Univera Medicare Freedom (HMO-POS) Medicare Advantage Plan H3351-001 • 2027
- Monthly Premium
- $0.00Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $6500.00In-network
- Part B Giveback
- −$25.00 reduction
- Prescription Coverage
- Not Included
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- See List
- Total Enrollment
- 249 beneficiaries
Univera Medicare Freedom (HMO-POS) Introduction
CMS Plan ID H3351-001 identifies Univera Medicare Freedom, a Medicare Advantage HMO-POS plan offered by Excellus Health Plan, Inc. The plan uses a Health Maintenance Organization with a Point of Service (HMO-POS) provider network and comes without prescription drug coverage. Its costs for the 2027 plan year include a $0.00 monthly premium, $0.00 medical deductible, and $6500.00 in-network maximum out-of-pocket.
Plan Benefits
Univera Medicare Freedom has cost-sharing, meaning there are out-of-pocket costs when receiving covered healthcare services. The tables below detail the most common in-network out-of-pocket expenses for plan H3351-001.
Compare 2027 plan benefits with 2026.
Office Visits
| Covered Service | 2027 | 2026 |
|---|---|---|
| Primary care | In-network: $5 copay Out-of-network: 30% coinsurance |
In-network: $5 copay Out-of-network: 30% coinsurance |
| Specialist | In-network: $35 copay Out-of-network: 30% coinsurance |
In-network: $35 copay Out-of-network: 30% coinsurance |
Preventive and Wellness Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Annual wellness exam | In-network: $0 copay | In-network: $0 copay |
| Telehealth benefit | In-network: $0-$35 copay, 20% coinsurance | In-network: $0-$35 copay, 20% coinsurance |
| Routine chiropractic | Not covered | Not covered |
| Fitness benefits | Coming soon | In-network: $0 copay |
| Health education | Not covered | Not covered |
| Counseling services | Not covered | Not covered |
| Over-the-counter drug benefits | Not covered | In-network: $0 copay |
| Health transportation (non-emergency) | Coming soon | Not covered |
Diagnostic, Lab, and Imaging Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Diagnostic radiology services | In-network: $150 copay Out-of-network: 30% coinsurance |
In-network: $150 copay Out-of-network: 30% coinsurance |
| Lab services | In-network: $10 copay Out-of-network: 30% coinsurance |
In-network: $10 copay Out-of-network: 30% coinsurance |
| Outpatient x-rays | In-network: $40 copay Out-of-network: 30% coinsurance |
In-network: $40 copay Out-of-network: 30% coinsurance |
| Diagnostic tests and procedures | In-network: $10 copay Out-of-network: 30% coinsurance |
In-network: $10 copay Out-of-network: 30% coinsurance |
Emergency and Urgent Care Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Emergency room care | $115 copay | $115 copay |
| Worldwide emergency care | Coming soon | $115 copay |
| Urgent care | $50 copay | $50 copay |
| Inpatient hospital care | In-network: Tier 1 $260 per day for days 1-5 $0 per day for days 6-90 $0 per stay Out-of-network: 30% per stay |
In-network: Tier 1 $260 per day for days 1-5 $0 per day for days 6-90 $0 per stay Out-of-network: 30% per stay |
| Skilled Nursing Facility | In-network: Tier 1 $0 per day for days 1-20 $221 per day for days 21-100 Out-of-network: 30% per stay |
In-network: Tier 1 $0 per day for days 1-20 $218 per day for days 21-100 Out-of-network: 30% per stay |
| Ground ambulance | In-network: $150 copay Out-of-network: $150 copay |
In-network: $150 copay Out-of-network: $150 copay |
Mental Health Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Outpatient individual therapy | In-network: $0 copay Out-of-network: 30% coinsurance |
In-network: $0 copay Out-of-network: 30% coinsurance |
| Outpatient group therapy | In-network: $0 copay Out-of-network: 30% coinsurance |
In-network: $0 copay Out-of-network: 30% coinsurance |
| Inpatient psychiatric hospital care | In-network: Tier 1 $260 per day for days 1-5 $0 per day for days 6-90 $0 per stay Out-of-network: 30% per stay |
In-network: Tier 1 $260 per day for days 1-5 $0 per day for days 6-90 $0 per stay Out-of-network: 30% per stay |
Rehabilitation Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Physical therapy and speech and language therapy | In-network: $35 copay Out-of-network: 30% coinsurance |
In-network: $35 copay Out-of-network: 30% coinsurance |
| Occupational therapy | In-network: $35 copay Out-of-network: 30% coinsurance |
In-network: $35 copay Out-of-network: 30% coinsurance |
Medical Equipment and Supplies
| Covered Service | 2027 | 2026 |
|---|---|---|
| Diabetes supplies | In-network: $5 copay, 20% coinsurance Out-of-network: 30% coinsurance |
In-network: $5 copay Out-of-network: 30% coinsurance |
| Durable medical equipment | In-network: 20% coinsurance Out-of-network: 30% coinsurance |
In-network: 20% coinsurance Out-of-network: 30% coinsurance |
| Prosthetics | In-network: 20% coinsurance Out-of-network: 30% coinsurance |
