Call now to get help signing up for plans from licensed insurance agents!
No obligation to enroll. Mon-Fri: 8am-11pm, Sat-Sun: 8am-11pm ET
 
Medicare65quote.com
TTY 711
Ready to Enroll Online?

Freedom Blue PPO Valor (PPO)

West Virginia Medicare Advantage Plan (2024 Plan)

Monthly Premium
Your Cost
$0
by Highmark Blue Cross Blue Shield
Additional Coverage
HearingVisionDental
Overall Government Star Rating
 4.5
out of 5 stars

Ready to Enroll Online?

Plan Overview

Plan Name
Freedom Blue PPO Valor (PPO)
Insurance Carrier
Highmark Blue Cross Blue Shield
Plan Type
Medicare Advantage Plan Without Prescription Drugs
Network Type
PPO

Freedom Blue PPO Valor (PPO) is a Medicare Advantage Plan Without Prescription Drugs, which is available in West Virginia and offered by the health insurance company Highmark Blue Cross Blue Shield. This plan’s network type is PPO which determines in-network doctors who accept the health plan and whether a referral is needed.

Cost Summary

Monthly Premium
$0
Annual Deductible
$0
Max Out-of-Pocket
$6,000
Primary doctor visit
$0 copay
Specialist visit
$10 copay per visit
ER visit
$100 copay per visit (always covered)
Ambulance
$250 copay

Freedom Blue PPO Valor (PPO) has a monthly premium cost of $0 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $8,950 In and Out-of-network $6,000 In-network. The most common benefit costs which people evaluate when choosing a plan are costs for a primary doctor visit, specialist doctor visit, emergency room visit, and ambulance. These costs are listed in this summary section and a full list of benefit costs for Freedom Blue PPO Valor (PPO) are defined below.

Additional Benefits and Coverage

No
Part D Prescription Drug Coverage
Yes
Dental
Yes
Vision
Yes
Hearing

Freedom Blue PPO Valor (PPO) 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. Freedom Blue PPO Valor (PPO) includes coverage for hearing, vision, dental.

Medicare Advantage health plans can offer even more additional benefits. Freedom Blue PPO Valor (PPO) includes coverage for the following additional benefits:

Other benefits

Fitness benefit
Limited coverage
Over the counter drug benefits
Limited coverage
In-home support services
Not covered
Home and bathroom safety devices
Limited coverage
Meals for short duration
Not covered
Annual physical exams
Limited coverage
Telehealth
Limited coverage

Comparing the Quality Score of Freedom Blue PPO Valor (PPO) to Other Plans in West Virginia

Each year the federal government evaluates the quality of Medicare Advantage and Part D Prescription Drug plans based on a 5-star scoring system. For 2024, Freedom Blue PPO Valor (PPO) received an overall government quality rating of 4.5 stars out of 5 stars.

Freedom Blue PPO Valor (PPO) performed better than West Virginia’s State average overall quality score of 4.1 stars.

This Plan’s 5-star Gov’t Quality Score
West Virginia State Average Score
Overall Government 5 Star Quality Rating
 4.5
 4.1
Summary rating of health plan quality
 4.5
 4.2
Staying healthy: screenings, tests, & vaccines
 4
 2.9
Managing chronic (long term) conditions
 4
 3.3
Member experience with health plan
 4
 4.3
Member complaints & changes in the health plan's performance
 4
 4.4
Health plan customer service
 5
 4.7

The government calculates an “Overall star rating” based on ratings for sub components including “Health plan star rating” and “Drug plan star rating”, which includes further subcomponents of each.

Freedom Blue PPO Valor (PPO) received 4.5 stars for its health plan quality score which is better than the West Virginia State average health plan quality score of 4.2 stars.

Plan Benefits and Coverage Details

Monthly Premium
$0
Health Portion of Premium
$0
Drug Portion of Premium
$0
Health Plan Deductible
$0
Health Plan Max Out-of-Pocket
$8,950 In and Out-of-network
$6,000 In-network
Nationwide Coverage included
No
Hearing Coverage included
Yes
Vision Coverage included
Yes
Dental Coverage included
Yes
Doctor Lookup Link
http://medicare.highmark.com
Plan Link
http://medicare.highmark.com

Medical Benefits

Doctor Services

Primary doctor visit
In-network: $0 copay
Out-of-network: $0 copay
Specialist visit
In-network: $10 copay per visit
Out-of-network: $10 copay per visit

Tests, labs, & imaging

Diagnostic tests & procedures
In-network: $0 copay
Out-of-network: $35 copay
Lab services
In-network: $0 copay
Out-of-network: $35 copay
Diagnostic radiology services (like MRI)
In-network: $225 copay
Out-of-network: $325 copay
Outpatient x-rays
In-network: $20 copay
Out-of-network: $35 copay
Emergency care
$100 copay per visit (always covered)
Urgent care
$50 copay per visit (always covered)

Hospital Services

Inpatient hospital coverage
In-network: $275 per stay
Out-of-network: $395 per stay
Outpatient hospital coverage
In-network: $245 copay per visit
Out-of-network: $375 copay per visit

