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Freedom Blue PPO Signature (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Freedom Blue PPO Signature (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Freedom Blue PPO Signature (PPO) in 2025, please refer to our full plan details page.
Freedom Blue PPO Signature (PPO) is a PPO plan offered by Highmark Health available for enrollment in 2025 to people living in Delaware. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Freedom Blue PPO Signature (PPO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Freedom Blue PPO Signature (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 Freedom Blue PPO Signature (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 $2.00. 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.
This plan has no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $10000.00 (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 $10000.00 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
The Freedom Blue PPO Signature (PPO) plan has an enhanced alternative drug benefit. This plan has no deductible for prescription drugs. In the initial coverage phase, you will pay a $5 copay for preferred generic drugs at a preferred pharmacy, and 25% coinsurance for standard generic drugs at a preferred pharmacy. For preferred brand drugs, you will pay 44% coinsurance at a preferred pharmacy. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The Freedom Blue PPO Signature (PPO) plan offers a range of benefits with varying costs. Inpatient hospital stays have copays, while outpatient services, including emergency services and primary care, have copays ranging from $0 to $300. The plan also includes coverage for hearing and vision services, with copays for exams and allowances for eyewear and hearing aids. Additional benefits encompass dental, home infusion, dialysis, medical equipment, and diagnostic services, often with coinsurance or copays. Home health services are covered with no copay, while skilled nursing facilities have copays depending on the length of stay. The plan also provides an OTC allowance, but excludes some services like acupuncture, private duty nursing, and certain rehabilitation services.
Inpatient Hospital See details
Inpatient Hospital benefits include coverage for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, you pay a $220 copay for days 1-5, and no copay for days 6-90; for Inpatient Hospital Psychiatric, you pay a $425 copay for days 1-3, and no copay for days 4-90. Additional Days for Inpatient Hospital-Acute are covered, but Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered, and Additional Days for Inpatient Hospital Psychiatric, and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient Hospital Services and Observation Services have a $300 copay, Ambulatory Surgical Center Services have a $225 copay, and Individual and Group Sessions for Outpatient Substance Abuse have a copay between $40 and $40.
Partial Hospitalization See details
Partial Hospitalization is covered by the Freedom Blue PPO Signature (PPO) plan. There is no information available about the cost of this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Freedom Blue PPO Signature (PPO) plan. Ground and air ambulance services both have a $225 copay, with no coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including Urgently Needed Services and Worldwide Emergency Services, are covered by the Freedom Blue PPO Signature (PPO) plan. Emergency Services have a $125 copay, Urgently Needed Services have a $40 copay, Worldwide Emergency Coverage has a $125 copay, Worldwide Urgent Coverage has a $40 copay, and Worldwide Emergency Transportation has a $225 copay.
Primary Care See details
Freedom Blue PPO Signature (PPO) covers primary care physician services, chiropractic services with a $15 copay, occupational therapy services with a $30 copay, physician specialist services with a $30 copay, mental health specialty services with a $40 copay for individual and group sessions, podiatry services with a $30 copay, other healthcare professional services with a $0-$30 copay, psychiatric services with a $40 copay for individual and group sessions, physical therapy and speech-language pathology services with a $25 copay, additional telehealth benefits with a $0-$40 copay, and opioid treatment program services with a $40 copay. Routine foot care is covered for 10 visits per year.
Preventive Services See details
Preventive Services, including Medicare-covered preventive services, annual physical exams, and other preventive services, are covered by the Freedom Blue PPO Signature (PPO) plan. Additional preventive services may include a coinsurance on Home and Bathroom Safety Devices and Modifications, and a copay on Remote Access Technologies. Some services, like health education, in-home safety assessments, and counseling services, are not covered.
Hearing Services See details
Hearing Services include coverage for hearing exams with a $30 copay. Prescription hearing aids are covered up to $500 per year, with a copay between $699 and $999, depending on the type. Fitting/evaluation for hearing aids, prescription hearing aids - inner ear, outer ear, and over the ear, and OTC hearing aids are not covered.
Vision Services See details
Vision services include coverage for eye exams with a $30 copay, and eyewear including contact lenses, eyeglasses, eyeglass lenses, and eyeglass frames, with a combined maximum benefit of $350 every year. Routine eye exams are covered once per year.
Dental Services See details
The Freedom Blue PPO Signature (PPO) plan covers dental services, including Medicare dental services with a $30 copay. Other dental services are covered up to a maximum of $2000 per year. The plan also covers oral exams, dental x-rays, prophylaxis (cleaning), and fluoride treatments with limitations. Restorative services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery are covered with a 40% coinsurance. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Insulin, Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Freedom Blue PPO Signature (PPO) plan. The coinsurance for this service is 20%.
Medical Equipment See details
Medical Equipment is covered by the Freedom Blue PPO Signature (PPO) plan, including Durable Medical Equipment (DME) with 20% coinsurance and Prosthetic Devices/Medical Supplies with 20% coinsurance. Diabetic Supplies have a coinsurance between 0-20%, and Diabetic Therapeutic Shoes/Inserts have 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests with a copay between $0 and $10, Lab Services with no copay, Diagnostic Radiological Services with a copay of at most $225, Therapeutic Radiological Services with a copay of at most $60, and Outpatient X-Ray Services with a $25 copay. Prior authorization is required for all services.
Home Health Services See details
Home Health Services are covered by the Freedom Blue PPO Signature (PPO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. This benefit requires authorization.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are technically covered, but none of the sub-services like Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are covered by the Freedom Blue PPO Signature (PPO) plan.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Freedom Blue PPO Signature (PPO) plan. 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 Over-the-Counter (OTC) Items with a maximum plan benefit coverage amount of $190 every three months, but Acupuncture, Meal Benefit, 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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