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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 2026, 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 2.5 out of 5 stars in 2026.
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:
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Drug Coverage
Prescription drugs are not covered by ATRIO Freedom (PPO).
Additional Benefits
The ATRIO Freedom (PPO) plan offers robust medical coverage featuring no copay and no coinsurance for primary care doctor visits, while specialist visits require a $35 copay. For acute inpatient hospital stays, members pay a daily copay of $375 for the first seven days with no coinsurance, and emergency room visits carry a $125 copay. Additionally, standard preventive services, annual physical exams, and home health services are covered with no copay and no coinsurance. Essential extras like preventive and comprehensive dental care are covered with no copay and no coinsurance up to $400 every six months. While routine vision and hearing exams require a $45 copay, the plan provides prescription hearing aids up to $1,500 annually and eyewear up to $150 yearly with no copay. Members also benefit from a $50 quarterly over-the-counter allowance and up to 24 one-way transportation trips per year at no cost.
Inpatient Hospital See details
ATRIO Freedom (PPO) covers inpatient hospital services with no coinsurance, requiring a daily copay of $375 for days 1 to 7 of acute stays and days 1 to 5 of psychiatric stays, with no copay for remaining days. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
ATRIO Freedom (PPO) covers outpatient hospital and observation services with a $375 copay and no coinsurance. Ambulatory surgical center and outpatient substance abuse services require no copay and a 20% coinsurance, while outpatient blood services are covered with no copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by ATRIO Freedom (PPO) with no copay and a 20% coinsurance.
Ambulance and Transportation Services See details
ATRIO Freedom (PPO) covers ambulance services with a $275 copay and no coinsurance for both ground and air transport. Transportation services are partially covered with no copay or coinsurance, providing up to 24 one-way trips per year to plan-approved locations, while trips to any health-related location are not covered.
Emergency Services See details
ATRIO Freedom (PPO) covers emergency services with a $125 copay and no coinsurance, and urgently needed services with a $50 copay and no coinsurance, with both copays waived if admitted to the hospital within 24 hours. Worldwide emergency and urgent services are partially covered up to a $250,000 lifetime maximum with no coinsurance and copays of $120 and $125 respectively, though worldwide emergency transportation is not covered.
Primary Care See details
ATRIO Freedom (PPO) primary care benefits are partially covered, featuring no copay and no coinsurance for primary care provider visits, a $35 copay and no coinsurance for specialists, and copays from $0 to $25 with no coinsurance for therapy, telehealth, and mental health services. Podiatry services and non-routine chiropractic care are not covered.
Preventive Services See details
Preventive services under the ATRIO Freedom (PPO) plan are covered with no copay and no coinsurance for annual physical exams, kidney disease education, and other Medicare-covered preventive services. Additional preventive services are partially covered with no coinsurance, featuring alternative therapies for a $20 copay and a memory fitness benefit up to $250 yearly, though sub-services such as health education, in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, therapeutic massage, adult day health, nutritional/dietary services, home-based palliative care, in-home support, caregiver support, smoking cessation, enhanced disease management, telemonitoring, remote access, home/bathroom safety modifications, and counseling are not covered.
Hearing Services See details
Hearing services under the ATRIO Freedom (PPO) plan are partially covered, featuring one annual routine hearing exam for a $45 copay and no coinsurance, and prescription hearing aids with no copay, no coinsurance, and a $1,500 annual limit. OTC hearing aids, along with inner ear, outer ear, and over-the-ear prescription hearing aids, are not covered.
Vision Services See details
Vision Services are partially covered by ATRIO Freedom (PPO), offering one routine eye exam per year for a $45 copay and no coinsurance, with no deductible. Eyewear is covered with no copay, no coinsurance, and no deductible up to a $150 yearly limit for contacts or eyeglasses, though other eye exam services, separate eyeglass lenses, and separate eyeglass frames are not covered.
Dental Services See details
ATRIO Freedom (PPO) covers Medicare-covered dental services for a $45 copay and no coinsurance, while other preventive and comprehensive dental services are covered with no copay and no coinsurance. These additional dental services, which include exams, cleanings, and implants, are subject to a maximum benefit of $400 every six months for both in-network and out-of-network care.
Home Infusion bundled Services See details
ATRIO Freedom (PPO) covers home infusion bundled services with no copay, subject to prior authorization and step therapy. Covered Medicare Part B chemotherapy, radiation, and other drugs require no copay and 0% to 20% coinsurance, while Medicare Part B insulin is covered with a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the ATRIO Freedom (PPO) plan with no copay and a 20% coinsurance.
Medical Equipment See details
ATRIO Freedom (PPO) covers durable medical equipment, prosthetics, and medical supplies with no copay and 20% coinsurance, subject to prior authorization. Diabetic equipment is partially covered with no copay and no coinsurance, but diabetic supplies and diabetic therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
ATRIO Freedom (PPO) partially covers Diagnostic and Radiological Services, as lab services are not covered and prior authorization is required. Covered diagnostic procedures require no coinsurance and a copay ranging from no copay to $50, while radiological services range from a $20 copay with coinsurance for X-rays to a 20% coinsurance for therapeutic services.
Home Health Services See details
Home health services are covered by ATRIO Freedom (PPO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by ATRIO Freedom (PPO) with no copay and require prior authorization, though only some services are covered. Standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered under this benefit and are subject to a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
ATRIO Freedom (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, although prior authorization is required and additional days beyond the Medicare-covered limit are not covered. There is a daily copayment of $10 for days 1 through 20, which increases to a $200 daily copayment for days 21 through 100.
Other Services See details
Other Services covered under ATRIO Freedom (PPO) include acupuncture, an annual wellness exam, a limited-duration meal benefit, and a $50 quarterly over-the-counter allowance, all offered with no copay and no coinsurance. Prior authorization is required for the meal benefit, and some other miscellaneous 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
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