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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 $1750.00 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 generic drugs, and 33% coinsurance for preferred brand drugs. Once your total drug costs reach $2000, you enter the catastrophic coverage phase. During the catastrophic coverage phase, you will pay nothing for Part D covered drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit.
Additional Benefits
The Freedom Platinum Plan Rx (HMO) offers comprehensive coverage, including inpatient hospital stays with a $40 copay for the first 5 days, and no copay for days 6-90. Outpatient services have varying copays, such as $75 for outpatient hospital services, and $120 for emergency services. Many services, including primary care, preventive services, and home health services, have no copay. This plan also provides coverage for hearing, vision, and dental services, with no copay for eye exams, and a maximum benefit for hearing aids and eyewear. Additional benefits include ambulance and transportation services, home infusion, and medical equipment, each with specific copays or coinsurance. The plan does not cover certain services such as cardiac rehabilitation and additional hours of care.
Inpatient Hospital See details
The Freedom Platinum Plan Rx (HMO) covers inpatient hospital stays, including acute and psychiatric care, with a $40 copay for days 1-5, and no copay for days 6-90. Additional days and non-Medicare-covered stays for inpatient hospital are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services with a $75 copay, observation services with a $75 copay, and ambulatory surgical center services with a $25 copay. Outpatient substance abuse services are covered, with a copay between $0 and $75 for both individual and group sessions, and outpatient blood services are covered with no copay.
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 by the Freedom Platinum Plan Rx (HMO). Ground ambulance services have a $200 copay, while air ambulance services have a 20% coinsurance; transportation services to a plan-approved health-related location have no copay, with a limit of 12 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Freedom Platinum Plan Rx (HMO). Emergency Services has a $120 copay, and Urgently Needed Services has a $10 copay; Worldwide Emergency Services has 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, 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 sessions for mental health specialty services, individual and group sessions for psychiatric services, and physical therapy and speech-language pathology services have no copay. Chiropractic services require a doctor referral and prior authorization. Occupational therapy has a copay, while podiatry services are not covered.
Preventive Services See details
The Freedom Platinum Plan Rx (HMO) covers preventive services, including Medicare-covered services with no copay, but annual physical exams are not covered. Additional preventive services and kidney disease education services are covered with no copay, and other preventive services such as glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit are covered with no copay.
Hearing Services See details
The Freedom Platinum Plan Rx (HMO) covers hearing exams, routine hearing exams, and fitting/evaluation for hearing aids with no copay, but prescription hearing aids are covered with a maximum benefit of $750 per year. Prescription hearing aids for the inner ear, outer ear, and over the ear are not covered, nor are over-the-counter hearing aids.
Vision Services See details
Vision Services include eye exams and eyewear, with a $0 copay for eye exams and a $30 copay for upgrades. Eyeglass lenses and frames are not covered, while there is a combined maximum of $300 per year for eyewear.
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, all with no copay. 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 with 0-20% coinsurance, and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required.
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, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment, is covered. DME has a 20% coinsurance and requires authorization, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, while Diabetic Supplies have between 0% and 20% coinsurance and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests with a coinsurance of at most 20% and a copay of at most $75.00, Lab Services with no copay, Diagnostic Radiological Services with a copay of at most $75.00, Therapeutic Radiological Services with a coinsurance of at most 20%, and Outpatient X-Ray Services with no copay. Prior authorization and a doctor referral are required.
Home Health Services See details
Home Health Services are covered under 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 not covered by the Freedom Platinum Plan Rx (HMO). 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 prior authorization and a doctor referral. You will have 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) Other Services benefit covers Over-the-Counter (OTC) Items with no copay, and a maximum plan benefit coverage amount of $85.00 per month. 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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