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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 a $0 deductible for prescription drugs. In the initial coverage phase, you'll pay a copay or coinsurance depending on the drug tier and pharmacy. For example, preferred generic drugs have a $35 copay, while preferred brand drugs have 33% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase and pay nothing for covered Part D drugs. This plan may also reduce your premium if you qualify for the low-income subsidy.
Additional Benefits
The Freedom Platinum Plan Rx (HMO) offers a range of benefits with varying costs. Inpatient hospital stays have a copay, while outpatient services have copays depending on the service. Emergency, primary care, and home health services are covered with no copay. The plan includes coverage for hearing, vision, and dental services, with no copays for many services. It also covers ambulance and transportation services with copays or coinsurance, as well as home infusion and dialysis services with coinsurance. Diagnostic, radiological, and medical equipment services are covered with coinsurance, while other services like OTC items and meals are covered with no copay.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric, are covered with a $150 copay for days 1-7, and no copay for days 8-90. Additional days for inpatient hospital, 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, Individual and Group Sessions for Outpatient Substance Abuse with a copay between $10 and $150, and Outpatient Blood Services with no copay. Outpatient Hospital Services, Observation Services, and Outpatient Substance Abuse Services require prior authorization and a doctor's referral.
Partial Hospitalization See details
Partial Hospitalization is covered by 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 are covered with no copay, with a limit of 12 one-way trips per year. Transportation Services to any health-related location is 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 Services have 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 with no copay. Chiropractic services have a $10 copay, and occupational therapy services have a $10 copay. Physician specialist services, mental health specialty services, and psychiatric services have a $10 copay. Physical therapy and speech-language pathology services have a $10 copay. Other health care professional services have a copay between $0 and $10, and opioid treatment program services have a copay between $0 and $150. Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
The Freedom Platinum Plan Rx (HMO) covers preventive services, including Medicare-covered preventive services and additional preventive services not usually covered by Medicare. 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, and telemonitoring services are not covered.
Hearing Services See details
Freedom Platinum Plan Rx (HMO) covers hearing exams and fitting/evaluation for hearing aids with no copay, as well as prescription hearing aids (all types) with no copay, up to $750 per year. Prescription hearing aids for the inner ear, outer ear, and over the ear are not covered, as well as OTC hearing aids.
Vision Services See details
The Freedom Platinum Plan Rx (HMO) covers vision services, including eye exams and eyewear. Eye exams and eyewear have no copay, while upgrades have a $30 copay; contact lenses and eyeglasses (lenses and frames) are covered every year, with a combined maximum amount of $400.
Dental Services See details
The Freedom Platinum Plan Rx (HMO) covers several dental services, including oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, periodontics, and oral and maxillofacial surgery, each with no copay. However, 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, with prior authorization required. 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 under the Freedom Platinum Plan Rx (HMO), with a coinsurance of 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 Supplies have a 20% coinsurance, and Diabetic Therapeutic Shoes/Inserts has a coinsurance of 20%.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including all diagnostic services, diagnostic procedures/tests, and lab services, are covered. The plan has a copay for diagnostic procedures/tests and lab services, and a coinsurance of at most 20% for diagnostic procedures/tests. Outpatient X-Ray Services have no copay, and therapeutic radiological services have a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the Freedom Platinum Plan Rx (HMO) with no copay and no coinsurance, however, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but not in practice because the sub-services of Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Prior authorization and a doctor referral are required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization and a doctor's referral. You will have no copay for days 1-20, and a $150 copay for days 21-100; additional days beyond Medicare-covered SNF and non-Medicare-covered SNF 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 plan benefit coverage amount of $70.00 every month; however, acupuncture, Dual Eligible SNPs with Highly Integrated Services, 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. The plan also covers a Meal Benefit with no copay, but requires prior authorization and a doctor's referral.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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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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