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Freedom Blue PPO Choice Deluxe (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Freedom Blue PPO Choice Deluxe (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 Choice Deluxe (PPO) in 2025, please refer to our full plan details page.
Freedom Blue PPO Choice Deluxe (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 Choice Deluxe (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 Choice Deluxe (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 Choice Deluxe (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $13.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $1.00. 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 $9550.00 (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 $9550.00 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 Choice Deluxe (PPO) plan has a $0 deductible for prescription drugs. During the initial coverage phase, you'll pay a copay or coinsurance depending on the drug tier and pharmacy. For example, preferred generic drugs have a $5 copay at preferred pharmacies and $15 at standard pharmacies. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for Part D covered drugs. If you qualify for the low-income subsidy (LIS), you'll pay $13.00.
Additional Benefits
The Freedom Blue PPO Choice Deluxe (PPO) plan offers a range of benefits with varying cost-sharing. Inpatient hospital stays have a $425 copay, while outpatient services range from no copay to a $350 copay, depending on the service. The plan covers primary care, specialist visits, and other services with copays typically between $10 and $40. Additional benefits include coverage for hearing and vision services, with copays for exams and coverage for hearing aids and eyewear. Dental services have a $30 copay for Medicare dental, and other dental services are covered up to $2500 per year. The plan also includes coverage for ambulance, emergency services, and home health services, with differing copays and coinsurance depending on the service.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For Inpatient Hospital-Acute, you will pay a $425 copay per admission, and there is no copay for additional days. For Inpatient Hospital Psychiatric, you will pay a $425 copay for days 1-3, and no copay for days 4-90. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and Additional Days and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, observation services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services and observation services have a $350 copay, Ambulatory Surgical Center (ASC) Services have a $250 copay, and individual and group sessions for outpatient substance abuse have a $40 copay. Outpatient blood services include an enhanced benefit where the three-pint deductible is waived.
Partial Hospitalization See details
Partial Hospitalization is covered by the Freedom Blue PPO Choice Deluxe (PPO) plan. There is no copay or coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Freedom Blue PPO Choice Deluxe (PPO) plan, with a $250 copay for both ground and air ambulance services; there is no coinsurance. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered by the Freedom Blue PPO Choice Deluxe (PPO) plan, with a $125 copay and no coinsurance. Urgently Needed Services have a $50 copay and no coinsurance, while Worldwide Emergency Coverage has a $125 copay, Worldwide Urgent Coverage has a $50 copay, and Worldwide Emergency Transportation has a $250 copay.
Primary Care See details
The Freedom Blue PPO Choice Deluxe (PPO) plan covers primary care physician services, chiropractic services with a $10 copay, occupational therapy services with a $25 copay, physician specialist services with a $30 copay, mental health specialty services with a $30 copay, podiatry services with a $30 copay, other health care professional services with a copay between $0 and $30, psychiatric services with a $30 copay, physical therapy and speech-language pathology services with a $25 copay, additional telehealth benefits with a copay between $0 and $50, and opioid treatment program services with a $40 copay. Routine chiropractic care is limited to 8 visits per year.
Preventive Services See details
Preventive Services, including Medicare-covered services, Annual Physical Exams, Fitness Benefit, Enhanced Disease Management, Kidney Disease Education Services, and Other Preventive Services are covered. Home and Bathroom Safety Devices and Modifications have 20% coinsurance, and Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline) have a copay between $0 and $30. Health Education, 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, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Telemonitoring Services, and Counseling Services are not covered.
Hearing Services See details
Hearing Services include coverage for hearing exams with a $30 copay, and prescription hearing aids with a copay between $699 and $999. Fitting/Evaluation for Hearing Aid, Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, Prescription Hearing Aids - 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 with a combined maximum benefit of $350 per year for both in-network and out-of-network services. This plan also covers contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades.
Dental Services See details
The Freedom Blue PPO Choice Deluxe (PPO) plan covers dental services with a $30 copay for Medicare dental services. Other dental services are also covered, with a maximum plan benefit of $2500 per year, and include oral exams (1 every six months), dental x-rays (1 per year), cleaning (1 every six months), and fluoride treatments (1 every six months). 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, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay, and the coinsurance is between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, the coinsurance is between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Freedom Blue PPO Choice Deluxe (PPO) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment, Prosthetics/Medical Supplies, and Diabetic Equipment, is covered by the Freedom Blue PPO Choice Deluxe (PPO) plan. Durable Medical Equipment has a 20% coinsurance and requires authorization, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Supplies have a 0-20% coinsurance, while Diabetic Therapeutic Shoes/Inserts has a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including diagnostic procedures, tests, lab services, and radiological services, are covered. Diagnostic Procedures/Tests have a copay between $0 and $10, Lab Services have no copay, Diagnostic Radiological Services have a copay of at least $250, Therapeutic Radiological Services have a copay of at least $60, and Outpatient X-Ray Services have a $15 copay.
Home Health Services See details
Home Health Services are covered under the Freedom Blue PPO Choice Deluxe (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 Freedom Blue PPO Choice Deluxe (PPO) plan. Specifically, Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered by the Freedom Blue PPO Choice Deluxe (PPO) plan, with prior authorization required. You will have no copay for days 1-20, and a $214 copay for days 21-100.
Other Services See details
The Freedom Blue PPO Choice Deluxe (PPO) plan does not cover acupuncture, meal benefits, 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. Over-the-counter (OTC) items are 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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