NextBlue Freedom PPO (PPO) 2025 Plan Details for Ward County, North Dakota Residents
NextBlue Freedom PPO (PPO) 2025 Plan Details for Ward County, North Dakota Residents
Navigating your Medicare Advantage options in Ward County for 2025 can be overwhelming, but we're here to help. With NextBlue Freedom PPO (PPO) included in your plan options, you can evaluate it alongside other plans to make an informed decision. Enroll online quickly, or consult with a licensed agent if you need assistance.
Based on May, 2025 CMS enrollment data, an estimated 712 Medicare beneficiaries are enrolled in this plan, with 95 members in Ward County, ND.
NextBlue Freedom PPO Overview
| Plan ID H6202-003-0 Overview | |
|---|---|
| Health Plan ID: | H6202-003-0 |
| Medicare Advantage Plan Type: | PPO |
| Plan Year: | 2025 |
| Monthly Premium: | $0.00 Plus your Medicare Part B premium. |
| Health Plan Deductible: | $0.00 |
| Annual Out-of-Pocket Maximum: | $5,500.00 (In-Network) |
| Part B Give Back: | $0.00/mo |
| Part D Drug Plan Benefit: | Not Included |
| Additional Benefits: | Dental, Vision, Hearing |
| Availability: | Ward County, ND |
| Insured By: | NextBlue of North Dakota |
Why Choose NextBlue Freedom PPO ?
This Medicare Advantage PPO plan delivers flexible access to care along with all the standard benefits of Medicare Part A and Part B. With a monthly premium of $0.00, it allows you to see any Medicare-approved provider — though you’ll typically pay less when using in-network doctors and facilities.
Primary care visits have a $0 copay, specialist visits come with a $30 copay, lab services cost $0 copay, urgent care services carry a $40 copay, and ambulance transportation is $200 copay. These costs count toward the plan’s annual maximum out-of-pocket (MOOP) limit of $5,500.00 . Once you reach that limit, in-network care is fully covered for the rest of the year.
Officially listed as CMS plan H6202-003-0. Below, you’ll find a breakdown of cost sharing for key services. Still have questions? Check the FAQ section for more information.
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Out-of-Pocket Expenses
With NextBlue Freedom PPO , you'll have cost-sharing expenses, which are the out-of-pocket costs for approved healthcare services. The table below provides a summary of the typical in-network out-of-pocket costs associated with plan H6202-003-0.
Find out the costs for visiting your primary care doctor and specialists, as well as coverage for wellness and preventive programs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Primary: | $0 Copay |
| Specialist: | $30 Copay |
Review the costs for emergency services, urgent care, ambulance services, inpatient hospital stays, and skilled nursing facility care.
| Service | Enrollee Cost |
|---|---|
| Emergency room care: | $120 Copay |
| Urgent care: | $40 Copay |
| Ground ambulance: | $200 Copay |
| Inpatient hospital care: | $375.00 per day for days 1 through 4 $0.00 per day for days 5 and beyond |
| Skilled Nursing Facility: | $0.00 per day for days 1 through 20 $150.00 per day for days 21 through 48 $0.00 per day for days 49 and beyond |
This section covers Medicare-approved foot care services, including exams and routine foot care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Foot Exams and Treatments (Medicare-covered): | $40 Copay |
| Routine Foot Care: | Not Covered |
Understand the coverage for Medicare-approved chiropractic services and routine chiropractic care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Medicare-covered chiropractic: | $20 Copay |
| Routine chiropractic: | Not Covered |
This section explains the costs for mental health services, including individual and group therapy, and inpatient care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Outpatient individual therapy: | $30 Copay |
| Outpatient group therapy: | $30 Copay |
| Inpatient psychiatric hospital care: | $375.00 per day for days 1 through 4 $0.00 per day for days 5 and beyond |
See the cost details for rehabilitation services, including physical therapy, speech therapy, and occupational therapy.
| Service | Enrollee Cost (in-network) |
|---|---|
| Physical therapy and speech and language therapy: | $30 Copay |
| Occupational therapy: | $25 Copay |
Learn about the costs associated with medical equipment and supplies, including diabetes supplies, durable medical equipment, and prosthetics.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diabetes supplies: | 0% Coinsurance |
| Durable medical equipment: | 20% Coinsurance Prior Authorization Required |
| Prosthetics: | 20% Coinsurance |
This section outlines the costs for diagnostic services, lab tests, x-rays, and other imaging services.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diagnostic radiology services: | $325 Copay Prior Authorization Required |
| Lab services: | $0 Copay Prior Authorization Required |
| Outpatient x-rays: | $15 Copay Prior Authorization Required |
| Diagnostic tests and procedures: | $150 Copay Prior Authorization Required |
Review the cost-sharing details for chemotherapy and other Medicare Part B-covered drugs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Chemotherapy: | 20% Coinsurance |
| Other Part B drugs (Medicare-covered): | 20% Coinsurance |
This section details the dental services covered under your plan including, Medicare-covered preventive dental, oral exams, x-rays, dental cleanings, and comprehensive dental.
| Service | Member Cost (in-network) |
|---|---|
| Medicare Covered Preventive Dental | $30 Copay |
| Oral exam | |
| Dental x-rays | |
| Cleaning | |
| Periodontics | |
| Endodontics | |
| Restorative Services |
This section outlines the coverage for hearing-related services, including exams, fittings, and hearing aids.
