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HealthSpring Preferred Savings (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HealthSpring Preferred Savings (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HealthSpring Preferred Savings (HMO) in 2026, please refer to our full plan details page.
HealthSpring Preferred Savings (HMO) is a HMO plan offered by Health Care Service Corporation available for enrollment in 2026 to people living in Athens. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that HealthSpring Preferred Savings (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 Savings (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 Savings (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. Additionally, this plan comes with a Part B Premium reduction of $128.00. You must continue to pay paying your reduced 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 $9250.00 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 Savings (HMO) Medicare prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, members pay no copay when using a preferred pharmacy or preferred mail-order service. Tier 2 generic drugs are also highly affordable, starting at a $4 copay for a one-month supply at preferred pharmacies, or even no copay for a three-month supply via preferred mail order. For Tier 3 preferred brand drugs, members pay a flat $47 copay for a one-month supply regardless of the pharmacy type chosen. Higher-tier medications require coinsurance, with Tier 4 non-preferred drugs carrying a 50% coinsurance and Tier 5 specialty drugs requiring a 25% coinsurance for a one-month supply. Utilizing preferred pharmacies and mail-order services helps maximize savings on this plan.
Additional Benefits
The HealthSpring Preferred Savings (HMO) plan offers affordable medical coverage with no copay for primary care doctor visits and a $45 copay for specialist visits. For hospital care, inpatient stays require a $375 daily copay for the first five days and no copay for days six through 90, while outpatient hospital services feature a copay ranging from no copay to $365. Emergency room visits have a $115 copay that is waived if you are admitted within 24 hours, and urgent care visits require a $40 copay. This plan also includes key extra benefits, such as routine dental cleanings and exams with no copay up to a $500 annual limit, and eyewear coverage with no copay up to a $100 annual maximum. Routine hearing exams carry a $30 copay, and prescription hearing aids are covered with copays between $399 and $1,800. Additionally, home health services are available with no copay, while durable medical equipment and dialysis services require no copay and a 20% coinsurance.
Inpatient Hospital See details
HealthSpring Preferred Savings (HMO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $375 daily copay for days 1 through 5 and no copay for days 6 through 90. Prior authorization is required, and while additional acute days are unlimited, psychiatric additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by HealthSpring Preferred Savings (HMO) with no coinsurance, featuring a $0 to $365 copay for outpatient hospital services and a $365 copay per stay for observation services. Ambulatory surgical center and blood services are provided with no copay and no coinsurance, while individual and group outpatient substance abuse sessions require a $45 copay.
Partial Hospitalization See details
HealthSpring Preferred Savings (HMO) covers partial hospitalization services with a $105.00 copay and no coinsurance. Prior authorization is required to access this covered benefit.
Ambulance and Transportation Services See details
HealthSpring Preferred Savings (HMO) covers ground ambulance services with a $300 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required for both. Transportation services to health-related locations are not covered.
Emergency Services See details
Emergency services are covered by HealthSpring Preferred Savings (HMO) with a $115 copay and no coinsurance, which is 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 Savings (HMO) covers primary care physician services with no copay and no coinsurance, while specialist visits require a $45 copay and no coinsurance. Physical, occupational, and mental health therapies have copays ranging from $30 to $35 with no coinsurance, though podiatry is not covered, and some chiropractic services are covered but routine and other chiropractic services are not.
Preventive Services See details
HealthSpring Preferred Savings (HMO) covers preventive services, including annual physical exams, kidney disease education, and other screenings, with no copay and no coinsurance. Additional preventive services are only partially covered, with no copay or coinsurance for caregiver support and fitness benefits, while sub-services like health education, in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, smoking cessation, disease management, telemonitoring, remote access, home safety modifications, and counseling are not covered.
Hearing Services See details
Hearing services are covered under the HealthSpring Preferred Savings (HMO) plan, featuring a $30.00 copay and no coinsurance for annual routine exams and fitting evaluations. Prescription hearing aids are partially covered with copays ranging from $399.00 to $1,800.00 and no coinsurance for up to two aids yearly, though inner ear, outer ear, and over the ear models are not covered. Up to two OTC hearing aids are also covered each year with a $399.00 copay and no coinsurance.
Vision Services See details
Vision services under HealthSpring Preferred Savings (HMO) are partially covered, as other eye exam services are not covered. Covered eye exams have a $0 to $40 copay and no coinsurance, while eyewear is covered with no copay, no coinsurance, and no deductible up to a $100 annual maximum.
Dental Services See details
HealthSpring Preferred Savings (HMO) covers Medicare-covered dental services with a $45 copay and no coinsurance, which require prior authorization. Other preventive and comprehensive dental services, including exams, cleanings, and orthodontics, are covered with no copay and no coinsurance up to a maximum annual benefit of $500.
Home Infusion bundled Services See details
Home infusion bundled services are covered by HealthSpring Preferred Savings (HMO) with no copay and no coinsurance, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs have no copay and no coinsurance to 20% coinsurance, while Part B insulin requires a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the HealthSpring Preferred Savings (HMO) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these services.
Medical Equipment See details
Medical Equipment is covered by HealthSpring Preferred Savings (HMO) with no copay and a 20% coinsurance for durable medical equipment, prosthetics, and medical supplies, subject to prior authorization. This benefit is partially covered because diabetic therapeutic shoes and inserts are covered under these terms, but diabetic supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by HealthSpring Preferred Savings (HMO) under prior authorization, featuring no coinsurance and no copay for lab services, with diagnostic test copays ranging from no copay to $95. Radiological benefits require a $10 copay plus coinsurance for X-rays, no minimum copay for diagnostic radiology, and a minimum 20% coinsurance plus copays for therapeutic services.
Home Health Services See details
Home Health Services are covered by HealthSpring Preferred Savings (HMO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by HealthSpring Preferred Savings (HMO) with a $15 copay and no coinsurance, though prior authorization is required. Some services are covered, but cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered.
Skilled Nursing Facility (SNF) See details
HealthSpring Preferred Savings (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but allowing admission without a prior three-day hospital stay. There is no copay for days 1 through 20, a $218 copay applies for days 21 through 100, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by HealthSpring Preferred Savings (HMO), which offers a meal benefit for chronic or qualifying medical conditions with no copay and no coinsurance. Acupuncture and over-the-counter (OTC) items are not covered under this benefit.
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