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Freedom Platinum Rewards Plan Rx (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Freedom Platinum Rewards 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 Rewards Plan Rx (HMO) in 2025, please refer to our full plan details page.
Freedom Platinum Rewards Plan Rx (HMO) is a HMO plan offered by Elevance Health, Inc. available for enrollment in 2025 to people living in Select Counties in Florida. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Freedom Platinum Rewards 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 Rewards 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 Rewards 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. Additionally, this plan comes with a Part B Premium reduction of $174.70. You must continue to pay paying your reduced 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 $3200.00 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 Rewards Plan Rx (HMO) has a $0 deductible for prescription drugs. During the initial coverage phase, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For example, a preferred generic drug has a $5 copay, while a preferred brand drug has 30% coinsurance. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you will pay nothing for covered drugs. If you qualify for the low-income subsidy, you may have your premium reduced.
Additional Benefits
The Freedom Platinum Rewards 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 primary care and specialist visits with a copay, and preventive services with no copay. Hearing exams, routine hearing exams, and vision eye exams have no copay, while prescription hearing aids and eyewear are covered up to a certain amount. Dental services, home infusion, and dialysis services are covered with no copay or coinsurance. The plan also covers medical equipment, diagnostic and radiological services, and home health services with no copay or coinsurance. Emergency services have a copay, while other services like over-the-counter items and meal benefits are covered with no copay.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric care, require prior authorization and a doctor's referral. For days 1-5, the copay is $195, and for days 6-90, there is no copay.
Outpatient Services See details
Outpatient Services include coverage for outpatient hospital services with a $195 copay, observation services with a $195 copay, ambulatory surgical center (ASC) services with a $50 copay, and outpatient substance abuse services with copays ranging from $20 to $195 for individual and group sessions. Outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the Freedom Platinum Rewards 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, including all ambulance services and transportation services to plan-approved health-related locations. Ground ambulance services have a $200 copay, while air ambulance services have a 20% coinsurance. Transportation services have no copay and are limited to 20 one-way trips per year to plan-approved health-related locations; transportation to any health-related location is not covered.
Emergency Services See details
Emergency Services, including Urgently Needed Services and Worldwide Emergency Services, are covered under the Freedom Platinum Rewards 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 Rewards Plan Rx (HMO) plan covers primary care physician services with no copay, while chiropractic services require a $20 copay. Occupational Therapy Services, Physician Specialist Services, Physical Therapy and Speech-Language Pathology Services, Individual Sessions for Mental Health Specialty Services, and Group Sessions for Mental Health Specialty Services have a $20 copay, and Other Health Care Professional services have a copay between $0 and $20. Psychiatric Services and Opioid Treatment Program Services are covered, and Individual and Group Sessions have a $20 copay. Podiatry Services are not covered.
Preventive Services See details
The Freedom Platinum Rewards Plan Rx (HMO) covers preventive services, with no copay for Medicare-covered preventive services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit. This plan does not cover 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, enhanced disease management, telemonitoring services, home and bathroom safety devices and modifications, or counseling services.
Hearing Services See details
Hearing Services include hearing exams, routine hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids. Hearing exams and routine hearing exams have no copay, and fitting/evaluation for hearing aids have no copay for 1 visit per year. Prescription hearing aids are covered up to $750 per year, and have no copay for 2 hearing aids per year, while inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have no copay. Eyewear has no copay, with a combined maximum plan benefit of $300 every year; however, eyeglass lenses and eyeglass frames are not covered. Upgrades have a $30 copay.
Dental Services See details
The Freedom Platinum Rewards Plan Rx (HMO) covers dental services, including oral exams, dental x-rays, cleaning, fluoride treatment, periodontics, and oral and maxillofacial surgery, with no copay for these services. 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 by the Freedom Platinum Rewards Plan Rx (HMO). Medicare Part B Insulin Drugs have a $35 copay. 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 by the Freedom Platinum Rewards Plan Rx (HMO) with a coinsurance between 20% and 20%.
Medical Equipment See details
Medical Equipment benefits include 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. Prosthetics/Medical Supplies and Diabetic Equipment have a 20% coinsurance, and Diabetic Supplies have between 0% and 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Freedom Platinum Rewards Plan Rx (HMO). Diagnostic Procedures/Tests have a maximum copay of $195 and at most 20% coinsurance, while Lab Services have no copay. Diagnostic Radiological Services have a copay of at most $195, and Therapeutic Radiological Services have at most 20% coinsurance. Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Freedom Platinum Rewards 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 Rewards Plan Rx (HMO). Prior authorization and a doctor's referral are required for coverage.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the Freedom Platinum Rewards Plan Rx (HMO) with prior authorization and a doctor referral. For days 1-20, there is no copay, and for days 21-100, the copay is $150.
Other Services See details
Under Other Services, 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. Over-the-counter items are covered with no copay, with a maximum plan benefit coverage amount of $65.00 every month, and the plan offers Nicotine Replacement Therapy (NRT). Meal benefits are covered with no copay, and require prior authorization and a doctor referral.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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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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