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Perennial Advantage Freedom (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Perennial Advantage Freedom (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Perennial Advantage Freedom (HMO-POS) in 2025, please refer to our full plan details page.
Perennial Advantage Freedom (HMO-POS) is a HMO-POS plan offered by Perennial Consortium, LLC available for enrollment in 2025 to people living in Ohio (partial). This plan received an overall rating of 5 out of 5 stars in 2025.
It's important to know that Perennial Advantage Freedom (HMO-POS) 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 Perennial Advantage Freedom (HMO-POS).
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 Perennial Advantage Freedom (HMO-POS), 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.
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 $3900.00 (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 $3900.00 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 Perennial Advantage Freedom (HMO-POS) plan offers an "Enhanced Alternative" drug benefit. This plan has a $0 deductible. In the initial coverage phase, you'll pay a copay for your prescriptions. For example, you'll pay a $10 copay for preferred generic drugs at a standard pharmacy, and a $95 copay for preferred brand drugs. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The Perennial Advantage Freedom (HMO-POS) plan offers a range of benefits with varying cost-sharing. Inpatient hospital stays have a copay, while outpatient services have copays or coinsurance depending on the service. The plan includes coverage for ambulance, emergency, and primary care services, with copays or coinsurance. The plan also offers preventive, hearing, vision, and dental services, often with coinsurance. Additionally, it covers home infusion, dialysis, medical equipment, and diagnostic services, typically with coinsurance. Home health services have no copay, and skilled nursing facilities are covered.
Inpatient Hospital See details
Inpatient Hospital benefits for the Perennial Advantage Freedom (HMO-POS) plan include coverage for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services, with a copay of $310 for days 1-7 and no copay for days 8-90 for Inpatient Hospital-Acute, and a copay of $300 for days 1-7 and no copay for days 8-90 for Inpatient Hospital Psychiatric. Additional days and non-Medicare covered stays are also covered, but upgrades are not covered.
Outpatient Services See details
Outpatient services include coverage for all outpatient hospital services, with a copay between $0 and $250, and observation services with a $100 copay. Ambulatory Surgical Center (ASC) Services and Outpatient Substance Abuse Services are covered, with a 20% coinsurance. Outpatient blood services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered with prior authorization, and requires a 20% coinsurance.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the Perennial Advantage Freedom (HMO-POS) plan. Ground ambulance services have a $260 copay, and air ambulance services have a 20% coinsurance. Transportation services to any health-related location are covered for 12 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Perennial Advantage Freedom (HMO-POS) plan. Emergency Services have a $90 copay with no coinsurance, and Urgently Needed Services have a $55 copay with no coinsurance. Worldwide Emergency Services are not covered.
Primary Care See details
The Perennial Advantage Freedom (HMO-POS) plan covers Primary Care services, including Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services. Chiropractic Services have a 20% coinsurance, and Routine Chiropractic Care is not covered. Specialist visits have a $20 copay. Individual and group mental health sessions have a $35 copay. Routine foot care has a $40 copay. Physical therapy and speech-language pathology services have a copay between $0 and $20. Telehealth services have a copay between $0 and $35.
Preventive Services See details
The Perennial Advantage Freedom (HMO-POS) plan covers Medicare-covered preventive services and other preventive services, including glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit. However, annual physical exams, health education, in-home safety assessments, personal emergency response systems (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 benefits, home-based palliative care, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, fitness benefit, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, and counseling services are not covered.
Hearing Services See details
The Perennial Advantage Freedom (HMO-POS) plan covers hearing exams with a coinsurance of at most 20%, routine hearing exams once per year, and fitting/evaluation for hearing aids once per year. Prescription hearing aids are covered, with a maximum benefit of $1560 every year for both ears combined, and OTC hearing aids are covered. Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered.
Vision Services See details
The Perennial Advantage Freedom (HMO-POS) plan covers vision services, including eye exams and eyewear. Eye exams have a 20% coinsurance, and routine eye exams are limited to one per year. Eyewear, including eyeglass lenses and frames, are covered with a 20% coinsurance and a combined maximum benefit of $150 per year, while contact lenses are not covered.
Dental Services See details
Dental services are covered, with a 20% coinsurance for Medicare dental services, and a $2,400 annual maximum for other dental services. Oral exams are covered for up to 2 visits per year, dental x-rays are covered for up to 2 x-rays, and prophylaxis (cleaning) is covered for up to 2 visits per year. Fluoride treatments are covered for 1 treatment every six months, and implant services are unlimited. Restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery are covered for up to 1 procedure, with periodicity details in the notes, while maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the Perennial Advantage Freedom (HMO-POS) plan, and prior authorization is required. Medicare Part B Insulin Drugs have a $35 copay with a coinsurance between 0% and 20%, while 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 Perennial Advantage Freedom (HMO-POS) plan. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical equipment benefits with the Perennial Advantage Freedom (HMO-POS) plan include Durable Medical Equipment (DME) with 20% coinsurance and authorization required, Prosthetics/Medical Supplies with coinsurance for Medicare-covered items, and Diabetic Equipment with no copay and 0-20% coinsurance depending on the service. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Perennial Advantage Freedom (HMO-POS) plan. All diagnostic services have no copay, and the coinsurance is not specified. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of at most 20%, and no copay. Lab Services and Outpatient X-Ray Services are not covered. Therapeutic Radiological Services have a coinsurance of at most 20%, and no copay.
Home Health Services See details
Home Health Services are covered by the Perennial Advantage Freedom (HMO-POS) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services. Prior authorization is required. There is a coinsurance, but the specific amount is not provided.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, though prior authorization is required. Additional days beyond Medicare-covered SNF stays and non-Medicare-covered SNF stays are not covered.
Other Services See details
The Perennial Advantage Freedom (HMO-POS) plan covers Over-the-Counter (OTC) Items, including nicotine replacement therapy and Naloxone, with a maximum benefit coverage amount of $0 every three months. 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 are not covered.
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