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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 Klamath. 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. Additionally, this plan comes with a Part B Premium reduction of $25.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan has a $110.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
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 for core medical needs, featuring a low $10 copay for primary care visits and a $25 copay for specialist appointments with no coinsurance. For hospital care, inpatient stays require a $275 daily copay for days 1 through 7 followed by no copay, while emergency room visits carry a $125 copay that is waived upon admission. Most outpatient services, dialysis, and durable medical equipment are covered with a 20% coinsurance and no copay. Beyond standard medical care, this plan provides excellent supplemental benefits, including preventive and comprehensive dental services with no copay up to $300 every six months. Routine vision and hearing exams are available for a $45 copay, with additional allowances provided for eyewear and prescription hearing aids. Members also enjoy no copay for home health services, acupuncture, and up to 12 one-way transportation trips per year to approved locations.
Inpatient Hospital See details
ATRIO Freedom (PPO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $275 daily copay for days 1 through 7 and no copay for days 8 through 90. Unlimited additional acute care days are covered at no copay, but psychiatric additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
ATRIO Freedom (PPO) covers outpatient services, offering ambulatory surgical center and outpatient substance abuse services with no copay and 20% coinsurance. Outpatient hospital services require 20% coinsurance, observation services carry a $275 copay per day, and outpatient blood services are available with no copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization services are 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 per ground or air trip, subject to prior authorization. Transportation services are partially covered, offering up to 12 one-way trips per year to plan-approved locations with no copay or coinsurance, though trips to any health-related location are not covered.
Emergency Services See details
ATRIO Freedom (PPO) covers emergency services with a $125 copay and urgently needed services with a $50 copay, with no coinsurance for either service and copays waived if admitted to the hospital within 24 hours. Worldwide emergency and urgent care are partially covered up to a $250,000 maximum with a $125 copay and no coinsurance, though worldwide emergency transportation is not covered.
Primary Care See details
ATRIO Freedom (PPO) primary care benefits are partially covered, featuring a $10 copay for primary care visits and a $25 copay for specialists, mental health, and physical therapy, all with no coinsurance. While routine chiropractic care is covered for a $15 copay with no coinsurance, other chiropractic services and podiatry services are not covered.
Preventive Services See details
Preventive services are covered by ATRIO Freedom (PPO) with no copay and no coinsurance, including annual physical exams and kidney disease education. Additional preventive benefits are only partially covered, with alternative therapies and memory fitness included, while services like health education, nutritional counseling, and weight management are not covered.
Hearing Services See details
Hearing services are covered by ATRIO Freedom (PPO), featuring routine hearing exams for a $45 copay and no coinsurance, and up to two prescription hearing aids per year with a copay between $699 and $999 and no coinsurance. This benefit is partially covered as OTC hearing aids, alongside 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), which features annual routine eye exams for a $45 copay and no coinsurance, while other eye exams are not covered. Eyewear is covered with no copay, no coinsurance, and no deductible, providing up to $100 annually for contact lenses and up to $150 for eyeglasses (lenses and frames), though individual lenses and frames are not covered.
Dental Services See details
ATRIO Freedom (PPO) covers Medicare-covered dental services with a $45 copay and no coinsurance, while other preventive and comprehensive dental services are covered with no copay and no coinsurance. These other dental services, including cleanings, x-rays, and implants, are subject to a maximum benefit of $300 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, though prior authorization is required. Associated Medicare Part B drugs, including insulin, chemotherapy, and other drugs, carry a coinsurance ranging from no coinsurance to 20%, with insulin also requiring a copay of up to $35.
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 a 20% coinsurance, with prior authorization required. Diabetic equipment is partially covered with no copay and no coinsurance, although diabetic supplies and therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
ATRIO Freedom (PPO) covers diagnostic and radiological services, with prior authorization required for all services. Diagnostic tests and lab services require a copay of up to $20 and no coinsurance, while therapeutic radiology requires a 20% coinsurance with no copay, and outpatient X-rays carry a $20 copay plus coinsurance.
Home Health Services See details
ATRIO Freedom (PPO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
ATRIO Freedom (PPO) cardiac rehabilitation services require prior authorization and have no copay, but only some services are covered. Specifically, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered and require a 10% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by ATRIO Freedom (PPO) with no coinsurance, requiring a $10 daily copay for days 1 through 20 and a $203 daily copay for days 21 through 100. Prior authorization is required, and while a 3-day prior inpatient hospital stay is not needed, additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services covered by ATRIO Freedom (PPO) include acupuncture, meal benefits, an annual wellness visit, and over-the-counter (OTC) items, all with no copay and no coinsurance. The OTC benefit provides up to $25 every three months, though nicotine replacement therapy and naloxone are not covered.
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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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