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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 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 Douglas County. 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 $6500.00 (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 $6500.00 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 comprehensive coverage, including inpatient hospital stays with a copay, outpatient services with coinsurance, and emergency services with copays. This plan also provides coverage for primary care, preventive services with no copay, and hearing, vision, and dental services with copays and annual limits. Additionally, the plan covers home health, dialysis, medical equipment, and diagnostic services with varying cost-sharing, as well as ambulance services and transportation services.
Inpatient Hospital See details
Inpatient Hospital coverage includes Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, you pay a $275 copay for days 1-7, and no copay for days 8-90; additional days are covered with no copay. Inpatient Hospital Psychiatric services have a $225 copay for days 1-7, and no copay for days 8-90; additional days are not covered. Non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Outpatient Services include outpatient hospital services with a 20% coinsurance, and observation services with a $275 copay per day. Outpatient substance abuse services, and individual and group sessions for substance abuse, have a minimum 20% coinsurance and a maximum 20% coinsurance. Outpatient blood services are also covered.
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, and no coinsurance. Transportation Services to a plan-approved health-related location are covered for up to 24 one-way trips per year, but transportation to any health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Coverage are covered by the ATRIO Freedom (PPO) plan. Emergency Services have a $125 copay, and Urgently Needed Services have a $55 copay, while Worldwide Emergency Coverage has a $125 copay. Worldwide Emergency Transportation is not covered.
Primary Care See details
ATRIO Freedom (PPO) 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, and Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, and Opioid Treatment Program Services all have a $25 copay. Podiatry Services are not covered.
Preventive Services See details
The ATRIO Freedom (PPO) plan covers preventive services, including an annual physical exam and additional preventive services that require prior authorization, with no copay. The plan also covers Personal Emergency Response System (PERS) and Alternative Therapies, with a maximum benefit coverage amount of $18.50 per month and $100 every six months, respectively, as well as a Fitness Benefit with a maximum benefit of $250 per year.
Hearing Services See details
Hearing Services include routine hearing exams with a $45 copay, and fitting/evaluation for hearing aids. Prescription hearing aids are covered with a copay between $699 and $999 per year, while inner ear, outer ear, and over-the-ear prescription hearing aids are not covered. OTC hearing aids are not covered.
Vision Services See details
The ATRIO Freedom (PPO) plan covers vision services including eye exams with a $45 copay. Eyewear is covered up to a combined maximum of $150 every year for in-network services, and you are eligible for one pair of contact lenses and one pair of eyeglasses (lenses and frames) every year. Eyeglass lenses and frames are not covered.
Dental Services See details
Dental Services are covered under the ATRIO Freedom (PPO) plan, with a $45 copay for Medicare Dental Services and a maximum plan benefit of $400 every six months for other dental services. 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 covered, but orthodontics is covered under diagnostic and preventive dental.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. Insulin has a $35 copay, and the coinsurance is between 0% and 20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the ATRIO Freedom (PPO) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a 0-20% coinsurance and no copay, as well as Prosthetics/Medical Supplies with a coinsurance. Diabetic Equipment is covered, but Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services, are covered. Diagnostic Procedures/Tests have a copay between $0 and $20, Lab Services have a $20 copay, Diagnostic and Therapeutic Radiological Services have a coinsurance of at most 20%, and Outpatient X-Ray Services have a $20 copay.
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. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the ATRIO Freedom (PPO) plan. This includes Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the ATRIO Freedom (PPO) plan. You will have no copay for days 1-20, but will have a $150 copay 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
The ATRIO Freedom (PPO) plan covers acupuncture with a maximum benefit coverage amount of $100 every six months, and over-the-counter items with a maximum benefit coverage amount of $50 every three months. The plan also covers a meal benefit requiring prior authorization, and provides an annual wellness visit. Several additional services are not covered.
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