A non-government entity
New Hanover Health Advantage Freedom (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for New Hanover Health Advantage Freedom (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on New Hanover Health Advantage Freedom (HMO-POS) in 2025, please refer to our full plan details page.
New Hanover Health Advantage Freedom (HMO-POS) is a HMO-POS plan offered by The Carle Foundation available for enrollment in 2025 to people living in New Hanover, Pender, and Brunswick counties. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that New Hanover Health Advantage Freedom (HMO-POS) 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 New Hanover Health Advantage Freedom (HMO-POS).
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 New Hanover Health Advantage Freedom (HMO-POS), 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 $75.00. 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 $8950.00 (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 $8950.00 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 New Hanover Health Advantage Freedom (HMO-POS)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
Prescription drugs are not covered by New Hanover Health Advantage Freedom (HMO-POS).
Additional Benefits
The New Hanover Health Advantage Freedom (HMO-POS) plan offers a wide range of benefits, including coverage for inpatient hospital stays with varying copays, outpatient services with copays ranging from $35 to $300, and ambulance services with a $265 copay. You'll also find coverage for primary care visits, preventive services, hearing exams, vision exams, and dental services, each with its own set of copays or coinsurance. Additional benefits include coverage for home health services with no copay, dialysis services with 20% coinsurance, and medical equipment with 0-20% coinsurance. The plan also covers skilled nursing facility stays with a copay for days 21-41, and provides coverage for acupuncture and over-the-counter items. However, some services like cardiac rehabilitation and certain dental services are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, with a copay of $300 per day for days 1-6, and no copay for days 7-90 for Inpatient Hospital-Acute; Inpatient Hospital Psychiatric has a copay of $160 for days 1-10, and no copay for days 11-90. Additional Days for Inpatient Hospital-Acute is also covered, but 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 outpatient hospital services with a $300 copay, observation services with a $300 copay, ambulatory surgical center services with a $250 copay, and outpatient substance abuse services with a $35 copay for individual and group sessions. Outpatient blood services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the New Hanover Health Advantage Freedom (HMO-POS) plan, and requires prior authorization. There is a $50 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including both ground and air ambulance services, each with a $265 copay and no coinsurance. Transportation Services to plan-approved health-related locations are covered for up to 26 one-way trips per year via various modes of transportation, while transportation to any health-related location is not covered.
Emergency Services See details
Emergency Services, including Worldwide Emergency Services, are covered. Emergency Services have a $140 copay, while Urgently Needed Services have a $40 copay. Worldwide Emergency Coverage has a $140 copay, Worldwide Urgent Coverage has a $40 copay, and Worldwide Emergency Transportation has a $265 copay.
Primary Care See details
The New Hanover Health Advantage Freedom (HMO-POS) plan covers Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services. Chiropractic Services have a $20 copay, Physician Specialist Services have a $35 copay, Physical Therapy and Speech-Language Pathology Services have a $35 copay, and Additional Telehealth Benefits have a $0-$35 copay.
Preventive Services See details
Preventive services are covered, including Medicare-covered preventive services, annual physical exams, and additional preventive services. Some services are not covered, including health education, in-home safety assessments, 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 benefit, 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, home and bathroom safety devices and modifications, and counseling services. Personal Emergency Response System (PERS), Remote Access Technologies, Fitness Benefit, Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit are covered.
Hearing Services See details
Hearing services include hearing exams with a $35 copay. Prescription hearing aids are covered with a maximum plan benefit of $750 per year, per ear. Routine hearing exams and fittings/evaluations for hearing aids are covered once per year. Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, Prescription Hearing Aids - Over the Ear, and OTC Hearing Aids are not covered.
Vision Services See details
Vision Services includes coverage for eye exams with a copay of $0-$35, and eyewear with 20% coinsurance for contact lenses. Routine eye exams are covered once per year.
Dental Services See details
Dental services are covered, with a $35 copay for Medicare dental services. Other dental services have a coinsurance of 0% to 30%, and a maximum plan benefit of $3,000 per year. Some dental services, such as fluoride treatment 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 and 0-20% coinsurance, Medicare Part B Chemotherapy/Radiation Drugs with 0-20% coinsurance, and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required for this benefit.
Dialysis Services See details
Dialysis Services are covered by the New Hanover Health Advantage Freedom (HMO-POS) plan. You will pay 20% coinsurance for this service.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), Prosthetics, Medical Supplies, and Diabetic Equipment, is covered. DME has a 20% coinsurance and requires authorization, while Medical Supplies have a 20% coinsurance; Diabetic Supplies have a 0-20% coinsurance and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
The New Hanover Health Advantage Freedom (HMO-POS) plan covers diagnostic and radiological services, including diagnostic procedures/tests with a copay between $0 and $85, and lab services with no copay. Radiological services include diagnostic radiological services with a copay up to $275, therapeutic radiological services with a copay up to $35 and 20% coinsurance, and outpatient X-ray services with no copay.
Home Health Services See details
Home Health Services are covered by the New Hanover Health Advantage Freedom (HMO-POS) 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 New Hanover Health Advantage Freedom (HMO-POS) plan. The plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization. You will have no copay for days 1-20, a $214 copay for days 21-41, and no copay for days 42-100.
Other Services See details
Under Other Services, acupuncture is covered with a $35 copay, up to 15 treatments per year. Over-the-counter items are covered with a maximum benefit of $90 every three months. Meal benefit, 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.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
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.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved