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HP

HealthPartners

Plan ID: H2462-28-0

HealthPartners Freedom Balance WI (Cost)

2024 HealthPartners Freedom Balance WI (Cost) H2462028 0 is a Medicare Advantage plan . It has received a 4-out-of-5 star rating from CMS for 2024.

Learn more about HealthPartners Freedom Balance WI (Cost) H2462 - 028 - 0, including the health and drug services it covers, by reading our easy-to-use guide. Or contact a licensed insurance agent for help now.

4 / 5 stars for 2024

$87.60 /mo

Monthly premium

$0

Health deductible

$3400.00

Out-of-pocket maximum

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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week!

Overview Icon

Plan Overview

2024 HealthPartners Freedom Balance WI (Cost) H2462028 0 is a Cost offered in Select Counties in Western WI by HealthPartners. It has a monthly premium of $87.60.

Premium Breakdown

Standard Part B Premium

$174.70

Part B premium reduction

- $0

Monthly Plan Premium

$87.60

Total Premium:

$262.30

Note:

The standard Part B premium for 2024 is $174.70. Your Part B premium may differ based on factors including late enrollment, income, and disability status. Higher-income beneficiaries may pay an income-related monthly adjustment amount (IRMAA). The Part B premium is required to be paid by everyone enrolled in Medicare Part B.

Special needs plan type

No

Out-of-pocket maximum

$3400.00

Plan Organization:

HealthPartners

Plan Type:

Cost

Location:

Select Counties in Western WI

Drugs Covered:

No

Drug Formulary:

Pharmacies:

Doctor Choice:

Plan Doctors for Most Services

Doctors Link:

Deductibles

The amount you must pay each year before your plan starts to pay for covered services or drugs.

Health deductible

$0

Sign up for HealthPartners Freedom Balance WI (Cost)

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Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week

Drug Coverage Icon

Drug Coverage

HealthPartners Freedom Balance WI (Cost) does not provide drug coverage. If drug coverage is something you need, you should consider shopping for other plans that do provide cost sharing on drugs.

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Additional Benefits

HealthPartners Freedom Balance WI (Cost) also provides the following benefits.

Note:

Limits, Authorizations, and Referrals may apply for the benefits below. Contact the plan for details.

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Comprehensive dental

Non-routine services
Not covered
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Diagnostic services
Not covered
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Restorative services
Not covered
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Endodontics
Not covered
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Periodontics
Not covered
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Extractions
Not covered
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Prosthodontics, other oral/maxillofacial surgery, other services
Not covered
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Preventive dental

Oral exam
Not covered
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Cleaning
Not covered
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Fluoride treatment
Not covered
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Dental x-ray(s)
Not covered
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Diagnostic procedures/lab services/imaging

Diagnostic tests and procedures
$0 copay
Lab services
$0 copay
Diagnostic radiology services (eg, MRI)
$200 copay
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Outpatient x-rays
$10 copay
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Doctor visits

Primary
$15 copay per visit
Specialist
$15 copay per visit
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Emergency care/Urgent care

Emergency
$90 copay per visit (always covered)
Urgent care
$15 copay per visit (always covered)
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Foot care (podiatry services)

Foot exams and treatment
$15 copay
Routine foot care
Not covered
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Ground ambulance

Service
$100 copay
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Hearing

Hearing exam
$15 copay
Fitting/evaluation
$0 copay
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Hearing aids
$499-999 copay
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Inpatient hospital coverage

Service
$200 per stay
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Outpatient hospital coverage

Service
$100 copay per visit
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Optional benefits

Service
Yes
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Medical equipment/supplies

Durable medical equipment (eg, wheelchairs, oxygen)
0-20% coinsurance per item
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Prosthetics (eg, braces, artificial limbs)
20% coinsurance per item
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Diabetes supplies
20% coinsurance per item
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Medicare Part B drugs

Chemotherapy
0-20% coinsurance
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Other Part B drugs
0-20% coinsurance
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Part B Insulin drugs
0-20% coinsurance (up to $35)
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Mental health services

Inpatient hospital - psychiatric
$200 per stay
Outpatient group therapy visit with a psychiatrist
$7.50 copay
Outpatient individual therapy visit with a psychiatrist
$15 copay
Outpatient group therapy visit
$7.50 copay
Outpatient individual therapy visit
$15 copay
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Preventive care

Service
$0 copay
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Rehabilitation services

Occupational therapy visit
$15 copay
Physical therapy and speech and language therapy visit
$15 copay
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Skilled Nursing Facility

Service
$0 copay
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Transportation

Service
Not covered
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Vision

Routine eye exam
$0 copay
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Other
Not covered
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Contact lenses
Not covered
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Eyeglasses (frames and lenses)
Not covered
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Eyeglass frames
Not covered
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Eyeglass lenses
Not covered
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Upgrades
Not covered
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Wellness programs (eg, fitness, nursing hotline)

Service
Covered
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Plan Providers

Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Anthem Blue Cross, Aspire Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, GlobalHealth, Health Care Service Corporation, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Baylor Scott & White Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.

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Every year, Medicare evaluates plans based on a 5-star rating system.

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.

* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.

Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period

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We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.

Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.

Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.

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