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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. During the initial coverage phase, you will pay a copay for generic drugs, and coinsurance for preferred brand drugs. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The Freedom Platinum Plan Rx (HMO) offers a range of benefits with varying costs. For hospital stays, you'll pay a $40 copay for days 1-5, and no copay for days 6-90. Outpatient services have a $100 copay, while emergency services have a $120 copay. Primary care and preventive services are covered with no copay, and the plan also includes benefits for hearing, vision, and dental services with no copays for exams. The plan covers ambulance services with a copay of $200 for ground transport and 20% coinsurance for air transport. Prescription hearing aids are covered with a maximum benefit of $750 per year, while eyewear has a maximum benefit of $300 per year. The plan also offers coverage for home infusion, dialysis, medical equipment, and diagnostic services with varying copays and coinsurance, and home health services with no copay.
Inpatient Hospital See details
Inpatient Hospital coverage with the Freedom Platinum Plan Rx (HMO) requires prior authorization and a doctor referral. For Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, you will pay a $40 copay for days 1-5, and no copay for days 6-90.
Outpatient Services See details
Outpatient Services include coverage for 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.
Partial Hospitalization See details
Partial Hospitalization is covered under the Freedom Platinum Plan Rx (HMO) and requires prior authorization and a doctor referral. You will have a $55 copay for this benefit.
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 and cover up to 20 one-way trips per year, while 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. Emergency Services have a $120 copay, Urgently Needed Services have a $10 copay, and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have a $500 copay.
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 have no copay, and the plan also offers chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, other health care professional services, psychiatric services, and opioid treatment program services with no copay. The plan does not cover podiatry services.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services with no copay, and additional services with a copay; annual physical exams, health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, 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, and enhanced disease management are not covered. Fitness Benefit, Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline), Kidney Disease Education Services, 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 and routine hearing exams with no copay, as well as fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered with a maximum plan benefit of $750 per year, but inner ear, outer ear, and over the ear prescription hearing aids are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams and eyewear have no copay, and eyewear has a combined maximum plan benefit of $300 per year; however, eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
Dental Services are covered under the Freedom Platinum Plan Rx (HMO), with no copay for Medicare Dental Services, 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, but require prior authorization. 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
The Freedom Platinum Plan Rx (HMO) covers medical equipment, including durable medical equipment with a 20% coinsurance and requiring authorization, and prosthetic devices and medical supplies with a 20% coinsurance. Diabetic equipment is covered, including diabetic supplies with a 0-20% coinsurance and diabetic therapeutic shoes/inserts with a 20% coinsurance. Durable medical equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including all diagnostic and radiological services, but prior authorization and a doctor referral are required. Diagnostic Procedures/Tests have a copay of up to $100 and a coinsurance of at least 20%, Lab Services have no copay, and Therapeutic Radiological Services have a coinsurance of at least 20%.
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 Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. A doctor's referral and prior authorization are required, and there is a copay for some services.
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. There is no copay for days 1-20, and a $150 copay for days 21-100; additional days beyond Medicare-covered for SNF and 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 plan benefit coverage amount of $55.00 every month. The plan does not cover 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. The Meal Benefit is covered with no copay, requiring prior authorization and a doctor referral.
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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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