Skilled nursing facility

Skilled nursing facility
In-network: $0 per day for days 1 through 20
$203 per day for days 21 through 100
Out-of-network: 30% per stay

Preventive services

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

Ambulance

Ground ambulance
In-network: $250 copay
Out-of-network: $250 copay or 30% coinsurance

Therapy services

Occupational therapy visit
In-network: $15 copay
Out-of-network: $35 copay
Physical therapy & speech & language therapy visit
In-network: $15 copay
Out-of-network: $35 copay

Mental health services

Outpatient group therapy with a psychiatrist
In-network: $5 copay
Out-of-network: $35 copay
Outpatient individual therapy with a psychiatrist
In-network: $5 copay
Out-of-network: $35 copay
Outpatient group therapy visit
In-network: $5 copay
Out-of-network: $35 copay
Outpatient individual therapy visit
In-network: $5 copay
Out-of-network: $35 copay

Opioid treatment services

Opioid treatment services
Covered

Other services

Durable medical equipment (like wheelchairs & oxygen)
In-network: 20% coinsurance per item
Out-of-network: 30% coinsurance per item
Prosthetics (like braces, artificial limbs)
In-network: 20% coinsurance per item
Out-of-network: 30% coinsurance per item
Diabetes supplies
In-network: 0-20% coinsurance per item
Out-of-network: 30% coinsurance per item

Prescription Drug Benefits

Tier drug costs for: Standard retail pharmacy drug cost for 1-month

Part B Drugs

Chemotherapy drugs
In-network: 0-20% coinsurance
Out-of-network: 30% coinsurance
Other Part B drugs
In-network: 0-20% coinsurance
Out-of-network: 30% coinsurance

Extra Benefits

Hearing

Hearing exam
In-network: $10 copay
Out-of-network: $10 copay
Fitting/evaluation
Not covered
Hearing aids - All types
In-network: $699-999 copay
Out-of-network: $0 copay

Preventive Dental

Oral exam
In-network: $0 copay
Out-of-network: 30% coinsurance
Cleaning
In-network: $0 copay
Out-of-network: 30% coinsurance
Fluoride treatment
In-network: $0 copay
Out-of-network: 30% coinsurance
Dental x-rays
In-network: $0 copay
Out-of-network: 30% coinsurance

Comprehensive dental

Non-routine services
In-network: 20% coinsurance
Out-of-network: 50% coinsurance
Diagnostic services
In-network: 20% coinsurance
Out-of-network: 50% coinsurance
Restorative services
In-network: 20% coinsurance
Out-of-network: 50% coinsurance
Endodontics
In-network: 20% coinsurance
Out-of-network: 50% coinsurance
Periodontics
In-network: 20% coinsurance
Out-of-network: 50% coinsurance
Extractions
In-network: 20% coinsurance
Out-of-network: 50% coinsurance
Prosthodontics, other oral/maxillofacial surgery, other services
In-network: 20% coinsurance
Out-of-network: 50% coinsurance

Vision

Routine eye exam
In-network: $0 copay
Out-of-network: $50 copay
Contact lenses
In-network: $0 copay
Out-of-network: $0 copay
Eyeglasses (frames & lenses)
Not covered
Eyeglass frames (only)
In-network: $0 copay
Out-of-network: $0 copay
Eyeglass lenses (only)
In-network: $0 copay
Out-of-network: $0 copay
Upgrades
In-network: $0 copay
Out-of-network: $0 copay

When Can I Sign Up for Medicare?

Enter your birthday month and year to learn when you can sign up for different Medicare plan options.

 

 

Ready to Enroll Online?

Please Support Our Sponsor

Advertisement

Medicare Health Plans

Get Advice & Sign Up Help
TTY 711

Speak with a Licensed Insurance Agent

Mon-Fri: 8am - 11pm ET
Sat-Sun: 8am - 11pm ET

Medicare65quote

  • Medicare Advantage Plans
  • Medicare Prescription Drug Plans
  • Medicare Supplement Insurance Plans

No obligation to enroll. Find your plan online or speak with a licensed insurance agent to get help signing up for the right plan for you! See www.medicare65quote.com for our Third-Party Marketing Organization disclaimer.

Related Articles
Best West Virginia Medicare Advantage Health Insurance Companies for 2024
Health Plan Radar Health Plan Radar

In this article we rank West Virginia Medicare Advantage plans based on our evaluation of government 5-star quality scores. Each year the government rates the quality of Medicare Advantage health insurance plans with a 5-star quality score. An overall quality score is assigned to each plan which is based on the scores of various quality metrics.

Read more →

New West Virginia Medicare Advantage Health Insurance Companies for 2024
Health Plan Radar Health Plan Radar

The Medicare landscape in West Virginia is constantly changing. In this article we show a summary of new and returning health insurance companies offering Medicare Advantage Plans (Part C) and Medicare Prescription Drug Plans (Part D) in West Virginia.

Read more →