HealthPartners Freedom Valley (COST) Plan Details for Brown County, SD
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*This plan is new and has not yet been rated by CMS.
HealthPartners Freedom Valley (Cost) is a Medicare Advantage plan with a prescription drug plan. The 2025 Annual Enrollment period starts October 15. Plan benefits begin January 1
See more Medicare Advantage Plans in Brown County, South Dakota.
HealthPartners Freedom Valley Basic Details
Plan Basics | |
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Plan ID: | H2462-029-0 |
Plan Type: | Cost |
Plan Year: | 2025 |
Premium: | $0.00/mo Plus your Medicare Part B premium. |
Health Plan Deductible: | $0.00 |
Out-of-Pocket Maximum: | 4,500.00 /yr |
Part B Reduction: | $0.00/mo |
Drug Plan Benefit: | Not Included |
Supplemental Benefits: | Vision, Hearing |
Availability: | Brown County, SD |
Insured By: | HealthPartners |
Summary of Benefits |
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HealthPartners Out-of-Pocket Costs
This HealthPartners Part C plan has cost-sharing. These are costs you pay out-of-pocket when you use approved health services. The following table summarizes the most common in-network out-of-pocket costs in plan H2462-029-0.
NOTE: Certain preventive services are covered 100% by the plan as a Part B benefit.
Doctor's Office Visits
Service | Enrollee Cost (in-network) |
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Primary: | Not Covered |
Specialist: | $40 Copay |
Emergency, Urgent, and Inpatient Hospital Coverage
Service | Enrollee Cost |
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Emergency room care: | $140 Copay |
Urgent care: | $40 Copay |
Ground ambulance: | $200 Copay |
Inpatient hospital care: | $300.00 per day for days 1 through 5 $0.00 per day for days 6 and beyond |
Skilled Nursing Facility: | $0.00 per day for days 1 through 20 $214.00 per day for days 21 and beyond |
Foot Care
Service | Enrollee Cost (in-network) |
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Foot Exams and Treatments (Medicare-covered): | $40 Copay |
Routine Foot Care: | Not Covered |
Chiropractic Care
Service | Enrollee Cost (in-network) |
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Medicare-covered chiropractic: | $15 Copay |
Routine chiropractic: | Not Covered |
Mental Health Services
Service | Enrollee Cost (in-network) |
---|---|
Outpatient individual therapy: | $40 Copay |
Outpatient group therapy: | $20 Copay |
Inpatient psychiatric hospital care: | $300.00 per day for days 1 through 5 $0.00 per day for days 6 and beyond |
Rehabilitation Services
Service | Enrollee Cost (in-network) |
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Physical therapy and speech and language therapy: | $40 Copay |
Occupational therapy: | $40 Copay |
Medical Equipment and Supplies
Service | Enrollee Cost (in-network) |
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Diabetes supplies: | 20% Coinsurance Prior Authorization Required |
Durable medical equipment: | 20% Coinsurance Prior Authorization Required |
Prosthetics: | 20% Coinsurance |
Diagnostics, Lab Services, and Imaging
Service | Enrollee Cost (in-network) |
---|---|
Diagnostic radiology services: | $150 Copay Prior Authorization Required |
Lab services: | Not Covered |
Outpatient x-rays: | $35 Copay Prior Authorization Required |
Diagnostic tests and procedures: | $40 Copay Prior Authorization Required |
Medicare Part B Drugs
Service | Enrollee Cost (in-network) |
---|---|
Chemotherapy: | 20% Coinsurance |
Other Part B drugs (Medicare-covered): | 20% Coinsurance |
Dental Services
Service | Member Cost (in-network) |
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Medicare Covered Preventive Dental | Not Covered |
Oral exam | $0 |
Dental x-rays | $0 |
Cleaning | $0 |
Periodontics | Not Covered |
Endodontics | Not Covered |
Restorative Services | Not Covered |
Maximum dental benefit: | $1,000.00 (Every year) |
Hearing Aids and Services
Service | Member Cost (in-network) |
---|---|
Fitting/evaluation | Covered Limits may apply |
Hearing aids | Not Covered |
Hearing exam | Covered Limits may apply |
Vision Services
Service | Member Cost (in-network) |
---|---|
Medicare-covered eye exam (in-network) | $ to $40 Copay |
Routine eye exam (in-network) | Covered Limits may apply |
Eyewear benefits | None |
Feel free to download our HealthPartners Freedom Valley Summary of Benefits information.
Prescription Drug Plan Costs & Benefits
This plan does not include a Medicare Part D plan for prescriptions.
CMS 5-Star Rating Marks
The following table shows the quality ratings for this HealthPartners plan. Each year CMS rates health plans (Part C) in five broad categories and drug plans (Part D) in four broad categories using a 5-star rating system. Here are the most recent ratings for HealthPartners Freedom Valley .
CMS Measure | Star Rating |
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2025 Overall Rating | |
Staying Healthy: Screenings, Tests, Vaccines | |
Managing Chronic (Long Term) Conditions | |
Member Experience with Health Plan | |
Complaints and Changes in Plans Performance | |
Health Plan Customer Service | Not enough data available |
Drug Plan Customer Service | Not enough data available |
Complaints and Changes in the Drug Plan | |
Member Experience with the Drug Plan | Not enough data available |
Drug Safety and Accuracy of Drug Pricing | Not enough data available |
Additional Plan Options
The Medicare Part C program offers a myriad of HMO, PPO, and PFFS plan options, including these plans:
- HealthPartners Freedom Balance WI
- HealthPartners Freedom Vital WI
- HealthPartners Freedom Plains
- HealthPartners Freedom Valley
- HealthPartners Freedom Basic WI
- HealthPartners Freedom Crest
- HealthPartners Freedom Prairie
If you are enrolled in a Part C plan with prescription drug coverage, you cannot be enrolled in a stand-alone Medicare Part D plan, regardless of your chosen insurance company.
You cannot be enrolled in a Part C health plan and simultaneously hold Medicare Supplement Insurance (Medigap). Medicare Supplement plans are only compatible with Medicare Parts A and B.
Contact HealthPartners
Website: | HealthPartners Plan Page |
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Providers: | HealthPartners Providers Page |
New Member Health Plan Help: | (800)247-7015 |
New Member Health Plan TTY: | 711 |
If you qualify for Medicare benefits but have not yet enrolled or verified your enrollment status, you can do so on the Social Security Administration website. You can learn more about the Medicare Part C program on www.medicare.gov or call 1-800-MEDICARE.
Citations & References
- HealthPartners, http://healthpartners.com/ExploreMedicare, Last Accessed February 20, 2024
- Medicare.gov, "Understanding Medicare Advantage Plans", Last Accessed January 21, 2024
- Medicare.gov, "How Original Medicare Works", Last Accessed February 19, 2024
- Medicare.gov, "Medicare & You Handbook", Last Accessed February 19, 2024
- Medicare.gov, "Your Medicare Coverage", Last Accessed April 11, 2023
- CMS.gov, Landscape Source Files, Last Accessed February 21, 2024
- CMS.gov, Medicare Part C & D Performance, Last Accessed February 21, 2024
- CMS.gov, Plan Benefits Package, Last Accessed February 21, 2024
Plans Offered
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, Healthy Blue, HealthSun, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.