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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 Select Parishes in LA. 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.
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 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 deductible of $590. Once you meet the deductible, you will pay 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. For standard generic drugs, you will pay 24% coinsurance. For preferred brand and non-preferred drugs, you will pay 25% coinsurance. After your yearly out-of-pocket drug costs reach $2000, you pay nothing for Part D covered drugs.
Additional Benefits
The Aetna Medicare Freedom (PPO) plan offers a range of benefits, including inpatient hospital stays with varying copays, and outpatient services with copays depending on the service. This plan also covers primary care with no copay for many services, along with vision and dental services, and offers coverage for hearing exams, and hearing aids. Additionally, the plan provides coverage for emergency services, ambulance services, and home health services.
Inpatient Hospital See details
The Aetna Medicare Freedom (PPO) plan covers inpatient hospital stays, with a copay of $245 for days 1-7 and no copay for days 8-90 for acute care, and a copay of $407 for days 1-5 and no copay for days 6-90 for psychiatric care. Additional days for inpatient psychiatric are not covered, and non-Medicare-covered stays and upgrades for inpatient hospital acute and psychiatric are also not covered.
Outpatient Services See details
Outpatient Services with the Aetna Medicare Freedom (PPO) plan includes coverage for outpatient hospital services with a copay between $0 and $245, and observation services with a $245 copay. This plan also covers ambulatory surgical center services with no copay, outpatient substance abuse services with a $30 copay for both individual and group sessions, and outpatient blood services with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Aetna Medicare Freedom (PPO) plan, but requires prior authorization. You will have an $80 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Aetna Medicare Freedom (PPO) plan, with prior authorization required for all ambulance services. Ground ambulance services have a $295 copay, while air ambulance services have a 20% coinsurance; 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 by the Aetna Medicare Freedom (PPO) plan. Emergency Services and Worldwide Emergency Coverage have a $110 copay, Urgently Needed Services has a $45 copay, and Worldwide Emergency Transportation has a $295 copay. Worldwide Urgent Coverage also has a $110 copay.
Primary Care See details
The Aetna Medicare Freedom (PPO) plan covers primary care physician services with no copay, chiropractic services with a $15 copay, occupational therapy services with a $30 copay, physician specialist services with a $0-$40 copay, mental health specialty services with a $30 copay, other health care professional services with a $0-$40 copay, psychiatric services with a $30 copay, physical therapy and speech-language pathology services with a $30 copay, additional telehealth benefits with a 20% coinsurance and $0-$45 copay, and opioid treatment program services with a $30 copay. Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
Preventive Services include no copay for annual physical exams, Medicare-covered zero dollar preventive services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit. Additionally, wigs for hair loss related to chemotherapy have no copay, with a maximum plan benefit coverage amount of $400 per year, and kidney disease education services have a 20% coinsurance.
Hearing Services See details
Hearing exams are covered with a $40 copay, routine hearing exams are covered with no copay for 1 visit every year, and fitting/evaluation for hearing aids are covered with no copay for 1 visit every year. Prescription hearing aids are covered, with a maximum plan benefit of $500 per ear every year and no copay for 2 visits every year for Prescription Hearing Aids (all types), but prescription hearing aids (inner ear, outer ear, and over the ear) are not covered, nor are OTC hearing aids.
Vision Services See details
Vision services are covered, including eye exams and eyewear. Eye exams have a copay of $0-$40, and routine eye exams and other eye exam services have no copay. Eyewear, including contact lenses, eyeglasses, eyeglass lenses, eyeglass frames, and upgrades, have no copay, with a combined maximum benefit of $370 per year.
Dental Services See details
Dental Services includes coverage for Medicare Dental Services with a $40 copay, and other services like oral exams, dental x-rays, and cleanings with no copay. This plan has a maximum benefit of $1500 per year for both in-network and out-of-network services. 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 have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Aetna Medicare Freedom (PPO) plan, but require prior authorization. You will pay 20% coinsurance for these services.
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, while prosthetics and medical supplies have a 20% coinsurance with no copay, and diabetic supplies have a 0-20% coinsurance, with no copay for diabetic therapeutic shoes/inserts.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including all diagnostic, radiological, and lab services. Diagnostic Procedures/Tests have a copay between $0 and $95, while Lab Services have no copay. Diagnostic Radiological Services have a copay of at most $300, and Therapeutic Radiological Services have a coinsurance of at least 20%. Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Aetna Medicare Freedom (PPO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but none of the listed sub-services are covered. The plan does not specify the copay or coinsurance for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Aetna Medicare Freedom (PPO) plan. There is no copay for days 1-20, and a $214 copay per day for days 21-100.
Other Services See details
The Aetna Medicare Freedom (PPO) plan's "Other Services" benefit includes over-the-counter items with no copay, a $15 maximum benefit every three months, and coverage for Nicotine Replacement Therapy (NRT). 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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