HealthPartners Freedom Vital WI (Cost)
HEALTHPARTNERS, INC. · 2027 plan year
Plan ID H2462-027-000
1876 Cost
- MOOP (in-network)
- $5,000
- MOOP (combined)
- —
- Monthly premium
- $80/mo
- Prescription drugs
- Not included
This plan in 2026
Plan information
- Contract / Plan / Segment
- H2462-027-000
- Medical deductible
- $0 — no deductible
- Also owed
- Your Medicare Part B premium, paid separately
More HEALTHPARTNERS, INC. plans in WI
Benefits & cost sharing
Hospital
| Benefit | In-network |
|---|---|
| Inpatient Hospital — Acute | $350/day for days 1–4, $0 after |
| Inpatient Hospital — Additional Days (Acute) | No charge |
| Inpatient Hospital — Psychiatric | $350/day for days 1–4, $0 after |
| Worldwide Urgent Care Coverage | 20% coinsurance |
| Inpatient Hospital — Additional Days (Psychiatric) | No charge |
Pharmacy
| Benefit | In-network |
|---|---|
| Chemotherapy & Radiation Drugs (Part B) | 0%-20% coinsurance |
| Other Part B Drugs | 0%-20% coinsurance |
| Part B Drugs | See plan details |
Mental Health
| Benefit | In-network |
|---|---|
| Supplemental Health Benefits | See plan details |
| Mental Health Specialty Services | See plan details |
| Mental Health — Individual Sessions | $40 |
| Mental Health — Group Sessions | $20 |
Other
| Benefit | In-network |
|---|---|
| Opioid Treatment Program Services | $40 |
| Radiological Services | See plan details |
| Therapeutic Radiology | $60 |
| X-Ray Services | $10 |
| Hospital Observation Services | No charge |
| Substance Abuse — Individual Sessions | $40 |
| Substance Abuse — Group Sessions | $40 |
| Ambulance Services | See plan details |
| Air Ambulance | 20% coinsurance |
| Durable Medical Equipment (DME) | 0%-20% coinsurance |
| Prosthetics & Orthotics | See plan details |
| Prosthetic Devices | 20% coinsurance |
| Diabetic Supplies & Services | See plan details |
| Diabetic Therapeutic Shoes & Inserts | 20% coinsurance |
| Medicare-Covered Preventive Services | See plan details |
| Annual Physical Exam | No charge |
| Nutritional & Dietary Benefit | No charge |
| Smoking & Tobacco Cessation Counseling | No charge |
| Fitness Benefit | No charge |
| Worldwide Emergency Transportation | 20% coinsurance |
| Chiropractic Services | $15 |
| Psychiatric Services — Individual Sessions | $40 |
| Insulin (Part B) | 0%-20% coinsurance (max $35) |
| Dental — Medicare-Covered Services | No charge |
| Vision — Eye Exams | $40 |
| Vision — Eye Exams | See plan details |
| Vision — Routine Eye Exams | No charge |
| Vision — Eyewear | No charge |
| Hearing — Exams | $40 |
| Diagnostic Tests & Lab Services | See plan details |
| Diagnostic Procedures & Tests | No charge |
| Laboratory Services | No charge |
| Diagnostic Radiology | 0%-20% coinsurance |
| Outpatient Hospital Services | $250 |
| Ambulatory Surgical Center (ASC) | $250 |
| Outpatient Substance Abuse Services | See plan details |
| Outpatient Blood Services | No charge |
| Ground Ambulance | $200 |
| Medical Supplies | 0%-20% coinsurance |
| Diabetic Supplies | 20% coinsurance |
| Diabetic Monitors | 20% coinsurance |
| Dialysis Services | No charge |
| Acupuncture | $40 |
| Other Supplemental Benefit | No charge |
| Other Health Care Professional Services | $0-$40 |
| Psychiatric Services | See plan details |
| Psychiatric Services — Group Sessions | $20 |
| Physical Therapy & Speech-Language Pathology | $40 |
| Hearing — Routine Exams | No charge |
| Hearing — Prescription Hearing Aids | See plan details |
| Worldwide Emergency & Urgent Coverage | See plan details |
| Urgently Needed Services | $40 |
| Welcome to Medicare EKG | No charge |
| Hearing — Fitting & Evaluation for Hearing Aid | No charge |
| Digital Rectal Exams | No charge |
| Other Supplemental Benefit | $200 |
| Hearing — Hearing Aids (All Types) | $499-$999 |
| Worldwide Emergency Coverage | 20% coinsurance |
| Partial Hospitalization Program | No charge |
| Intensive Outpatient Program (IOP) | No charge |
| Home Health Services | No charge |
| Primary Care Physician Services | $0-$15 |
| Occupational Therapy Services | $40 |
| Physician Specialist Services | $0-$40 |
| Podiatry Services | $40 |
| Skilled Nursing Facility (SNF) | No charge |
| Cardiac & Pulmonary Rehabilitation | See plan details |
| Cardiac Rehabilitation — Additional Sessions | No charge |
| Intensive Cardiac Rehabilitation — Additional Sessions | No charge |
| Pulmonary Rehabilitation — Additional Sessions | No charge |
| Supervised Exercise Therapy (SET) | No charge |
| Emergency Services | $140 |
| Hearing — Exams | See plan details |
| Remote Access Technologies | Nurse hotline: No charge; Web/phone-based technologies: $0-$40 |
| Kidney Disease Education Services | No charge |
| Glaucoma Screening | No charge |
| Diabetes Self-Management Training | No charge |
Service area
- WI: 7 counties
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