| Service | Member Cost (in-network) |
|---|---|
| Fitting/evaluation | Covered Limits may apply |
| Hearing aids | Covered Limits may apply |
| Hearing exam | Covered Limits may apply |
Learn about the costs for vision-related services, including eye exams, eyeglasses, and contact lenses.
| Service | Member Cost (in-network) |
|---|---|
| Medicare-covered eye exam (in-network) | $0 to $30 Copay |
| Routine eye exam (in-network) | Covered Limits may apply |
| Eyewear benefits | Eyeglasses: No Contact Lenses: Yes Eyeglass Lenses: Yes Eyeglass Frames: Yes Eyewear Upgrades: Yes |
Maximum eyewear benefit: | Non Specified |
Certain preventive services are covered 100% by NextBlue Freedom PPO as a Part B benefit.
Part D Prescription Drug Costs & Benefits
This plan does not include a Medicare Part D plan for prescriptions.
CMS 5-Star Rating Overview
Each year, the Centers for Medicare & Medicaid Services (CMS) evaluates health and drug plans using a comprehensive 5-star rating system. These ratings offer valuable insights into the quality of care, member satisfaction, and overall plan performance.
When selecting a Medicare Advantage plan, looking at the star ratings can help you gauge how well a plan might meet your healthcare needs, making it easier to choose a plan with confidence.
| CMS Measure | Star Rating |
|---|---|
| 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 | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
If you are new to Medicare or Medicare Advantage plans, the following information will help you understand the enrollment process and restrictions.
Who Can Enroll in NextBlue Freedom PPO ?
You are eligible to enroll in NextBlue Freedom PPO if you meet the following conditions:
- You qualify for Medicare Part A and Part B.
- You live in the plan’s service area.
If these criteria describe your situation, you’re eligible to sign up for NextBlue Freedom PPO and take advantage of its full range of benefits.
Enrollment Periods for NextBlue Freedom PPO
Knowing when you can enroll in NextBlue Freedom PPO is essential. Here are the main enrollment periods:
- Initial Enrollment Period (IEP): Your IEP starts three months before your 65th birthday and ends three months after, giving you a seven-month window to enroll in Medicare.
- Annual Enrollment Period (AEP): The AEP, from October 15 to December 7, allows you to make changes to your Medicare Advantage plan if you are currently enrolled in a Medicare Advantage plan.
- Medicare Advantage Open Enrollment Period (MA OEP): Running from January 1 to March 31, the MA OEP lets you switch plans or return to Original Medicare if you are currently enrolled in a Medicare Advantage plan.
- Special Enrollment Periods (SEPs): Life events such as moving or losing coverage may qualify you for a SEP, enabling you to enroll or make changes outside the usual periods.
If you're uncertain about the right time to enroll, Call HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711) for guidance from a licensed insurance agent.
How to Enroll in NextBlue Freedom PPO
Enrolling in NextBlue Freedom PPO is easy. Choose the option that works best for you:
- Online through MedicareEnrollment.com: Visit the enrollment page and complete your enrollment through their Secure Online Enrollment Form.
- By Phone: Call HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711). A licensed insurance agent can assist you with the enrollment process and provide answers to any questions.
- Through Medicare.gov: Go to Medicare.gov, log in or create an account, and follow the instructions to join NextBlue Freedom PPO through the official Medicare website.
- Directly with NextBlue Freedom PPO : You can also enroll directly with the plan. The necessary contact details are provided below in the "Contact" section.
Remember to enroll during the correct enrollment period to ensure your coverage starts on time.
Here are some of the most frequently asked questions people have about plan ID H6202-003-0:
Is there a premium for this plan in 2025?
Members pay their Part B premium and the plan's of $0.00 per month to be in this 2025 plan.
What’s the MOOP for NextBlue Freedom PPO in 2025?
For 2025, the maximum you’d spend out-of-pocket in-network is $5,500.00 .
What’s the CMS star score for NextBlue Freedom PPO ?
CMS rates it ★4.0 out of 5 stars for 2025.
How many members does NextBlue Freedom PPO have?
As of last month, about 712 beneficiaries are enrolled.
Contact NextBlue of North Dakota
| Website: | NextBlue of North Dakota Plan Page |
|---|---|
| Providers: | NextBlue of North Dakota Providers Page |
| New Member Health Plan Help: | (844)753-5678 |
| New Member Health Plan TTY: | 711 |
If you're eligible for Medicare but haven't enrolled or need to verify your enrollment status, visit the Social Security Administration website. For more information about Medicare Advantage, visit medicare.gov.
- NextBlue of North Dakota, http://www.nextblueND.com, Last Accessed June 1, 2025
- Medicare.gov, "Compare types of Medicare Advantage Plans", Last Accessed 25 May, 2025
- NCOA.org, "5 Steps to Choosing the Right Medicare Plan for You", Last Accessed 25 May, 2025
- Medicare.gov, "Your coverage options", Last Accessed 25 May, 2025
- CMS.gov, Landscape Source Files, Last Accessed October 15, 2024
- CMS.gov, Medicare Part C & D Performance, Last Accessed October 15, 2024
- CMS.gov, Plan Benefits Package, Last Accessed October 15, 2024
- CMS.gov, Monthly Enrollment by Contract/Plan/State/County, Last Accessed June 6, 2025
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