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<, HealthPartners° <br /> National Joint Powers Alliance (NJPA) <br /> HealthPartners Freedom Medical and Prescription Drug Plan Overview <br /> 1/1/2016 <br /> (Benefit/Service within U.S. HealthPartners Freedom <br /> ILifetime maximum Unlimited <br /> (Annual deductible none <br /> (Monthly premium $24570 <br /> (Annual out-of-pocket maximum $3,000(Medical only) <br /> Preventive Health Care <br /> Routine physical,eye and hearing exams 100%coverage <br /> Immunizations 100%coverage <br /> Hearing 100%coverage <br /> Vision 100%coverage <br /> Office Visits <br /> For illness or injury $20 copayment <br /> Chiropractic care $20 copayment <br /> Mental health care $20 copayment <br /> Podiatry $20 copayment <br /> E-visits 100%coverage <br /> Inpatient Hospital Care <br /> For illness or injury $300 copayment per benefit period <br /> (Mental health care $300 copayment per benefit period <br /> IChemical health care $300 copayment per benefit period <br /> (Skilled nursing facility 100%coverage <br /> IEmereenev Care <br /> IEmergency room $50 copayment <br /> (Urgently needed care $20 copayment <br /> (Ambulance 80%coverage <br />