $500 copay per service and no coinsurance, up to a $100,000 maximum benefit.
Primary Care See details
Freedom Platinum Plan Rx (HMO) provides primary care physician services with no copay and no coinsurance, while specialist visits, physical therapy, occupational therapy, speech pathology, and mental health services cost a $15 copay with no coinsurance. Other healthcare services feature no coinsurance with copays ranging from $0 to $15 for health professionals and $0 to $150 for opioid treatment, though chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive services are partially covered under the Freedom Platinum Plan Rx (HMO) with no copays and no coinsurance, although prior authorization and referrals are required for many services. Covered benefits include glaucoma screenings, diabetes training, and a memory fitness benefit, while annual physical exams, health education, in-home safety assessments, and weight management are not covered.
Hearing Services See details
Hearing services are covered by the Freedom Platinum Plan Rx (HMO) with no copay and no coinsurance for Medicare-covered exams, routine exams, and fitting evaluations. While prescription hearing aids are covered up to $750 per ear annually with no copay or coinsurance, OTC hearing aids and inner, outer, or over-the-ear prescription hearing aids are not covered.
Vision Services See details
Freedom Platinum Plan Rx (HMO) partially covers vision services, featuring one annual routine eye exam and eyewear (contact lenses or eyeglasses up to $400 yearly) with no copay and no coinsurance. Standalone eyeglass lenses, standalone eyeglass frames, and other eye exam services are not covered, though eyewear upgrades are offered for a $30 copay.
Dental Services See details
Dental services are partially covered by the Freedom Platinum Plan Rx (HMO) with no copay and no coinsurance for covered benefits like oral exams, cleanings, x-rays, fluoride, restorative care, periodontics, and oral surgery. However, other diagnostic and preventive services, adjunctive general services, endodontics, prosthodontics, maxillofacial prosthetics, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
Freedom Platinum Plan Rx (HMO) covers home infusion bundled services with no copay, subject to prior authorization. Under this plan, Medicare Part B insulin has a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Freedom Platinum Plan Rx (HMO) with no copay and a 20% coinsurance.
Medical Equipment See details
Freedom Platinum Plan Rx (HMO) covers durable medical equipment, prosthetics, and diabetic supplies with no copays, though prior authorization is required. Most covered medical equipment and supplies are subject to a 20% coinsurance, while diabetic supplies range from no coinsurance to 20% coinsurance.
Diagnostic and Radiological Services See details
Freedom Platinum Plan Rx (HMO) covers diagnostic and radiological services, though prior authorization and referrals are required. Diagnostic procedures carry a $0 to $150 copay and 20% coinsurance, while lab services and outpatient X-rays feature no copay but require coinsurance. Diagnostic radiological services require a minimum $25 copay with no coinsurance, and therapeutic radiological services require both a copay and 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the Freedom Platinum Plan Rx (HMO) with no copay and no coinsurance. Please note that both a referral and prior authorization are required to receive these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered with no coinsurance under the Freedom Platinum Plan Rx (HMO), although some services are covered while cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services are not covered and require a $15 copay. Prior authorization and referrals are required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Freedom Platinum Plan Rx (HMO) with no coinsurance and no copay for the first 20 days. Days 21 through 100 require a $218 daily copay, prior authorization, and a referral, while additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Freedom Platinum Plan Rx (HMO) partially covers other services, offering over-the-counter (OTC) items and a chronic illness meal benefit with no copay and no coinsurance, while acupuncture is not covered. The OTC benefit provides up to $80 monthly for select items, and the meal benefit requires a referral and prior authorization.
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Every year, Medicare evaluates plans based on a 5-star rating system.
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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