A non-government entity
ATRIO Freedom (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for ATRIO Freedom (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on ATRIO Freedom (PPO) in 2025, please refer to our full plan details page.
ATRIO Freedom (PPO) is a PPO plan offered by ATRIO Health Plans available for enrollment in 2025 to people living in Jackson and Josephine Counties. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that ATRIO Freedom (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 ATRIO 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 ATRIO 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.
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 $7900.00 (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 $7900.00 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 ATRIO Freedom (PPO)
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 ATRIO Freedom (PPO).
Additional Benefits
The ATRIO Freedom (PPO) plan offers a wide range of benefits with varying costs. This plan includes coverage for inpatient and outpatient hospital services, with copays ranging from $0 to $375, depending on the service. You'll also have coverage for primary care, specialist visits, hearing, vision, and dental services, with copays between $20 and $45 for most services. Additional benefits include ambulance services with a $275 copay, and transportation services with 24 one-way trips per year. The plan also covers home health services with no copay, and skilled nursing facility services with copays ranging from $10 to $200. Other notable benefits are acupuncture, over-the-counter items, and a meal benefit.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services, both requiring prior authorization. For Inpatient Hospital-Acute, you pay a $375 copay for days 1-7, and no copay for days 8-90, while Additional Days are covered with no copay. For Inpatient Hospital Psychiatric, you pay a $375 copay for days 1-5, and no copay for days 6-90, while Additional Days and Non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient Services with the ATRIO Freedom (PPO) plan covers outpatient hospital services and observation services with a $375 copay, Ambulatory Surgical Center (ASC) Services with 20% coinsurance, outpatient substance abuse services with 20% coinsurance, and outpatient blood services.
Partial Hospitalization See details
Partial Hospitalization is covered under the ATRIO Freedom (PPO) plan, with a 20% coinsurance.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with a $275 copay for both Ground and Air Ambulance Services. Transportation Services to a plan-approved health-related location are covered for 24 one-way trips per year, with a variety of transportation modes available. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Coverage are covered under the ATRIO Freedom (PPO) plan. Emergency Services have a $125 copay, Urgently Needed Services have a $55 copay, and Worldwide Emergency Coverage has a $120 copay; all have no coinsurance. Worldwide Urgent Coverage has a $125 copay, and Worldwide Emergency Transportation is not covered.
Primary Care See details
The ATRIO Freedom (PPO) plan covers primary care physician services, chiropractic services with a $20 copay, occupational therapy services with a $25 copay, physician specialist services with a $35 copay, and mental health specialty services with a $25 copay. The plan also covers physical therapy and speech-language pathology services with a $25 copay, additional telehealth benefits with a copay between $0 and $25, and opioid treatment program services with a $25 copay. Podiatry services are not covered.
Preventive Services See details
Preventive services, including annual physical exams, are covered. Additional preventive services include alternative therapies with a $20 copay, and fitness benefits with a maximum of $250 per year. Health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss, weight management programs, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers, additional sessions of smoking cessation, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices, and counseling services are not covered.
Hearing Services See details
Hearing Services include coverage for hearing exams with a $45 copay, as well as fitting/evaluation for hearing aids with no coinsurance. Prescription hearing aids are covered up to a maximum of $1500 every year, but inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
The ATRIO Freedom (PPO) plan covers vision services, including eye exams with a $45 copay, and eyewear with a combined maximum of $150 per year for both in-network and out-of-network services. Contact lenses and eyeglasses (lenses and frames) are covered, with one pair allowed per year, but eyeglass lenses and frames are not covered.
Dental Services See details
The ATRIO Freedom (PPO) plan covers Medicare Dental Services with a $45 copay, and Other Dental Services with a $400 maximum benefit every six months. 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), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics are also covered.
Home Infusion bundled Services See details
Home Infusion bundled Services, including Medicare Part B drugs, are covered, but require prior authorization. For Medicare Part B insulin drugs, there is a $35 copay and a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the ATRIO Freedom (PPO) plan. The coinsurance for Dialysis Services is between 20% and 20%.
Medical Equipment See details
Medical Equipment benefits under the ATRIO Freedom (PPO) plan include Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a coinsurance between 0% and 20%, and Prosthetic Devices have a 20% coinsurance; however, DME for use outside the home and Diabetic Supplies and Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for Diagnostic Procedures/Tests with a copay between $0 and $50, and Diagnostic Radiological Services with a coinsurance up to 20%. Therapeutic Radiological Services also have a coinsurance up to 20%, and Outpatient X-Ray Services have a $20 copay. Lab Services are not covered.
Home Health Services See details
Home Health Services are covered by the ATRIO Freedom (PPO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the ATRIO Freedom (PPO) 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 under the ATRIO Freedom (PPO) plan, but require prior authorization. You will pay a copay of $10 for days 1-20, and a copay of $200 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
Under the ATRIO Freedom (PPO) plan, acupuncture is covered with a maximum benefit coverage amount of $100 every six months, and over-the-counter items are covered up to $50 every three months. The plan also covers a meal benefit and an annual wellness exam, but does not cover Dual Eligible SNPs with Highly Integrated Services, or the other services listed.
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