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HealthSpring Preferred (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HealthSpring Preferred (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HealthSpring Preferred (HMO) in 2026, please refer to our full plan details page.
HealthSpring Preferred (HMO) is a HMO plan offered by Health Care Service Corporation available for enrollment in 2025 to people living in Savannah. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that HealthSpring Preferred (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about HealthSpring Preferred (HMO).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For HealthSpring Preferred (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $615.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $6751.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The HealthSpring Preferred (HMO) Medicare plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, you will pay no copay when using a preferred pharmacy or preferred mail-order service, while standard options require a $10 copay for a one-month supply. Tier 2 generic medications cost as little as a $4 copay for a one-month supply at preferred pharmacies, or no copay for a three-month supply via preferred mail order. For higher-tier medications, Tier 3 preferred brand drugs carry a $47 copay for a one-month supply across all pharmacy and mail-order options. Tier 4 non-preferred drugs require a 50% coinsurance, while Tier 5 specialty drugs have a 25% coinsurance for a one-month supply. These tiered options allow you to choose between preferred and standard networks to best fit your prescription drug budget.
Additional Benefits
The HealthSpring Preferred (HMO) plan offers comprehensive medical coverage featuring no copays and no coinsurance for primary care visits, preventive services, and home health care. For specialist visits, outpatient services, and emergency care, members can expect predictable copayments, such as a $25 copay for specialists and a $115 copay for emergency room visits with no coinsurance. Inpatient hospital stays require daily copays for the first six days, after which there is no copay for additional covered days. This plan also includes valuable extra benefits, offering dental coverage with no copay up to a $1,250 annual limit and eyewear coverage with no copay up to a $200 yearly limit. Hearing exams and hearing aids are available with flat copays and no coinsurance, alongside a $50 quarterly over-the-counter allowance and limited free transportation services. For specialized needs like medical equipment and dialysis, members will generally pay no copay and a 20% coinsurance.
Inpatient Hospital See details
HealthSpring Preferred (HMO) covers inpatient hospital services with no coinsurance, subject to prior authorization. Acute care requires a $250 daily copay for days 1-6 and no copay for days 7 and beyond, while psychiatric care requires a $320 daily copay for days 1-6 and no copay for days 7-90. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
HealthSpring Preferred (HMO) covers outpatient services with no coinsurance, including no copay for ambulatory surgical center and blood services. Outpatient hospital services require a copay of $0 to $300, while outpatient substance abuse sessions carry a $25 copay.
Partial Hospitalization See details
HealthSpring Preferred (HMO) covers partial hospitalization services with a $105.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
HealthSpring Preferred (HMO) covers ground ambulance services with a $290 copay and coinsurance, and air ambulance services with a copay and 20% coinsurance, both requiring prior authorization. Transportation services are partially covered with no copay and no coinsurance for up to 10 one-way trips per year to plan-approved locations, while transportation to any health-related location is not covered.
Emergency Services See details
HealthSpring Preferred (HMO) covers emergency services with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $50,000 maximum with a $115 copay and no coinsurance.
Primary Care See details
HealthSpring Preferred (HMO) covers primary care physician services with no copay and no coinsurance, while specialist, physical therapy, occupational therapy, and opioid treatment services require a $25 copay and no coinsurance. Telehealth and other healthcare professional services have a $0 to $25 copay and no coinsurance, whereas chiropractic, podiatry, mental health, and psychiatric services are not covered.
Preventive Services See details
Preventive Services are covered by HealthSpring Preferred (HMO) with no copay and no coinsurance, including annual physical exams, kidney disease education, and diabetes self-management training. Additional preventive benefits are partially covered, excluding services such as health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, weight management, alternative therapies, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, and counseling.
Hearing Services See details
HealthSpring Preferred (HMO) covers hearing services, including annual routine hearing exams for a $25 copay and no coinsurance, and up to two OTC hearing aids per year for a $399 copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $399 to $1,800, though inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Vision Services are partially covered by HealthSpring Preferred (HMO), offering one annual routine eye exam with a $0 to $30 copay and no coinsurance, while other eye exam services are not covered. Eyewear is covered with no copay and no coinsurance up to a $200 yearly limit for contacts, lenses, and frames.
Dental Services See details
HealthSpring Preferred (HMO) covers Medicare dental services with a $25 copay and no coinsurance, while other preventive and comprehensive dental services are covered with no copay and no coinsurance up to a $1,250 annual maximum. These additional covered services include exams, cleanings, X-rays, and restorative care, all offered with no copay or coinsurance.
Home Infusion bundled Services See details
Home infusion bundled services are covered by HealthSpring Preferred (HMO) with no copay and no coinsurance, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and radiation, have no copay and up to 20% coinsurance, while insulin drugs require a $35 copay and up to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the HealthSpring Preferred (HMO) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Medical equipment is covered by HealthSpring Preferred (HMO) with no copay and a 20% coinsurance, though prior authorization is required. This benefit is partially covered because durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes are covered, while diabetic supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by HealthSpring Preferred (HMO) with prior authorization required. Diagnostic procedures and tests have no coinsurance and a copay ranging from $0 to $95, lab services and outpatient X-rays feature no copay, and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by HealthSpring Preferred (HMO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the HealthSpring Preferred (HMO) plan, which includes intensive cardiac, pulmonary, and supervised exercise therapy (SET) services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by HealthSpring Preferred (HMO) with no coinsurance, requiring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
HealthSpring Preferred (HMO) partially covers Other Services with no copay and no coinsurance, which includes a meal benefit and a $50 quarterly over-the-counter (OTC) allowance. Acupuncture is not covered under this benefit.
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