Simply Freedom (PPO)
Simply Freedom (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Simply Healthcare
Plan ID: H9469-001
HelpAdvisor Editorial Team analysis of data from the 2025 MA Landscape Source Files and carrier-provided plan data supplied by SunFire, Inc., a private company that creates software solutions for agents and brokers to compare Medicare plans. For more information, visit www.sunfireinc.com.
Medicare beneficiaries may find it helpful to review available Medicare Advantage plans in their area. Medicare Advantage plans are designed to combine the coverage offered from Original Medicare (Medicare Part A and Part B) while also offering additional benefits.
Many Medicare Advantage plans may cover prescription drug coverage as well as additional benefits such as Dental, Vision and Hearing.
Learn more about Medicare Advantage plans such as Simply Freedom (PPO) - H9469-001 by Simply Healthcare as well as other Medicare Advantage plans available in your area.
Simply Freedom (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Simply Healthcare
Plan ID: H9469-001
HelpAdvisor Editorial Team analysis of data from the 2025 MA Landscape Source Files and carrier-provided plan data supplied by SunFire, Inc., a private company that creates software solutions for agents and brokers to compare Medicare plans. For more information, visit www.sunfireinc.com.
Medicare beneficiaries may find it helpful to review available Medicare Advantage plans in their area. Medicare Advantage plans are designed to combine the coverage offered from Original Medicare (Medicare Part A and Part B) while also offering additional benefits.
Many Medicare Advantage plans may cover prescription drug coverage as well as additional benefits such as Dental, Vision and Hearing.
Learn more about Medicare Advantage plans such as Simply Freedom (PPO) - H9469-001 by Simply Healthcare as well as other Medicare Advantage plans available in your area.
Florida Counties Served
Basic Costs and Coverage
| Coverage | Cost |
|---|---|
| Monthly Deductible | $125 |
| Out of Pocket Max |
In-Network: $3600 Out-of-Network: N/A |
| Initial Coverage Limit | $2000 |
| Catastrophic Coverage Limit | $2,000 |
| Primary Care Doctor Visit | In-Network: $0.00 copay Out-of-Network: $40.00 copay |
| Specialty Doctor Visit | In-Network: $35.00 copay 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 Out-of-Network: 40% coinsurance per stay |
| 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 |
Health Care Services and Medical Supplies
Simply Freedom (PPO) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B).
| Coverage | Cost |
|---|---|
| Chiropractic Services | In-Network: Medicare Covered Chiropractic Services: $0.00 copay Out-of-Network: Medicare Covered Chiropractic Services: 40% coinsurance |
| Diabetes Supplies, Training, Nutrition Therapy and Monitoring | In-Network: Diabetic Supplies: $0.00 copay Out-of-Network: 40% coinsurance |
| Durable Medical Eqipment (DME) | In-Network: 0% - 20% coinsurance depending on the equipment Out-of-Network: 40% coinsurance |
| 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 Out-of-Network: Lab Services: 40% coinsurance X-Rays: 40% coinsurance Therapeutic Radiological Services: 40% coinsurance Outpatient Diagnostic Procedures/Tests: 40% coinsurance Diagnostic Radiological Services: 40% coinsurance |
| Home Health Care | In-Network: $0.00 copay Out-of-Network: 40% coinsurance |
| Mental Health Inpatient Care | In-Network: Days 1-5: $280.00 per day / Days 6-90: $0.00 per day Out-of-Network: 40% coinsurance per stay |
| Mental Health Outpatient Care | In-Network: Individual and Group Sessions: $35.00 copay Out-of-Network: 40% coinsurance |
| Outpatient Services / Surgery | In-Network: Outpatient Hospital - Surgery: $250.00 copay Observation Services: $250.00 copay Ambulatory Surgical Center: $150.00 copay 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 Out-of-Network: 40% coinsurance |
| Over-the-counter (OTC) 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 Out-of-Network: Medicare Covered Podiatry Services: $70.00 copay |
| Skilled Nursing Facility Care | In-Network: Days 1 - 20: $0.00 per day / Days 21 - 100: $196.00 per day Out-of-Network: 40% coinsurance per stay |
Dental Benefits
The following dental services are covered from in-network providers.
| Coverage | Cost |
|---|---|
| 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 Out-of-Network: Medicare Covered Dental: $70.00 copay Non-Medicare Preventive Dental Services: 50% coinsurance Non-Medicare Comprehensive Dental Services: 50% coinsurance |
Vision Benefits
The following vision services are covered from in-network providers.
| Coverage | Cost |
|---|---|
| Vision Benefits | In-Network: Medicare Covered Eye Exam: $0.00 copay Routine Eye Exam: $0.00 copay This plan covers 1 routine eye exam(s) every year. $69 maximum eye exam coverage amount. Medicare Covered Eye Wear: $0.00 copay Routine Eye Wear: $0.00 copay This plan covers up to $200 for eyeglasses or contact lenses every year. 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 |
Hearing Benefits
The following hearing services are covered from in-network providers.
| Coverage | Cost |
|---|---|
| Hearing Benefits | 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. Out-of-Network: Medicare Covered Hearing Exam: $70.00 copay Routine Hearing Exam: 50% coinsurance for routine hearing exam(s). |
Preventive Services and Health/Wellness Education Programs
The following services are covered from in-network providers.
| Coverage | Cost |
|---|---|
| Preventive Services and Health/Wellness Education Programs | In-Network: $0.00 copay for Medicare Covered Preventive Services Out-of-Network: 40% coinsurance |
Prescription Drug Costs and Coverage
The Simply Freedom (PPO) plan offers the following prescription drug coverage, with an annual drug deductible of $125 (excludes Tiers 1, 2 and 6) per year.
| Coverage |
Cost
|
|---|---|
|
Coverage & Cost
|
|
| Annual Drug Deductible | $125 (excludes Tiers 1, 2 and 6) |
| Preferred Generic |
|
| Generic |
|
| Supplemental Drugs |
|
| Annual Drug Deductible | $125 (excludes Tiers 1, 2 and 6) |
| Preferred Generic |
|
| Generic |
|
| Supplemental Drugs |
|
| Annual Drug Deductible | $125 (excludes Tiers 1, 2 and 6) |
| Preferred Generic |
|
| Generic |
|
| Supplemental Drugs |
|
