2023 HealthPartners Freedom Plains (Cost)

HealthPartners Freedom Plains (Cost) H2462-023 is a 2023 Medicare Advantage Plan or Part-C by HealthPartners available to residents in North Dakota and South Dakota. This plan does not provide extra prescription drug (Part-D) coverage. HealthPartners HealthPartners Freedom Plains (Cost) has a monthly premium of $39.70 and has an in-network maximum out-of-pocket limit of $3,400 (MOOP). This means that if you get sick or need a high-cost procedure the co-pays are capped once you pay $3,400 out-of-pocket. This can be an extremely nice safety net.

HealthPartners works with Medicare to provide significant coverage beyond Part A and Part B benefits. If you decide to sign up for HealthPartners Freedom Plains (Cost) you still retain Original Medicare. But you will get extra Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from HealthPartners and not Original Medicare. With 2023 Medicare Advantage Plan you are always covered for urgently needed and emergency care. Plus, you receive all the benefits of Original Medicare from HealthPartners except hospice care. Original Medicare still provides you with hospice care if you sign up for Medicare Advantage in North Dakota or Medicare Advantage in South Dakota.



2023 HealthPartners Medicare Advantage Plan Overview

Name:HealthPartners Freedom Plains (Cost)
Plan ID:H2462 023 0
Provider:HealthPartners
Year:2023
Type:Cost *
Combined Premium (C+D):$39.70/mo
MOOP:$3,400/yr
Similar Plan: H2462-024




What type of plan is HealthPartners Freedom Plains (Cost)

HealthPartners Freedom Plains (Cost) is a Cost * plan. A Cost plan is operated by a Health Maintenance Organization (HMO) in accordance with a cost reimbursement contract. A Medicare Cost Plan is a type of HMO. These plans may work in much the same way, and have some of the same rules, as Medicare Advantage Plans. You may use the cost plans network of providers or receive their health care services through Original Medicare. With a Cost Plan, if you go to a non-network provider, the services are covered under Original Medicare. You would pay the Medicare Part A and Part B coinsurance and deductibles.

How much does HealthPartners Freedom Plains (Cost) cost?


Part-C Premium

A monthly premium is the fee you pay to the plan in exchange for coverage. HealthPartners charges a $39.70 premium. The Part C premium covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.


MOOP

The maximum out-of-pocket (MOOP) is a yearly limit on your out-of-pocket costs. HealthPartners Freedom Plains (Cost) by HealthPartners MOOP is $3,400. Once you spend $3,400 you will pay nothing for Part A or Part B covered services. Copayments and coinsurance for Medicare approved services apply toward your out-of-pocket limit. Remember Original Medicare (Parts A and B) doesn’t have a MOOP.





2023 Summary of Benefits


The benefit information provided is a summary of what HealthPartners Freedom Plains (Cost) covers and what you pay (such as copayments and coinsurance amounts) for certain common medical events. The Summary of Benefits from HealthPartners helps get an idea of how much financial protection the plan is generally expected to provide for common health conditions. This section also contains information on coverage for in-network and out-of-network providers.

Wellness programs (e.g., fitness, nursing hotline)Covered



Contact lenses


Vision$0 copay



Eyeglass frames


Vision$0 copay



Eyeglass lenses


Vision$0 copay



Eyeglasses (frames and lenses)


Vision$0 copay



Other


VisionNot covered



Routine eye exam


Vision$0 copay



Upgrades


Vision$0 copay




TransportationNot covered
Skilled Nursing Facility$0 per day for days 1 through 20
$196 per day for days 21 through 100



Occupational therapy visit


Rehabilitation services$40 copay



Physical therapy and speech and language therapy visit


Rehabilitation services$40 copay



Cleaning


Preventive dentalNot covered



Dental x-ray(s)


Preventive dentalNot covered



Fluoride treatment


Preventive dentalNot covered



Oral exam


Preventive dentalNot covered




Preventive care$0 copay
Outpatient hospital coverage$150 copay per visit
In-Network Other health plan deductibles?No
Optional supplemental benefitsNo



Inpatient hospital - psychiatric


Mental health services$400 per stay



Outpatient group therapy visit


Mental health services$20 copay



Outpatient group therapy visit with a psychiatrist


Mental health services$20 copay



Outpatient individual therapy visit


Mental health services$40 copay



Outpatient individual therapy visit with a psychiatrist


Mental health services$40 copay



Diabetes supplies


Medical equipment/supplies$0 copay



Durable medical equipment (e.g., wheelchairs, oxygen)


Medical equipment/supplies0-20% coinsurance per item



Prosthetics (e.g., braces, artificial limbs)


Medical equipment/supplies20% coinsurance per item




Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)$3,400 In-network
Inpatient hospital coverage$400 per stay



Fitting/evaluation


Hearing$0 copay



Hearing aids


Hearing$499-999 copay



Hearing exam


Hearing$40 copay




Health plan deductible$0
Ground ambulance$200 copay



Foot exams and treatment


Foot care (podiatry services)$40 copay



Routine foot care


Foot care (podiatry services)Not covered



Emergency


Emergency care/Urgent care$90 copay per visit (always covered)



Urgent care


Emergency care/Urgent care$40 copay per visit (always covered)



Primary


Doctor visits$0 copay



Specialist


Doctor visits$40 copay per visit



Diagnostic radiology services (e.g., MRI)


Diagnostic procedures/lab services/imaging$150 copay



Diagnostic tests and procedures


Diagnostic procedures/lab services/imaging$0 copay



Lab services


Diagnostic procedures/lab services/imaging$0 copay



Outpatient x-rays


Diagnostic procedures/lab services/imaging$10 copay



Diagnostic services


Comprehensive dentalNot covered



Endodontics


Comprehensive dentalNot covered



Extractions


Comprehensive dentalNot covered



Non-routine services


Comprehensive dentalNot covered



Periodontics


Comprehensive dentalNot covered



Prosthodontics, other oral/maxillofacial surgery, other services


Comprehensive dentalNot covered



Restorative services


Comprehensive dentalNot covered




In-Network Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?No




Coverage Area

(Click county or state to compare all available Advantage plans)

The availability of Medicare Advantage Plans will vary according to your region. This is why the Coverage Area matters in terms of Medicare eligibility. You will always be eligible for Original Medicare, but eligibility for HealthPartners Freedom Plains (Cost) requires you to live in that plan’s service area. The service area is listed below:



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How much does HealthPartners Freedom Plains (Cost) cost?

HealthPartners charges a $39.70 monthly premium. A monthly premium is the fee you pay to the plan in exchange for coverage. The premium covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.

How much is HealthPartners Freedom Plains (Cost) MOOP?

The maximum out-of-pocket (MOOP) is a yearly limit on your out-of-pocket costs. HealthPartners Freedom Plains (Cost) by HealthPartners MOOP is $3,400. Once you spend $3,400 you will pay nothing for Part A or Part B covered services.

What type of plan is HealthPartners Freedom Plains (Cost)?

HealthPartners Freedom Plains (Cost) is a Cost * plan. A Cost plan is operated by a (HMO) in accordance with a cost reimbursement contract. You may use the cost plans network of providers or receive their health care services through Original Medicare.



Source:CMS. Data as of Oct 1, 2022.

Last updated on

Notes: Data are subject to change as contracts are finalized. For 2023, enhanced alternative may offer extra cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part-D benefit. Includes 2023 approved contracts. Employer sponsored 800 series and plans under sanction are excluded.

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