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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 Washoe. 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 $4150.00 (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 $4150.00 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 a variety of benefits, including no copay for inpatient hospital stays and home health services, along with coverage for outpatient services and ambulance services with varying copays. This plan also includes coverage for hearing, vision, and dental services, with specific maximum benefit amounts and copays for certain services. Additionally, the plan covers diagnostic and radiological services, home infusion, and medical equipment with coinsurance requirements.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, with no copay for Medicare-covered stays. For Inpatient Hospital Psychiatric services, there is a $100 copay for days 1-5, and no copay for days 6-90, but additional days and non-Medicare covered stays are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services with a copay of $0-$350, observation services with a $100 copay, ambulatory surgical center services with a $25 copay, outpatient substance abuse services with a $10 copay for both individual and group sessions, and outpatient blood services.
Partial Hospitalization See details
Partial Hospitalization is covered by the ATRIO Freedom (PPO) plan. The copay for this benefit is $55.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the ATRIO Freedom (PPO) plan, with a $300 copay for both ground and air ambulance services. Transportation services to a plan-approved health-related location are covered up to 24 one-way trips per year, while 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 by the ATRIO Freedom (PPO) plan. Emergency Services have a $125 copay, Urgently Needed Services have a $30 copay, and Worldwide Emergency Coverage has a $120 copay. Worldwide Urgent Coverage also has a $120 copay, while Worldwide Emergency Transportation is not covered.
Primary Care See details
ATRIO Freedom (PPO) covers primary care, including primary care physician services, chiropractic services with a $10 copay for routine care, occupational therapy services with no copay, physician specialist services with a $25 copay, mental health specialty services with a $10 copay for individual and group sessions, psychiatric services with a $10 copay for individual and group sessions, physical therapy and speech-language pathology services with no copay, additional telehealth benefits with 0-25% coinsurance, and opioid treatment program services with a $10 copay. Podiatry services are not covered.
Preventive Services See details
The ATRIO Freedom (PPO) plan covers preventive services, including Medicare-covered services with no copay, annual physical exams, and additional preventive services that require prior authorization. The plan also covers Personal Emergency Response Systems (PERS) with a maximum benefit coverage amount of $18.50 every month, alternative therapies with a maximum benefit coverage amount of $100 every six months, and a fitness benefit for memory fitness with a maximum benefit coverage amount of $100 every year; however, health education, in-home safety assessments, Medical Nutrition Therapy (MNT), and several other services are not covered.
Hearing Services See details
Hearing Services include coverage for routine hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids, with a $1500 maximum plan benefit per year for in-network services, and no copay or coinsurance. Prescription hearing aids (inner ear, outer ear, and over the ear) and OTC hearing aids are not covered.
Vision Services See details
Vision Services are covered, including routine eye exams with one visit per year, and eyewear, including contact lenses and eyeglasses (lenses and frames). Contact lenses have a maximum benefit coverage amount of $100 per year, and eyeglasses (lenses and frames) have a maximum benefit coverage amount of $200 per year. Eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
The ATRIO Freedom (PPO) plan covers a variety of dental services, including oral exams, dental x-rays, and cleanings with no copay. This plan has a maximum benefit of $350 every three months for both in-network and out-of-network services, and it also covers orthodontic services with no copay.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance that ranges from 0% to 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance that ranges from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered under the ATRIO Freedom (PPO) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits are covered, with Durable Medical Equipment (DME) requiring prior authorization and a 20% coinsurance, and Prosthetic Devices also with a 20% coinsurance. Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance, while Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, but Diagnostic Procedures/Tests, Lab Services, and Outpatient X-Ray Services are not covered. Diagnostic Radiological Services have a copay of at most $60, and Therapeutic Radiological Services have a copay of at most $20.
Home Health Services See details
Home Health Services are covered by the ATRIO Freedom (PPO) plan with no copay and no coinsurance, but authorization is required. Additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the ATRIO Freedom (PPO) plan. Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are also not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the ATRIO Freedom (PPO) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $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 plan benefit of $100 every six months, and over-the-counter items with a maximum plan benefit of $100 every three months. Also covered is a meal benefit, and an annual wellness visit. However, the plan does not cover 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.
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