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BlueAdvantage Freedom (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for BlueAdvantage Freedom (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on BlueAdvantage Freedom (PPO) in 2025, please refer to our full plan details page.
BlueAdvantage Freedom (PPO) is a PPO plan offered by BlueCross BlueShield of Tennessee available for enrollment in 2025 to people living in Statewide Tennessee + Northwest GA. This plan received an overall rating of 4.5 out of 5 stars in 2025.
It's important to know that BlueAdvantage 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 BlueAdvantage 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 BlueAdvantage 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 $40.00. You must continue to pay paying your reduced 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 $5750.00 (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 $5750.00 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 BlueAdvantage Freedom (PPO).
Additional Benefits
The BlueAdvantage Freedom (PPO) plan provides coverage for a wide range of services, including inpatient and outpatient hospital care, with varying copays depending on the specific service. The plan also covers ambulance and emergency services, with copays for each. Preventive services, primary care, hearing, vision, and dental services are also included, each with their own specific cost structures. Additional benefits with this plan include coverage for home infusion, dialysis, medical equipment, and diagnostic services, each with its own cost-sharing arrangements like copays and coinsurance. The plan also offers coverage for skilled nursing facilities, and other services like over-the-counter items. However, the plan does not cover cardiac rehabilitation services or certain other services.
Inpatient Hospital See details
Inpatient Hospital services, including Acute and Psychiatric, are covered. For Inpatient Hospital-Acute, you will pay a $175 copay for days 1-5, and no copay for days 6-90; for Inpatient Hospital Psychiatric, you will also pay a $175 copay for days 1-5, and no copay for days 6-90. Additional days for Inpatient Hospital-Acute are covered, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, as well as Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, are covered by the BlueAdvantage Freedom (PPO) plan. Outpatient Hospital Services have a $175 copay, Observation Services have a $200 copay, and Ambulatory Surgical Center (ASC) Services have a $125 copay. Individual and Group Sessions for Outpatient Substance Abuse are covered with a copay between $15 and $25. Outpatient Blood Services are also covered, with a waived three-pint deductible.
Partial Hospitalization See details
Partial Hospitalization is covered by the BlueAdvantage Freedom (PPO) plan, but requires prior authorization. You will have a $40 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required for all ambulance services. Ground ambulance services have a $250 copay, and air ambulance services have a 20% coinsurance, while transportation services to plan-approved health-related locations and any health-related locations are not covered.
Emergency Services See details
Emergency Services, including urgently needed services, are covered by the BlueAdvantage Freedom (PPO) plan. Emergency Services have a $140 copay, and no coinsurance. Urgently Needed Services have a $25 copay, and no coinsurance. Worldwide Emergency Services are covered, with Worldwide Emergency Coverage and Worldwide Urgent Coverage each having a $60 copay and no coinsurance, and Worldwide Emergency Transportation having a $250 copay and 20% coinsurance.
Primary Care See details
The BlueAdvantage Freedom (PPO) plan covers primary care physician services, chiropractic services with a $20 copay, occupational therapy services with a $25 copay, physician specialist services with a $25 copay, mental health specialty services, podiatry services, other health care professional services with a copay between $20 and $25, psychiatric services, physical therapy and speech-language pathology services with a $25 copay, additional telehealth benefits, and opioid treatment program services. Routine chiropractic care is not covered.
Preventive Services See details
Preventive Services, including Medicare-covered services, annual physical exams, and additional preventive services, are covered. However, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Home and Bathroom Safety Devices and Modifications, and Counseling Services are not covered.
Hearing Services See details
Hearing Services includes routine hearing exams for a $10 copay, with 1 visit covered every year, and fitting/evaluation for hearing aids. Prescription hearing aids (all types) are covered with a copay between $199 and $699 for 2 visits every year, but prescription hearing aids for the inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
The BlueAdvantage Freedom (PPO) plan covers vision services, including routine eye exams once per year with no copay, and eyewear with a combined maximum benefit of $225 per year for both in-network and out-of-network services. Contact lenses are covered once per year, and eyeglasses (lenses and frames) are covered once per year. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
The BlueAdvantage Freedom (PPO) plan covers dental services with a $25 copay for Medicare dental services. Other dental services are covered up to a maximum of $2500 per year, and include oral exams with 2 visits per year, dental x-rays, other diagnostic dental services, prophylaxis (cleaning) with 2 visits per year, fluoride treatment (prior authorization required) with 1 visit per year, and other preventive dental services. Restorative services, prosthodontics (removable and fixed), implant services, and oral and maxillofacial surgery are covered with 20% coinsurance, while adjunctive general services and maxillofacial prosthetics are not covered. Endodontics, periodontics, and implant services require prior authorization. Orthodontics is not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the BlueAdvantage Freedom (PPO) plan, and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%; for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the BlueAdvantage Freedom (PPO) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits are covered by the BlueAdvantage Freedom (PPO) plan, including Durable Medical Equipment (DME) with a 20% coinsurance and no copay, and Prosthetics/Medical Supplies with a 20% coinsurance and no copay. Diabetic Equipment is also covered, and Diabetic Therapeutic Shoes/Inserts have a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests with a copay between $0 and $35, and lab services with no copay and a coinsurance of at most 20%. Diagnostic radiological services have a copay of at least $110, and therapeutic radiological services have a copay of at least $50, while outpatient X-ray services have no copay.
Home Health Services See details
Home Health Services are covered by the BlueAdvantage Freedom (PPO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the BlueAdvantage Freedom (PPO) plan. This includes Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by BlueAdvantage Freedom (PPO), but require prior authorization. There is no copay for days 1-20, and a $214 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
Other Services include coverage for Over-the-Counter (OTC) Items with a $100 maximum benefit every three months, and a meal benefit for chronic illness, however, acupuncture, 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 are not covered.
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