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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 Lake Charles and Surrounding Parishes. 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 no drug deductible. Your prescription medication coverage will start immediately.
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:
Sign up for Aetna Medicare Freedom (PPO)
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Drug Coverage
The Aetna Medicare Freedom (PPO) plan has a $0 deductible for prescription drugs. During the initial coverage phase, you'll pay varying costs depending on the drug tier and pharmacy type. For example, preferred generic drugs have no copay at preferred pharmacies and mail order, but a $12 copay at standard pharmacies. After your total drug costs reach $2,000, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs. However, if you qualify for the low-income subsidy (LIS), you will pay $0.00.
Additional Benefits
The Aetna Medicare Freedom (PPO) plan offers a range of benefits with varying costs. Hospital stays include a copay, while outpatient services have a copay between $0 and $225. Emergency, urgently needed, and worldwide emergency services are covered with copays ranging from $45 to $295. The plan covers primary care with no copay, and specialist visits with a copay between $0 and $35. Preventive services and many vision and dental services have no copay, although hearing aids are only partially covered. Other benefits include coverage for ambulance, home infusion, dialysis, and medical equipment, each with specific copays or coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, with a copay of $225 per day for days 1-8 and no copay for days 9-90 for Inpatient Hospital-Acute. Inpatient Hospital Psychiatric has a copay of $407 for days 1-5 and no copay for days 6-90; however, 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, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have a copay between $0 and $225, observation services have a $225 copay, ambulatory surgical center services have no copay, and outpatient blood services have no copay. Outpatient substance abuse individual and group sessions have a copay of $30.
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, 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 health-related locations 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 have a $110 copay, Urgently Needed Services have a $45 copay, and Worldwide Emergency Services has a copay of $110 for Worldwide Emergency Coverage and Worldwide Urgent Coverage, and a $295 copay for Worldwide Emergency Transportation.
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 $25 copay, and physician specialist services with a copay between $0 and $35. The plan also covers mental health specialty services and psychiatric services with a $30 copay for individual and group sessions, and physical therapy and speech-language pathology services with a $25 copay. Additional telehealth benefits are covered with a 20% coinsurance and a copay between $0 and $50, and opioid treatment program services are covered with a $30 copay.
Preventive Services See details
Preventive services include an annual physical exam with no copay, and other preventive services with no copay for glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a welcome visit. Kidney disease education services have 20% coinsurance.
Hearing Services See details
Hearing exams have a $35 copay, routine hearing exams and fitting/evaluation for hearing aids have no copay. Prescription hearing aids have a $500 maximum plan benefit per ear per year, while OTC hearing aids, prescription hearing aids - inner ear, prescription hearing aids - outer ear, and prescription hearing aids - over the ear are not covered.
Vision Services See details
Vision services are covered, including eye exams and eyewear. Eye exams have a copay of $0-$35, while routine eye exams, other eye exam services, contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades have no copay. Eyewear has a combined maximum benefit of $315 every year.
Dental Services See details
Dental Services are covered under the Aetna Medicare Freedom (PPO) plan, with a $35 copay for Medicare Dental Services and a $1,300 annual maximum. 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, while 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, Medicare Part B Chemotherapy/Radiation Drugs with 0-20% coinsurance, and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required.
Dialysis Services See details
Dialysis services are covered by the Aetna Medicare Freedom (PPO) plan and require prior authorization. You are responsible for a 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 medical supplies and prosthetic devices also have a 20% coinsurance. 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 are covered by the Aetna Medicare Freedom (PPO) plan, with all diagnostic services requiring prior authorization. Diagnostic Procedures/Tests have a copay between $0 and $95, and Lab Services have no copay. Diagnostic Radiological Services have a copay up to $300, while Therapeutic Radiological Services have a coinsurance of at least 20%, and 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; however, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the Aetna Medicare Freedom (PPO) plan, but the plan does not cover any of the sub-services. There is a copay for the covered services, but the specific amount is not listed in the provided information.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Aetna Medicare Freedom (PPO) plan, with prior authorization required. There is no copay for days 1-20, and a $214 copay per day for days 21-100. Additional days beyond Medicare-covered for SNF, and Non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include coverage for Over-the-Counter (OTC) Items and Meal Benefits with no copay. 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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