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Simply Freedom (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Simply Freedom (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Simply Freedom (PPO) in 2025, please refer to our full plan details page.
Simply Freedom (PPO) is a PPO plan offered by Elevance Health, Inc. available for enrollment in 2025 to people living in Select counties in Tampa Area. This plan received an overall rating of 2.5 out of 5 stars in 2025.
It's important to know that Simply Freedom (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 Simply 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 Simply 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.
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 $150.00 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 $8950.00 (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 $8950.00 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 Simply Freedom (PPO) plan has an enhanced alternative drug benefit. The plan has a $150 deductible for prescription drugs. In the initial coverage phase, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For example, you will pay a $10 copay for preferred generic drugs at preferred and standard pharmacies, and no copay at standard mail order. Once your total drug costs reach $2000, you will enter the catastrophic coverage phase where you will pay nothing for covered drugs.
Additional Benefits
The Simply Freedom (PPO) plan offers a range of benefits, including coverage for inpatient and outpatient services, with varying copays. This plan provides no copay for many services, such as primary care, preventive services, vision, dental, and home health services. The plan also covers hearing services with no copay for exams and up to $2,000 for hearing aids, and covers medical equipment with varying coinsurance. Emergency services have a copay, and ambulance services have a copay or coinsurance depending on the service. Additionally, the plan covers Skilled Nursing Facility (SNF) services and home infusion services.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For days 1-5, the copay is $250, and there is no copay for days 6-90. Additional days, non-Medicare-covered stays, and upgrades are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, are covered by Simply Freedom (PPO), with copays ranging from $0 to $250, depending on the service. Ambulatory Surgical Center (ASC) Services and outpatient blood services have no copay, while individual and group sessions for outpatient substance abuse have a $30 copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the Simply Freedom (PPO) plan, with a $30 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Simply Freedom (PPO) plan. Ground ambulance services have a $250 copay, while air ambulance services have a 20% coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Simply Freedom (PPO) plan. Emergency Services and Worldwide Emergency Coverage have a $120 copay, while Urgently Needed Services have a $40 copay; all have no coinsurance. Worldwide Urgent Coverage and Worldwide Emergency Transportation also have a $120 copay, and no coinsurance.
Primary Care See details
The Simply Freedom (PPO) plan covers primary care physician services with no copay, as well as chiropractic services and occupational therapy services with no copay. This plan also covers physician specialist services with a $30 copay, and mental health specialty services with a $30 copay. Additionally, this plan covers physical therapy and speech-language pathology services with a $30 copay.
Preventive Services See details
Preventive services are covered, including Medicare-covered zero-dollar preventive services, which require prior authorization. The plan does not cover annual physical exams, but covers other preventive services, including fitness benefits, and remote access technologies, with a maximum plan benefit coverage amount of $500 for fitness benefits. Kidney disease education services, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following welcome visits are also covered with no copay.
Hearing Services See details
Hearing Services for the Simply Freedom (PPO) plan include hearing exams, routine hearing exams, and fitting/evaluation for hearing aids with no copay, and prescription hearing aids with up to $2,000 coverage per year. Prescription hearing aids - inner ear, outer ear, and over the ear, and OTC hearing aids are not covered.
Vision Services See details
The Simply Freedom (PPO) plan covers vision services, including eye exams and eyewear. Eye exams and eyewear have no copay, and the plan covers one routine eye exam per year with a maximum benefit of $69.00. The plan also covers contact lenses and eyeglasses (lenses and frames), with a combined maximum benefit of $200.00 per year, but upgrades are not covered.
Dental Services See details
The Simply Freedom (PPO) plan covers a wide range of dental services, including oral exams, x-rays, and cleanings, all with no copay. Other services such as restorative, endodontics, and orthodontics are also covered with no copay, up to a maximum of $2000 per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B insulin drugs with a $35 copay. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs are covered with coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Simply Freedom (PPO) plan. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) with 0-20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment with no copay for both Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts. 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 Simply Freedom (PPO) plan. Diagnostic Procedures/Tests have a copay between $0 and $25, and Lab Services have no copay. Diagnostic Radiological Services have a copay up to $125, Therapeutic Radiological Services have a copay up to $60, and Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered under the Simply Freedom (PPO) plan with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Simply Freedom (PPO) plan. This includes Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Simply Freedom (PPO) plan. For days 1-20, there is no copay, but for days 21-100, the copay is $196.
Other Services See details
The Simply Freedom (PPO) plan covers Over-the-Counter (OTC) items with no copay. 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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