Health Plans
| Liberty Medicare Advantage Nursing Home Plan - ISNP | Liberty Medicare Advantage Plan CSNP | |
|---|---|---|
| Monthly Premium | $51.00 | $0 |
| Deductible | Part B - $240.00 | |
| Maximum Out of Pocket | $6,800.00 | $3,500.00 |
| Inpatient Hospital Coverage | 2025 Medicare Rates | 2025 Medicare Rates |
| Ambulatory Surgery Center | 20% coinsurance for Medicare covered services | $250.00 maximum co-pay ($0 for colonoscopy) |
| Doctor Visits | Primary care - $0 Specialist – 20% per visit | Primary Care $0 Specialist – Max $10.00 |
| Annual Wellness Visit and Preventative Services | $0 | $0 |
| Emergency Care | 20% coinsurance, ($110 maximum per visit waived if admitted to the hospital within three days) | $100.00 co-pay |
| Urgently Needed Services | 20% coinsurance for Medicare covered services or maximum per visit amount $45 | $25.00 co-pay |
| Diagnostic Services Outpatient | 0 – 20% coinsurance for Medicare covered services | $0 In Office $50 Urgent Care $75 Outpatient |
| Mental Health Services | 20% coinsurance for Medicare covered services | $50.00 co-pay for Individual or Group Sessions |
| Skilled Nursing Facility | 2025 Medicare Rates | 2025 Medicare Rates |
| Therapies | 20% coinsurance for Medicare covered services | $25.00 co-pay |
| Ambulance | 20% coinsurance for Medicare covered services (one way or round-trip service) | Ground Ambulance - $275.00 Air Ambulance - $300.00 |
| Medicare Part B Drugs | 20% coinsurance for each Medicare-covered service | 20% coinsurance for each Medicare-covered service |
| Durable Medical Equipment | 20% of Medicare-covered service | 20% of Medicare-covered service |
| Prescription Drug Deductible | $590.00 | $0 |
| Copay or coinsurance for a 30-day supply of prescription drugs for Tier 1 (CSNP also Tier 2) | $35.00 | $0 |
| 90 Day supply of prescription drugs | $105.00 | $0 |
| 90 Day supply Mail Order | $105.00 | $0 |
| 31-day supply of long-term care prescription drugs | $35.00 | $0 |
| Over and Above Traditional Medicare | ||
| Customized Care Team | X | X |
| Hearing | Routine exam hearing aid fittings and $3450.00 for hearing aids for two years. | Liberty Medicare Advantage Freedom Flex card allows you to choose where to spend your annual $2000 benefit for either Vision Dental or Hearing in any combination. |
| Vision | Routine eye exam and up to $450.00 every year for eyewear. | Liberty Medicare Advantage Freedom Flex card allows you to choose where to spend your annual $2000 benefit for either Vision Dental or Hearing in any combination. |
| Podiatry | 12 routine foot care visits every year. | 4 routine foot care visits every year. |
| Non-Emergency Transportation | 55 one-way trips annually not to exceed 25 miles per trip. | Freedom Flex Card allows for $40.00 per month for either transportation or fitness. |
| Prescription Drugs | Prescription Drug coverage plus pharmacy coordination and monitoring | Prescription Drug coverage plus pharmacy coordination and monitoring |
| Fitness Benefit | N/A | Freedom Flex Card allows for $40.00 per month for either transportation or fitness. |
| Skilled Nursing | No prior hospital stay required. | No prior hospital stay required. |
| Meal Preparation | N/A | Eligible to receive 2 meals per day for up to 7 days following an acute inpatient stay. |
| At Home Monitoring | N/A | Remote monitoring of vital signs with referral from RN case manager. |
| Insulin Coverage | Maximum cost sharing $35.00. | $0 co-pay for insulins covered on our formulary. |
| Dental | N/A | Liberty Medicare Advantage Freedom Flex card allows you to choose where to spend your annual $2000 benefit for either Vision Dental or Hearing in any combination. |
| Over The Counter And Groceries | $250.00 every three months. | $75 per month with no rollover. |
Call 1-844-854-6884 (TTY 711) to speak with a Liberty Medicare Advantage Representative
Contact Us
Contact Liberty Medicare Advantage Today!
Call us at 1-833-354-1498 (TTY 711) to learn more and schedule a one-on-one appointment with a Liberty Medicare Advantage Representative.