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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 FL. 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 $3400.00 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. In the initial coverage phase, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For preferred generic drugs, the copay is $10.00 at preferred and standard pharmacies, and also $10.00 at standard mail. For standard generic drugs, the copay is $85.00 at preferred mail and $90.00 at standard pharmacies, and $85.00 at standard mail. For preferred brand drugs, you pay 33% coinsurance at preferred and standard pharmacies, and also 33% coinsurance at standard mail.
Additional Benefits
The Freedom Platinum Rewards Plan Rx (HMO) offers a range of benefits with varying costs. You'll find no copay for primary care visits, routine hearing and eye exams, and many dental services. Hospital stays have a copay of $195 for the first five days, and then no copay for the next 85 days. The plan also covers outpatient services, emergency services, and ambulance services, each with specific copays and coinsurance. The plan provides coverage for hearing aids up to $750 per year, and vision care including eyeglasses and contact lenses with a combined maximum of $300 per year. Additionally, the plan includes coverage for OTC items and a meal benefit.
Inpatient Hospital See details
Inpatient Hospital coverage includes both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services, both of which require prior authorization and a doctor referral. For days 1-5, the copay is $195, and for days 6-90, there is no copay. Additional days and non-Medicare-covered stays for both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a $195 copay, and observation services, also with a $195 copay. Ambulatory Surgical Center (ASC) Services have a $25 copay, while Outpatient Blood Services have no copay. Outpatient Substance Abuse Services have a copay between $10 and $195 for individual and group sessions.
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, with prior authorization required. 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 for 20 one-way trips per year with no copay, while transportation to any health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by 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) covers primary care physician services with no copay, chiropractic services with a $10 copay, occupational therapy services with a $10 copay, physician specialist services with a $10 copay, and physical therapy and speech-language pathology services with a $10 copay. Mental health and psychiatric services, as well as opioid treatment program services, have a copay that varies between $0 and $10. Podiatry services are not covered.
Preventive Services See details
Preventive Services are covered, with no copay for Medicare-covered services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit. Annual Physical Exams, Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), 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 Benefit, 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, Home and Bathroom Safety Devices and Modifications, and Counseling Services are not covered.
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; you are allowed one routine hearing exam and one fitting/evaluation for hearing aids each year. Prescription hearing aids are covered, and are limited to a maximum of $750 per year, per ear, and have no copay. Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered, as well as OTC hearing aids.
Vision Services See details
Vision services include eye exams and eyewear, with no copay for eye exams. Eyeglasses (lenses and frames) and contact lenses are covered with no copay, and have a combined maximum plan benefit of $300 every year.
Dental Services See details
The Freedom Platinum Rewards Plan Rx (HMO) covers dental services, including oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, periodontics, and oral and maxillofacial surgery 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, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with a coinsurance between 0% and 20%. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered under the Freedom Platinum Rewards Plan Rx (HMO) with a coinsurance between 20% and 20%.
Medical Equipment See details
The Freedom Platinum Rewards Plan Rx (HMO) covers medical equipment, including Durable Medical Equipment (DME) with 20% coinsurance, Prosthetic Devices with 20% coinsurance, and Medical Supplies with 20% coinsurance; Durable Medical Equipment for use outside the home is not covered. Diabetic Supplies have between 0% and 20% coinsurance, while Diabetic Therapeutic Shoes/Inserts have 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Freedom Platinum Rewards Plan Rx (HMO). Diagnostic Procedures/Tests have a copay of up to $195 and at least 20% coinsurance, while Lab Services have no copay. Diagnostic Radiological Services have a copay of at most $195, while Therapeutic Radiological Services have at least 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 referral are required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Freedom Platinum Rewards Plan Rx (HMO) with prior authorization and a doctor referral required. For days 1-20, there is no copay, but for days 21-100, the copay is $150.
Other Services See details
The Freedom Platinum Rewards Plan Rx (HMO) covers Over-the-Counter (OTC) Items with no copay, and a maximum benefit coverage amount of $75.00 per month. The plan also covers a Meal Benefit with no copay, but requires prior authorization and a doctor's referral. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, and many other services are not covered.
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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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