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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 $105.00. 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. During the initial coverage phase, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For preferred generic drugs, you will pay a $35 copay at preferred and standard pharmacies, and at standard mail order. For standard generic drugs, you will pay an $85 copay at preferred and standard mail order, and a $90 copay at standard pharmacies. For preferred brand drugs, you pay 33% coinsurance at preferred and standard pharmacies, as well as standard mail order.
Additional Benefits
The Freedom Platinum Rewards Plan Rx (HMO) offers a range of benefits with varying cost-sharing. Inpatient hospital stays have a copay, while outpatient services and emergency services have copays as well. Primary care, preventive, hearing, vision, and dental services often have no copay. This plan also includes coverage for ambulance, home infusion, dialysis, and medical equipment, with costs typically involving copays or coinsurance. Additional benefits include coverage for home health, cardiac rehabilitation, and skilled nursing facilities, along with over-the-counter items and a meal benefit.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric care, are covered with a $195 copay for days 1-5 and no copay for days 6-90. Additional days and non-Medicare-covered stays for both acute and psychiatric care are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services and observation services, are covered, and all require prior authorization and a doctor's referral. Outpatient hospital services and observation services each have a $195 copay, while ambulatory surgical center services have a $25 copay. Outpatient substance abuse services have copays between $25 and $195 for individual and group sessions, and 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. Prior authorization and a doctor referral are required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Freedom Platinum Rewards 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, but services to any health-related location are 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, and Urgently Needed Services have a $10 copay, while Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation each have a $500 copay.
Primary Care See details
Primary Care benefits include coverage for Primary Care Physician services with no copay, Chiropractic Services with a $20 copay, Occupational Therapy Services with a $25 copay, Physician Specialist Services with a $25 copay, and Mental Health Specialty Services with a $25 copay for individual and group sessions. The plan also covers Physical Therapy and Speech-Language Pathology Services with a $25 copay, Additional Telehealth Benefits, and Opioid Treatment Program Services with a copay ranging from $0 to $195. However, Routine Chiropractic Care and Podiatry Services are not covered.
Preventive Services See details
Preventive services are covered, including Medicare-covered zero-dollar preventive services. Additional preventive services, including Fitness Benefit, Remote Access Technologies, and Kidney Disease Education Services are covered with no copay.
Hearing Services See details
The Freedom Platinum Rewards Plan Rx (HMO) covers hearing exams, routine hearing exams, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered, with a maximum plan benefit of $750 per year, and a copay of $0 for all types of prescription hearing aids except for inner ear, outer ear, and over the ear hearing aids, which are not covered.
Vision Services See details
The Freedom Platinum Rewards Plan Rx (HMO) covers vision services, including eye exams with no copay. Eyewear is covered with no copay, up to a combined maximum of $150 per year, and contact lenses are covered with no copay, up to one pair per year. Eyeglass lenses and frames are not covered, but 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, 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. Other Medicare Part B Drugs and Medicare Part B Chemotherapy/Radiation Drugs are covered with 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 are covered under the Freedom Platinum Rewards Plan Rx (HMO). Durable Medical Equipment (DME) has a 20% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices have a coinsurance of 20%, and Medical Supplies have a 20% coinsurance. Diabetic Supplies have a coinsurance between 0% and 20%, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, diagnostic procedures/tests, lab services, all radiological services, diagnostic radiological services, therapeutic radiological services, and outpatient X-Ray services. Diagnostic procedures/tests have a coinsurance of at most 20% and a copay of up to $195, while lab services have no copay. Diagnostic radiological services have a copay of up to $195, and therapeutic radiological services have a coinsurance of at most 20%. Outpatient X-Ray services have no copay.
Home Health Services See details
Home Health Services are covered under 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 covered, but Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. 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 Rewards Plan Rx (HMO) and 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 and non-Medicare-covered SNF stays are not covered.
Other Services See details
Other Services include Over-the-Counter (OTC) Items and a Meal Benefit. The OTC benefit has no copay and the plan provides a $50 monthly allowance. The Meal Benefit has no copay and requires prior authorization and a doctor referral. 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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