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Aetna Medicare Freedom (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Freedom (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Aetna Medicare Freedom (PPO) in 2025, please refer to our full plan details page.
Aetna Medicare Freedom (PPO) is a PPO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Central AL. This plan received an overall rating of 4.5 out of 5 stars in 2025.
It's important to know that Aetna Medicare Freedom (PPO) 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 Aetna Medicare Freedom (PPO).
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 Aetna Medicare Freedom (PPO), 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 $10.00. 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 a $590.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $14000.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $14000.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 Aetna Medicare Freedom (PPO) plan has an enhanced alternative drug benefit. The plan has a $590 deductible. After the deductible is met, you will pay either a copay or coinsurance for your prescriptions. For preferred generic drugs, you will pay no copay at preferred pharmacies and mail order, and a $12 copay at standard pharmacies.
Additional Benefits
The Aetna Medicare Freedom (PPO) plan offers comprehensive coverage with a variety of benefits. This plan includes coverage for inpatient hospital stays, outpatient services, and emergency services, each with varying copays. The plan also offers coverage for primary care, preventive services, hearing, vision, and dental, often with no copay or low copays for many services. Additional benefits include coverage for ambulance services, home health services, and skilled nursing facility care, with specific copays and coinsurance amounts. The plan also provides coverage for medical equipment, diagnostic services, and home infusion services. The plan does not cover services such as cardiac rehabilitation, private duty nursing, and certain other services.
Inpatient Hospital See details
Inpatient Hospital coverage includes Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, you pay a $275 copay for days 1-9, and no copay for days 10-90. For Inpatient Hospital Psychiatric, you pay a $407 copay for days 1-5, and no copay for days 6-90. Additional Days for Inpatient Hospital-Acute are covered with no copay. Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a copay between $0 and $275, and observation services with a $275 copay. The plan also covers ambulatory surgical center services and outpatient blood services with no copay, and outpatient substance abuse services with a $30 copay for individual and group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered under the Aetna Medicare Freedom (PPO) plan with an $80 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by Aetna Medicare Freedom (PPO). Ground Ambulance Services have a $295 copay, and Air Ambulance Services have 20% coinsurance, 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. For Emergency Services, the copay is $110, and there is no coinsurance; for Urgently Needed Services, the copay is $40, and there is no coinsurance; and for Worldwide Emergency Coverage and Worldwide Urgent Coverage, the copay is $110, and the copay for Worldwide Emergency Transportation is $295.
Primary Care See details
The Aetna Medicare Freedom (PPO) plan covers primary care physician services and physician specialist services with no copay, and covers chiropractic services with a $15 copay. Occupational therapy services, individual and group sessions for mental health specialty services, individual and group sessions for psychiatric services, and physical therapy and speech-language pathology services have a $30 copay. Other health care professional services have a copay between $0 and $30. Additional telehealth benefits have a 20% coinsurance and a copay between $0 and $30. Opioid treatment program services have a $30 copay. Podiatry services are not covered.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services with no copay, and an annual physical exam with no copay. Other services include Health Education, Additional Sessions of Smoking and Tobacco Cessation Counseling, Fitness Benefit, and Remote Access Technologies, all with no copay. Also covered are wigs for hair loss related to chemotherapy, with no copay and a maximum plan benefit coverage amount of $400. Kidney Disease Education Services have a 20% coinsurance. Other preventive services include Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, all with no copay.
Hearing Services See details
Hearing exams are covered with a $30 copay, and routine hearing exams and fitting/evaluation for hearing aids have no copay. Prescription hearing aids are covered with a maximum benefit of $500 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 have a copay of $0-$30, and eyewear has no copay, with a combined maximum plan benefit coverage of $410 every year.
Dental Services See details
Dental Services are covered, with a $30 copay for Medicare Dental Services, and a $2,000 annual maximum benefit. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery have no copay. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the Aetna Medicare Freedom (PPO) plan, with a $35 copay for Medicare Part B Insulin Drugs, and a coinsurance between 0% and 20% for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Freedom (PPO) plan, but require prior authorization. The coinsurance for this benefit is 20%.
Medical Equipment See details
Medical equipment is covered, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment. Durable Medical Equipment has a 20% coinsurance, and Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, while Diabetic Supplies have a 0-20% coinsurance and Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including diagnostic procedures/tests, lab services, diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services, are covered. Diagnostic procedures/tests have a copay between $0 and $95, and diagnostic radiological services have a copay up to $300. Lab services and outpatient X-ray services have no copay. Therapeutic radiological services have a coinsurance of at least 20%.
Home Health Services See details
Home Health Services are covered by the Aetna Medicare Freedom (PPO) plan 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 not covered by the Aetna Medicare Freedom (PPO) plan. Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are also not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214.
Other Services See details
The Aetna Medicare Freedom (PPO) plan covers Over-the-Counter (OTC) items with no copay, a maximum benefit coverage amount of $60 every three months, and includes nicotine replacement therapy. Acupuncture, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and other services are not covered.
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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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