HealthPartners Freedom Vital WI (Cost)

by HealthPartners

2026 Medicare Advantage plan available in Wisconsin

Plan ID H2462-027-0

Additional coverage:

HearingVision

Medicare Advantage COST

Monthly plan premium $70 / mo

Annual deductible $0 / yr

Max out-of-pocket · in-network $5,000 / yr

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Plan Overview

HealthPartners Freedom Vital WI (Cost) is a Medicare Advantage Plan Without Prescription Drugs, which is available in Wisconsin and offered by the health insurance company HealthPartners. This plan's network type is COST, which determines the in-network doctors who accept the plan and whether a referral is needed.

Plan Name HealthPartners Freedom Vital WI (Cost)

Insurance Carrier HealthPartners

Plan Type Medicare Advantage Plan Without Prescription Drugs

Network Type COST

Cost Summary

HealthPartners Freedom Vital WI (Cost) has a monthly premium cost of $70 per month, with an annual deductible of $0 and a maximum out-of-pocket cost sharing of $5,000. The most common costs people evaluate when choosing a plan are listed here; a full list of benefit costs is defined below.

Monthly Premium $70 / mo

Annual Deductible $0 / yr

Max Out-of-Pocket · in-network $5,000 / yr

Primary doctor visit $15 copay

Specialist visit $40 copay

ER visit $140 copay

Ambulance $200 copay

Additional Benefits and Coverage

HealthPartners Freedom Vital WI (Cost) is a Medicare Advantage plan which does not include Medicare Part D prescription drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. HealthPartners Freedom Vital WI (Cost) includes coverage for hearing, vision.

Part D Prescription Drug Coverage No

Dental No

Vision Yes

Hearing Yes

Nationwide Coverage No

Other benefits

Fitness benefit Limited coverage

Over-the-counter drug benefits Not covered

In-home support services Not covered

Home & bathroom safety devices Not covered

Meals for short duration Not covered

Annual physical exams Limited coverage

Telehealth Limited coverage

Medical Benefits

Doctor Services

Primary doctor visit In-network: $15 copay
Out-of-network: $15 copay

Specialist visit In-network: $40 copay
Out-of-network: $40 copay

Tests, labs & imaging

Diagnostic tests & procedures In-network: $0 copay
Out-of-network: $0 copay

Lab services In-network: $0 copay
Out-of-network: $0 copay

Diagnostic radiology services (like MRI) In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Outpatient x-rays In-network: $10 copay
Out-of-network: $10 copay

Emergency care $140 copay

Urgent care $40 copay

Hospital Services

Inpatient hospital coverage Tier 1
$350 per day for days 1-4
$0 per day for days 5-90
$0 per stay

Outpatient hospital coverage In-network: $250 copay
Out-of-network: $250 copay

Skilled nursing facility

Skilled nursing facility
$0 copay

Preventive services

Preventive services In-network: $0 copay
Out-of-network: $0 copay

Ambulance

Ground ambulance In-network: $200 copay
Out-of-network: $200 copay

Therapy services

Occupational therapy visit In-network: $40 copay
Out-of-network: $40 copay

Physical therapy & speech & language therapy visit In-network: $40 copay
Out-of-network: $40 copay

Mental health services

Outpatient group therapy with a psychiatrist In-network: $20 copay
Out-of-network: $20 copay

Outpatient individual therapy with a psychiatrist In-network: $40 copay
Out-of-network: $40 copay

Outpatient group therapy visit In-network: $20 copay
Out-of-network: $20 copay

Outpatient individual therapy visit In-network: $40 copay
Out-of-network: $40 copay

Opioid treatment services

Opioid treatment services Covered

Other services

Durable medical equipment (like wheelchairs & oxygen) In-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance

Prosthetics (like braces, artificial limbs) In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Diabetes supplies In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Extra Benefits

Hearing

Hearing exam In-network: $0 copay
Out-of-network: $0 copay

Fitting/evaluation In-network: $0 copay
Out-of-network: $0 copay

Hearing aids - prescription In-network: $499-$999 copay
Out-of-network: $499-$999 copay

Hearing aids - over the counter Not covered

Preventive dental

Oral exam Not covered

Cleaning Not covered

Fluoride treatment Not covered

Dental x-rays Not covered

Comprehensive dental

Restorative services Not covered

Endodontics Not covered

Periodontics Not covered

Prosthodontics, removable Not covered

Prosthodontics, fixed Not covered

Maxillofacial prosthetics Not covered

Implant services Not covered

Oral and maxillofacial surgery Not covered

Orthodontics Not covered

Adjunctive general services Not covered

Vision

Routine eye exam In-network: $0 copay
Out-of-network: $0 copay

Contact lenses Not covered

Eyeglasses (frames & lenses) Not covered

Eyeglass frames (only) Not covered

Eyeglass lenses (only) Not covered

Upgrades Not covered

Plan documents & tools

Plan details (carrier site)Provider directory Drug list (formulary)

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