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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 Portland Counties and Lane 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 $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 range of benefits, including inpatient and outpatient hospital services with varying copays. Emergency services have a $125 copay, while primary care and preventive services often have no copay. The plan also covers hearing and vision services, with coverage for hearing exams and eyewear, and dental services up to $400 every three months. Additional benefits include ambulance and transportation services, home infusion, and dialysis services with coinsurance requirements. The plan covers medical equipment, diagnostic and radiological services, and home health services with no copay. Other services like acupuncture, over-the-counter items, and meal benefits are also available, but may have maximum coverage amounts.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you will pay a $100 copay for days 1-5, and no copay for days 6-90; additional days are covered with no copay. For Inpatient Hospital Psychiatric, you will pay a $100 copay for days 1-5, and no copay for days 6-90; additional days and non-medicare covered stays are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, are covered under the ATRIO Freedom (PPO) plan. Outpatient hospital services have a copay between $0 and $350, observation services have a $100 copay, and ambulatory surgical center services have a $25 copay. Individual and group sessions for outpatient substance abuse have a copay between $10 and $10, and outpatient blood services are covered with a waived three-pint deductible.
Partial Hospitalization See details
Partial Hospitalization is covered under the ATRIO Freedom (PPO) plan with a copay of $55.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services with a $300 copay. Transportation Services to a plan-approved health-related location are covered for 24 one-way trips per year, and transportation to any other health-related location is not covered.
Emergency Services See details
Emergency Services are covered by the ATRIO Freedom (PPO) plan, with a $125 copay and no coinsurance. Urgently Needed Services have a $30 copay and no coinsurance. Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $120 copay and no coinsurance, but Worldwide Emergency Transportation is not covered.
Primary Care See details
The ATRIO Freedom (PPO) plan covers primary care services, including chiropractic services with a $10 copay, and occupational therapy services with no copay. Physician specialist services have a $25 copay, while mental health and psychiatric individual and group sessions have a $10 copay. Additionally, physical therapy and speech-language pathology services have no copay, and additional telehealth benefits have a 0-25% coinsurance.
Preventive Services See details
The ATRIO Freedom (PPO) plan covers preventive services, including annual physical exams, with no copay. Other services like Fitness Benefit, Personal Emergency Response System (PERS), and Alternative Therapies are covered, but may have a maximum plan benefit coverage amount. Some services, such as Health Education, and several others, are not covered.
Hearing Services See details
Hearing services include coverage for hearing exams, routine hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids (all types), with a maximum benefit of $1,500 every year for prescription hearing aids. Inner ear, outer ear, and over the ear prescription hearing aids, as well as OTC hearing aids are not covered.
Vision Services See details
ATRIO Freedom (PPO) covers vision services, including routine eye exams with no copay for one visit every year, and eyewear. Eyewear includes contact lenses, eyeglasses (lenses and frames), and upgrades, but eyeglass lenses and eyeglass frames are not covered. Contact lenses have a maximum plan benefit coverage of $100 every year, and eyeglasses (lenses and frames) have a maximum plan benefit coverage of $200 every year.
Dental Services See details
The ATRIO Freedom (PPO) plan covers dental services, with a maximum benefit of $400 every three months for both in-network and out-of-network 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), maxillofacial prosthetics, implant services, prosthodontics (fixed), oral and maxillofacial surgery, and orthodontics are also covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the ATRIO Freedom (PPO) plan. Medicare Part B Insulin Drugs have a $35 copay and a coinsurance between 0% and 20%. 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 a 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a coinsurance between 0% and 20%, and Prosthetics/Medical Supplies with a coinsurance for Medicare-covered devices and supplies. 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. Diagnostic Procedures/Tests, and Lab Services are not covered. Diagnostic Radiological Services have a copay of at most $60.00, while Therapeutic Radiological Services have a copay of at most $20.00.
Home Health Services See details
Home Health Services are covered under the ATRIO Freedom (PPO) plan, with no copay or coinsurance. 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. Prior authorization is required for Cardiac Rehabilitation Services, but the plan does not cover any of the sub-services.
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 and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services benefits include acupuncture, over-the-counter (OTC) items, and meal benefits. Acupuncture is covered with a maximum plan benefit coverage amount of $100 every six months. OTC items are covered with a maximum benefit coverage amount of $150 every three months, and the coverage does not carry over if it is unused. Meal benefits are covered, and prior authorization is required. Annual Wellness Visits are covered once per year. Some services are covered but not offered, including Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), and others.
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