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Disease Specific Assessment - Members

Congestive Heart Failure Assessment Form
Cardiovascular Assessment Form
COPD Assessment Form
Asthma Disease Management Assessment
Diabetes Health Assessment Form

Last updated 10/01/2023

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CMS Model Electronic Complaint Form
The Medicare Beneficiary Ombudsman
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Disaster and Emergency Declaration Policy
Multi-Language Interpreter Service
Servicios de interpretación en varios idiomas
(Multi-Language Insert) | (Inserción de varios idiomas)

Section 1557 Notice of Non-Discrimination:
English | Spanish

Hours
From October 1 to March 31, we are open 7 days a week from 8 a.m. to 8 p.m. EST.

From April 1 to September 30, we are open Monday through Friday, 8 a.m. to 8 p.m. EST.

Telephone
Toll Free 1-800-401-2740
TTY/TDD: 711

Mailing Address
P.O. Box 151137
ATTN: Freedom Health
Tampa, FL 33684

Serving the following areas in Florida:

Brevard County

Broward County

Citrus County

Charlotte County

Collier County

Hernando County

Hillsborough County

Indian River County

Lake County

Lee County

Marion County

Manatee County

Martin County

Orange County

Osceola County

Palm Beach County

Pasco County

Pinellas County

Polk County

Saint Lucie County

Sarasota County

Seminole County

Sumter County

Volusia County

Freedom Health, Inc. is an HMO with a Medicare contract and a contract with the state of Florida Medicaid program. Enrollment in Freedom Health, Inc. depends on contract renewal. This Information is not a complete description of benefits. Call 1-800-401-2740 (TTY: 711) for more information. Medicare beneficiaries may also enroll in Freedom Health through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov. Every year, Medicare evaluates plans based on a 5-star rating system.

Freedom Health, Inc. has been approved by the National Committee for Quality Assurance (NCQA) to operate as a Chronic Condition Special Needs Plan (C-SNP) through 2024 and a Dual Special Needs Plan (D-SNP) through 2026 based on a review Freedom Health, Inc.’s Model of Care.

Freedom Health, Inc. complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Freedom Health, Inc. cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo. Freedom Health, Inc. konfòm ak lwa sou dwa sivil Federal ki aplikab yo e li pa fè diskriminasyon sou baz ras, koulè, peyi orijin, laj, enfimite oswa sèks. Español (Spanish): ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-800-401-2740 (TTY: 711). Kreyòl Ayisyen (French Creole): ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele 1-800-401-2740 (TTY: 711).

These materials may be made available in alternate formats (e.g., large print, Braille) to individuals with disabilities, upon request.

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