In-network: 20% coinsurance Out-of-network: 30% coinsurance |
Medicare Part B Drugs
| Covered Service | 2027 | 2026 |
|---|---|---|
| Chemotherapy | In-network: 0%-20% coinsurance Out-of-network: 30% coinsurance |
In-network: 0%-20% coinsurance Out-of-network: 30% coinsurance |
| Other Part B drugs (Medicare-covered) | In-network: 0%-20% coinsurance Out-of-network: 30% coinsurance |
In-network: 0%-20% coinsurance Out-of-network: 30% coinsurance |
Dental Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Oral exam | In-network: $0 copay | In-network: $0 copay |
| Dental x-rays | In-network: $0 copay | In-network: $0 copay |
| Cleaning | In-network: $0 copay | In-network: $0 copay |
| Periodontics | In-network: $0 copay | In-network: $0 copay |
| Endodontics | In-network: $0 copay | In-network: $0 copay |
| Restorative services | In-network: $0 copay | In-network: $0 copay |
| Implant services | Not covered | Not covered |
| Orthodontics | Not covered | Not covered |
| Oral/Maxillofacial surgery | In-network: $0 copay | In-network: $0 copay |
Vision Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Routine eye exam | In-network: $0 copay | In-network: $0 copay |
| Contact lenses | In-network: $0 copay | In-network: $0 copay |
| Eyeglass frames only | Not covered | Not covered |
| Eyeglass lenses only | Not covered | Not covered |
| Eyeglasses (frames & lenses) | In-network: $0 copay | In-network: $0 copay |
| Upgrades | Not covered | Not covered |
Hearing Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Hearing exam | In-network: $0 copay | In-network: $0 copay |
| Fitting/evaluation | In-network: $0 copay | In-network: $0 copay |
| Prescription hearing aids | In-network: $299-$799 copay | In-network: $499-$799 copay |
| OTC hearing aids | Not covered | Not covered |
Additional and Special Needs Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Adult day health services | Not covered | Not covered |
| Home-based palliative care | Not covered | Not covered |
| Personal emergency response system | Coming soon | Not covered |
| Weight management programs | Not covered | Not covered |
| Wigs for chemotherapy-related hair loss | Coming soon | Not covered |
| Alternative therapies | Not covered | Not covered |
| Massage therapy | Not covered | Not covered |
| Home/bathroom safety devices | Not covered | Not covered |
Certain preventive services are covered 100% by Univera Medicare Freedom as a Part B benefit.
Prescription Drug Coverage
This plan does not include a Medicare Part D plan for prescriptions.
CMS 5-Star Performance Ratings (Contract ID: H3351)
The Centers for Medicare & Medicaid Services (CMS) rates Medicare Advantage (Part C) and Part D prescription drug plans each year using a 5-star system. These ratings measure plan performance in areas such as preventive care, management of chronic conditions, and member experience.
| CMS Measure | Star Rating |
|---|---|
| 2027 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 | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
Contact Information for Excellus Health Plan, Inc
- Website
- Excellus Health Plan, Inc Plan Page
- Providers
- Excellus Health Plan, Inc Providers Page
- Formulary
- Excellus Health Plan, Inc Formulary Page
- Pharmacy
- Excellus Health Plan, Inc Pharmacy Page
- New Member Health Plan Help
- (800)659-1986
- New Member Health Plan TTY
- 711
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at Medicare.gov.
Plan Availability
Univera Medicare Freedom (H3351-001-0) is available in the following locations:
New York Counties Served
Frequently Asked Questions
Here are some of the most frequently asked questions about this plan (click to open).
Frequently Asked Questions About Univera Medicare Freedom (HMO-POS)
How much does plan H3351-001 cost per month?
The plan’s monthly premium is $0.00 for 2027. The Part B premium is not included.
What is the annual out-of-pocket maximum (MOOP) for this plan?
The annual in-network MOOP is $6500.00 for 2027. After this limit is reached, covered in-network services are fully paid.
What is the current enrollment for Univera Medicare Freedom?
The plan has 249 enrolled beneficiaries according to CMS.
What is the prescription drug deductible for 2027?
For 2027, the prescription drug deductible is $0.00.
Medicare Plan Data Sources and Methodology
| Data Source | Publisher | Last Accessed |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | October 5, 2026 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| Excellus Health Plan, Inc (official source) | http://www.UniveraMedicare.com | October 4, 2026 |
| Medicare.gov | Compare types of Medicare Advantage Plans | 25 May, 2025 |
| NCOA.org | 5 Steps to Choosing the Right Medicare Plan for You | 25 May, 2025 |
| Medicare.gov | Compare Original Medicare & Medicare Advantage | 25 May, 2025 |
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