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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 Northeast Georgia. 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) plan features an annual prescription drug deductible of $615. Under this plan, Tier 1 preferred generic drugs have no copay when filled through a preferred pharmacy or preferred mail order, compared to a $10 copay for a one-month supply at standard pharmacies. Tier 2 generic drugs cost a low $4 copay for a one-month supply at preferred pharmacies, and you will pay no copay for a three-month supply when using preferred mail order. Tier 3 preferred brand drugs require a flat $47 copay for a one-month supply regardless of whether you use preferred or standard pharmacy and mail services. For higher-tier medications, you will pay a 50% coinsurance for Tier 4 non-preferred drugs and a 25% coinsurance for Tier 5 specialty drugs. Utilizing preferred network pharmacies and mail-order options is the most effective way to minimize your out-of-pocket prescription costs.
Additional Benefits
The HealthSpring Preferred Savings (HMO) plan offers affordable coverage for core healthcare needs, featuring no copay for primary care visits and a $45 copay for specialist consultations. For hospital stays, members pay a $375 daily copay for the first five days of inpatient care and no copay for days six through ninety. Emergency room visits require a $115 copay, which is waived if you are admitted to the hospital within 24 hours. Routine preventive services, annual physicals, and home health care are available with no copay or coinsurance. Supplemental benefits include routine dental services with no copay up to a $500 annual limit, as well as vision exams and a $100 annual eyewear allowance. Other specialized services like dialysis and durable medical equipment are covered with a 20% coinsurance.
Inpatient Hospital See details
Inpatient hospital care is covered by HealthSpring Preferred Savings (HMO) 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 non-Medicare-covered stays, upgrades, and psychiatric additional days are not covered.
Outpatient Services See details
Outpatient services covered under the HealthSpring Preferred Savings (HMO) plan feature no coinsurance, with outpatient hospital copays ranging from no copay to $365 and observation services requiring a $365 copay per stay. Ambulatory surgical center and outpatient blood services are available with no copay and no coinsurance, while outpatient substance abuse sessions carry 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 for 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. Under the transportation benefit, some services are covered, but transportation to plan-approved health-related locations and any health-related locations is not covered.
Emergency Services See details
HealthSpring Preferred Savings (HMO) covers emergency services with a $115 copay and no coinsurance, and urgently needed services with a $40 copay and no coinsurance, with both copays waived if admitted to the hospital within 24 hours. Worldwide emergency, urgent, and transportation services are also covered up to a $50,000 maximum plan benefit with a $115 copay and no coinsurance.
Primary Care See details
HealthSpring Preferred Savings (HMO) offers primary care physician services with no copay and no coinsurance, and specialist visits for a $45 copay and no coinsurance. Therapy and mental health services require a $30 to $35 copay and no coinsurance, while podiatry is not covered, and only some chiropractic services are covered for a $15 copay and no coinsurance, excluding routine and other chiropractic services.
Preventive Services See details
HealthSpring Preferred Savings (HMO) covers preventive services, including annual physicals, kidney disease education, and glaucoma screenings, with no copay and no coinsurance. Additional preventive services are only partially covered; fitness benefits and caregiver support are included, but services like health education, in-home safety assessments, and personal emergency response systems are not covered.
Hearing Services See details
Hearing services are covered by HealthSpring Preferred Savings (HMO), featuring a $20 copay and no coinsurance for annual routine exams and fittings. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $399 to $1,800 for up to two devices per year, though inner ear, outer ear, and over the ear aids are not covered. Over-the-counter (OTC) hearing aids are also covered with a $399 copay and no coinsurance for up to two devices per year.
Vision Services See details
Vision Services are partially covered by HealthSpring Preferred Savings (HMO), offering eye exams with a $0 to $40 copay and no coinsurance, though other non-routine eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and a $100 annual maximum allowance for contacts, frames, lenses, and upgrades.
Dental Services See details
HealthSpring Preferred Savings (HMO) covers Medicare-covered dental services with a $45 copay and no coinsurance. Other preventive and comprehensive dental services are covered with no copay and no coinsurance, up to a maximum plan benefit of $500 per year.
Home Infusion bundled Services See details
HealthSpring Preferred Savings (HMO) covers home infusion bundled services with no copay, although prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and insulin, carry a 0% to 20% coinsurance, with insulin specifically requiring a $35 copay.
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
HealthSpring Preferred Savings (HMO) covers medical equipment, including durable medical equipment and prosthetics, with no copay and 20% coinsurance. This benefit is partially covered because diabetic therapeutic shoes and inserts are covered under the plan, while diabetic supplies are not covered.
Diagnostic and Radiological Services See details
HealthSpring Preferred Savings (HMO) covers diagnostic and radiological services, with prior authorization required for most services. Lab services and diagnostic radiological services are available with no copay and no coinsurance, while diagnostic procedures range from no copay up to a $95 copay, outpatient X-rays require a $10 copay, and therapeutic radiological services carry a 20% coinsurance.
Home Health Services See details
HealthSpring Preferred Savings (HMO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by HealthSpring Preferred Savings (HMO) with no coinsurance and prior authorization required, but only some services are covered in practice. Standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require a $15 copay.
Skilled Nursing Facility (SNF) See details
HealthSpring Preferred Savings (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring 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 Medicare-covered 100 days are not covered.
Other Services See details
HealthSpring Preferred Savings (HMO) partially covers other services, offering a limited-duration meal benefit for chronic or home-confining medical conditions with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, and other additional services are not covered.
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