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Monthly Premium
Simply Freedom (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Simply Healthcare
Plan ID: H9469-001-000
* Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system.
Monthly Premium
Florida Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A and Part B) benefits into a single plan.
Most Medicare Advantage plans cover prescription drugs, and many plans may offer other extra benefits Original Medicare doesn’t cover.
Learn more about Florida Medicare Advantage plans like the one below and find a plan that offers the benefits you want at an affordable price.
Coverage | Details |
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Monthly plan premium | $0.00 |
Vision coverage | |
Dental coverage | |
Hearing coverage | |
Prescription drugs | |
Medical deductible | $125.00 |
Out-of-pocket maximum | $3,600.00 |
Initial drug coverage limit | $0.00 |
Catastrophic drug coverage limit | $2,000.00 |
Primary care doctor visit | Out-of-Network: $40.00 copay |
Specialty doctor visit | Out-of-Network: $70.00 copay |
Inpatient hospital care | In-Network: Days 1-5: $280.00 per day / Days 6-90: $0.00 per day |
Urgent care | Urgent Care: $40.00 copay Urgently Needed Services Copay Waived with Inpatient Admission |
Emergency room visit | Emergency Care: $135.00 copay Copay waived if admitted to hospital within 24 hours Worldwide Coverage: This plan covers urgent care and emergency services when traveling outside of the United States for less than six months. This benefit is limited to $100,000 per year. |
Ambulance transportation | Ground Ambulance: $250.00 copay Per Trip Air Ambulance: 20% coinsurance |
Simply Freedom (PPO) covers a range of additional benefits. Learn more about Simply Freedom (PPO) benefits, some of which may not be covered by Original Medicare (Part A and Part B).
Coverage | Details |
---|---|
Chiropractic services | Out-of-Network: Medicare Covered Chiropractic Services: 40% coinsurance |
Diabetes supplies, training, nutrition therapy and monitoring | Out-of-Network: 40% coinsurance |
Durable medical equipment (DME) | In-Network: 0% - 20% coinsurance depending on the equipment |
Diagnostic tests, lab and radiology services, and X-rays | In-Network: Lab Services: $0.00 copay X-Rays: $0.00 copay - $25.00 copay Therapeutic Radiological Services: $0.00 copay - $60.00 copay Outpatient Diagnostic Procedures/Tests: $0.00 copay - $25.00 copay Diagnostic Radiological Services: $0.00 copay - $150.00 copay |
Home health care | Out-of-Network: 40% coinsurance |
Mental health inpatient care | Out-of-Network: 40% coinsurance per stay |
Mental health outpatient care | Out-of-Network: 40% coinsurance |
Outpatient services/surgery | Out-of-Network: Outpatient Hospital - Surgery: 40% coinsurance Observation Services: 40% coinsurance Ambulatory Surgical Center: 40% coinsurance |
Outpatient substance abuse care | In-Network: Individual and Group Sessions: $35.00 copay |
Over-the-counter items | This plan covers certain approved, non-prescription, over-the-counter drugs and health-related items, up to $72 every month. Unused OTC amounts expire at the end of each month. |
Podiatry services | In-Network: Medicare Covered Podiatry Services: $35.00 copay |
Skilled Nursing Facility (SNF) care | Out-of-Network: 40% coinsurance per stay |
The following dental services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
Coverage | Details |
---|---|
Dental care | This plan covers up to a $2,500 allowance for covered preventive and comprehensive dental services every year. In-Network: Medicare Covered Dental: $0.00 copay Preventive Dental Services: $0.00 copay Comprehensive Dental Services: $0.00 copay |
The following vision services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage
Coverage | Details |
---|---|
Vision care | Out-of-Network: Medicare Covered Eye Exam: $70.00 copay Routine Eye Exam: $0.00 copay Medicare Covered Eye Wear: $70.00 copay Routine Eye Wear: $0.00 copay |
The following hearing services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
Coverage | Details |
---|---|
Hearing care | In-Network: Medicare Covered Hearing Exam: $0.00 copay Routine Hearing Exam: $0.00 copay for routine hearing exam(s). $0.00 copay for hearing aids up to the maximum plan benefit amount. This plan covers 1 routine hearing exam up to a $59 maximum plan benefit every year. This plan covers 1 routine hearing aid fitting evaluation and a $2,000 maximum plan benefit for prescribed hearing aids every year. |
The following services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
Coverage | Details |
---|---|
Preventive services and health/wellness education programs | Out-of-Network: 40% coinsurance |
The Simply Freedom (PPO) offers prescription drug coverage, with an annual drug deductible of $125.00 (excludes Tiers 1, 2, and 6)
Coverage & Cost | |
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Coverage | Cost |
Annual drug deductible | $125.00 (excludes Tiers 1, 2, and 6) |
Tier 1 |
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Tier 2 |
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Tier 6 |
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Annual drug deductible | $125.00 (excludes Tiers 1, 2, and 6) |
Tier 1 |
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Tier 2 |
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Tier 6 |
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Annual drug deductible | $125.00 (excludes Tiers 1, 2, and 6) |
Tier 1 |
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Tier 2 |
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Tier 6 |
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When reviewing Florida Medicare plans, be sure to find out if your doctors are part of the plan network. If a Medicare Advantage plan covers prescription drugs, make sure the plan formulary (list of drugs covered by the plan) includes your drugs.
You may be able to find plans in your part of Florida that offer similar benefits at similar or lower prices than the plan above. Call 1-800-557-6059 TTY 711, 24/7 to speak with a licensed insurance agent who can help you compare plans.
Links to plan documents |
We represent carriers such as Humana, UnitedHealthcare®, Anthem Blue Cross and Blue Shield, Aetna, Cigna Healthcare, Wellcare, or Kaiser Permanente.
Every 60 seconds, we help someone enroll in a Medicare Advantage plan.1