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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 2026, 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 2026.
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 a $90.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
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) prescription drug plan features a low $90 annual deductible. Under this plan, Tier 1 preferred generic medications have no copay for up to a three-month supply when filled at standard pharmacies or via standard mail order. Tier 2 generic drugs require a $10 copay for a one-month supply, $20 for a two-month supply, and $30 for a three-month supply. For Tier 3 preferred brand drugs, the copay is $45 for a one-month supply, $90 for a two-month supply, and $135 for a three-month supply. Tier 4 non-preferred drugs cost $95 for a one-month supply, while Tier 5 specialty drugs require a 25% coinsurance for a one-month supply. These predictable copays and coinsurance rates apply to both standard pharmacy fills and standard mail order options.
Additional Benefits
The Perennial Advantage Freedom (HMO-POS) plan offers comprehensive medical coverage with no copays for primary care visits, home health services, and skilled nursing facility stays. For specialized care, members pay a low $5 copay for specialist visits, while acute inpatient hospital stays require a $275 daily copay for the first five days. Emergency room visits carry a $90 copay, which is waived if you are admitted to the hospital within three days. Ancillary benefits are highly accessible, featuring no copays or coinsurance for most preventive and comprehensive dental services up to a $2,500 annual limit. Hearing services include prescription hearing aids with no copays up to a $1,560 yearly allowance, while routine vision exams and glasses are covered with no copay and a 20% coinsurance up to a $150 annual limit. Members also enjoy no copays for diabetic supplies, home infusion bundled services, and over-the-counter items.
Inpatient Hospital See details
Inpatient hospital care is partially covered by Perennial Advantage Freedom (HMO-POS) with no coinsurance and required prior authorization, as upgrades for acute stays are not covered. Acute stays require a $275 copay for days 1 to 5 and no copay for days 6 and beyond, while psychiatric stays require a $300 copay for days 1 to 7 and no copay for days 8 and beyond.
Outpatient Services See details
Perennial Advantage Freedom (HMO-POS) covers outpatient hospital services with no coinsurance and copays ranging from $0 to $250, and observation services with a $100 copay per stay and no coinsurance. Ambulatory surgical center, outpatient substance abuse, and outpatient blood services are all covered with no copays and a 20% coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered under the Perennial Advantage Freedom (HMO-POS) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Perennial Advantage Freedom (HMO-POS) covers ground ambulance services with a $260 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered, offering up to 12 one-way trips per year to any health-related location with no copay or coinsurance, though transport to plan-approved health-related locations is not covered.
Emergency Services See details
Perennial Advantage Freedom (HMO-POS) covers emergency services with a $90 copay and no coinsurance, and urgently needed services with a $55 copay and no coinsurance, with both copays waived if you are admitted to the hospital within three days. Worldwide emergency, urgent, and emergency transportation services are not covered.
Primary Care See details
Perennial Advantage Freedom (HMO-POS) primary care benefits feature primary care physician visits with no copay and no coinsurance, and specialist visits for a $5 copay and no coinsurance. Therapy services require a $0 to $20 copay and no coinsurance, while chiropractic care is partially covered, offering routine care for a $20 copay and 20% coinsurance but excluding other chiropractic services.
Preventive Services See details
Perennial Advantage Freedom (HMO-POS) offers partially covered Preventive Services with no copay and no coinsurance for covered benefits, including Medicare-covered zero-dollar preventive services, kidney disease education, therapeutic massage, in-home support, fitness benefits, and telemonitoring. However, several services are not covered under this benefit, such as annual physical exams, health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, and weight management programs.
Hearing Services See details
Perennial Advantage Freedom (HMO-POS) covers hearing services with no deductible and no copays, featuring routine hearing exams with a 20% coinsurance and fitting evaluations with no coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to a $1,560 annual limit (excluding inner ear, outer ear, and over the ear types), while over-the-counter (OTC) hearing aids are covered with no copay or coinsurance.
Vision Services See details
Vision Services are partially covered by Perennial Advantage Freedom (HMO-POS) with no deductible, offering routine eye exams (one per year) and eyeglasses with no copay and 20% coinsurance up to a $150 annual limit. Other eye exam services and contact lenses are not covered.
Dental Services See details
Dental services are partially covered by Perennial Advantage Freedom (HMO-POS), with Medicare-covered dental requiring no copay and a 20% coinsurance, and most preventive and comprehensive services offered with no copay and no coinsurance up to a $2,500 annual limit. However, other preventive services, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
Perennial Advantage Freedom (HMO-POS) covers home infusion bundled services with no copay and no coinsurance, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs require a coinsurance ranging from no coinsurance to 20%, while Part B insulin has a $35 copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis services are covered under the Perennial Advantage Freedom (HMO-POS) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Perennial Advantage Freedom (HMO-POS) covers medical equipment with no copays, applying a 20% coinsurance and prior authorization requirement for durable medical equipment, prosthetics, and medical supplies. Diabetic supplies are covered with no copay and no coinsurance, while diabetic therapeutic shoes and inserts carry a 0% to 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are partially covered by Perennial Advantage Freedom (HMO-POS), with prior authorization required for all covered services. Diagnostic procedures and tests require a $60 copay with no coinsurance, diagnostic radiological services require a minimum $125 copay with no coinsurance, and therapeutic radiological services require a copay and a minimum 20% coinsurance; however, lab services and outpatient x-ray services are not covered.
Home Health Services See details
Home Health Services are covered by Perennial Advantage Freedom (HMO-POS) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered with no copay under Perennial Advantage Freedom (HMO-POS) and require prior authorization. While some services are covered, cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered in practice and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Perennial Advantage Freedom (HMO-POS) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, though prior authorization is required. The plan allows for SNF admission without a prior three-day inpatient hospital stay, but additional days beyond standard Medicare coverage are not covered.
Other Services See details
Perennial Advantage Freedom (HMO-POS) partially covers other services, offering over-the-counter (OTC) items with no copay and no coinsurance, while acupuncture and meal benefits are not covered.
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