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Blue Cross Medicare Advantage Freedom Blue (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Blue Cross Medicare Advantage Freedom Blue (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Blue Cross Medicare Advantage Freedom Blue (PPO) in 2025, please refer to our full plan details page.
Blue Cross Medicare Advantage Freedom Blue (PPO) is a PPO plan offered by Aware Integrated, Inc. available for enrollment in 2025 to people living in 66 County Region. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Blue Cross Medicare Advantage Freedom Blue (PPO) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Blue Cross Medicare Advantage Freedom Blue (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 Blue Cross Medicare Advantage Freedom Blue (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 $100.00. 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.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $7500.00 (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 $7500.00 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
Prescription drugs are not covered by Blue Cross Medicare Advantage Freedom Blue (PPO).
Additional Benefits
The Blue Cross Medicare Advantage Freedom Blue (PPO) plan offers a range of benefits, including inpatient hospital stays with no copay for the first 60 days, and outpatient services with copays ranging from $10 to $150. You'll also have access to emergency services with a $125 copay, and primary care physician visits with a $20-$30 copay. Additional benefits include coverage for hearing and vision services, with no copay for routine hearing exams, and a combined maximum of $250 per year for eyewear. Dental services are covered with a $30 copay, and the plan also offers coverage for home health services with no copay, and over-the-counter items with a maximum benefit of $100 every three months.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, with prior authorization required. For Inpatient Hospital-Acute, there is no copay for days 1-60, while the copay for a Medicare-covered stay is $200. Additional days for Inpatient Hospital-Acute are covered, but Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered. Non-Medicare-covered Stay and Additional Days for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for outpatient hospital services with a copay of $10-$150, observation services with a $150 copay, and ambulatory surgical center services with a $100 copay. Outpatient substance abuse services are not covered, and outpatient blood services are covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the Blue Cross Medicare Advantage Freedom Blue (PPO) plan, but requires prior authorization. You will pay a $55 copay for this service.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Blue Cross Medicare Advantage Freedom Blue (PPO) plan. Ground and air ambulance services have a $200 copay, and there is no 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 Blue Cross Medicare Advantage Freedom Blue (PPO) plan. Emergency Services has a $125 copay, and Urgently Needed Services has a $35 copay, and Worldwide Emergency Coverage has a $125 copay, and Worldwide Emergency Transportation has a 20% coinsurance.
Primary Care See details
The Blue Cross Medicare Advantage Freedom Blue (PPO) plan covers primary care physician services, chiropractic services with a $20 copay, occupational therapy services with a $30 copay, physician specialist services with a $30 copay, and physical therapy and speech-language pathology services with a $30 copay. The plan does not cover individual or group sessions for mental health and psychiatric services, or podiatry services.
Preventive Services See details
Preventive services include coverage for Medicare-covered services, annual physical exams, health education, fitness benefits, remote access technologies, counseling services, kidney disease education services, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit. In-home safety assessments, personal emergency response systems, medical nutrition therapy, 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 benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, and home and bathroom safety devices and modifications are not covered.
Hearing Services See details
Hearing services include hearing exams and prescription hearing aids. Routine hearing exams have no copay, and you are limited to two exams per year, while fitting/evaluation for hearing aids has no copay and is unlimited. Prescription hearing aids (all types) have a copay between $599 and $899, and are limited to two per year; however, prescription hearing aids - inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
The Blue Cross Medicare Advantage Freedom Blue (PPO) plan covers vision services, including routine eye exams with one visit per year, and eyewear with a combined maximum of $250 per year for both in-network and out-of-network services, but upgrades are not covered. Contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames are all unlimited.
Dental Services See details
Dental services, including Medicare dental services, are covered with a $30 copay. Other dental services include oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, restorative services with 20% coinsurance, adjunctive general services with 0-20% coinsurance, endodontics with 20% coinsurance, periodontics with 0-20% coinsurance, prosthodontics (removable) with 20% coinsurance, implant services with 20% coinsurance, prosthodontics (fixed) with 20% coinsurance, and oral and maxillofacial surgery with 20% coinsurance. Maxillofacial prosthetics and orthodontics are not covered. This plan has a maximum benefit of $2,500 per year for in-network and out-of-network services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by this plan, including Medicare Part B Insulin Drugs with a copay between $0 and $35.00, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with coinsurance between 0% and 20%. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered by the Blue Cross Medicare Advantage Freedom Blue (PPO) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a 20-30% coinsurance and Prosthetic Devices with a 20% coinsurance, but Durable Medical Equipment for use outside the home is not covered. Medical Supplies have a 20% coinsurance, and Diabetic Therapeutic Shoes/Inserts have a 15% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services includes coverage for diagnostic procedures and tests with a copay between $0 and $20, and therapeutic radiological services with a coinsurance of 15%. Lab services and outpatient X-ray services are not covered.
Home Health Services See details
Home Health Services are covered by the Blue Cross Medicare Advantage Freedom Blue (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 the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization is required, and copays apply.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the Blue Cross Medicare Advantage Freedom Blue (PPO) plan. 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 are not covered.
Other Services See details
The Blue Cross Medicare Advantage Freedom Blue (PPO) plan covers acupuncture with a $20 copay, and covers Over-the-Counter (OTC) items with a maximum benefit coverage amount of $100 every three months. The plan also covers a meal benefit for a chronic illness, but does not cover Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, or several other services.
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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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