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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 Northwest 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 drug deductible of $615. For Tier 1 preferred generic drugs, you pay no copay when using preferred pharmacies or preferred mail order services, compared to a $10 one-month copay at standard locations. Tier 2 generic drugs cost $4 for a one-month supply at preferred pharmacies, and you pay no copay for a three-month supply when using preferred mail order. For Tier 3 preferred brand drugs, you will pay a flat $47 copay for a one-month supply regardless of whether you use preferred or standard pharmacies and mail order. Tier 4 non-preferred drugs require a 50% coinsurance across all pharmacy and mail order options. Finally, Tier 5 specialty drugs require a 25% coinsurance for a one-month supply at both preferred and standard locations.
Additional Benefits
The HealthSpring Preferred Savings (HMO) plan offers robust coverage for essential medical services, often with low out-of-pocket costs and no coinsurance. Members enjoy primary care visits with no copay, while specialist visits require a $45 copay, and inpatient hospital stays carry a $355 copay for the first five days followed by no copay. Emergency care is available with a $115 copay, which is waived upon hospital admission, and urgent care has a $40 copay. This plan also provides key supplemental benefits, including routine dental and vision care with no copay up to annual maximums of $500 and $100 respectively. Skilled nursing facility stays feature no copay for the first 20 days, and home health services are fully covered with no copay. Diagnostic labs and preventive services are also available with no copay, while durable medical equipment and dialysis require a 20% coinsurance.
Inpatient Hospital See details
HealthSpring Preferred Savings (HMO) partially covers inpatient hospital services with no coinsurance, requiring a $355 copay for days 1 through 5 and no copay for days 6 through 90. Unlimited additional days are covered for acute care, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
HealthSpring Preferred Savings (HMO) covers outpatient services with no coinsurance, featuring a copay of $0 to $345 for outpatient hospital services and a $345 copay per stay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse services require a $45 copay per session with no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered under the HealthSpring Preferred Savings (HMO) plan with a $105.00 copay and no coinsurance. Prior authorization is required to receive these services.
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. Transportation services to plan-approved or other health-related locations are not covered under this plan.
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, and 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) provides primary care physician services with no copay and no coinsurance, and specialist visits with a $45 copay and no coinsurance. Additional covered benefits include physical, occupational, mental health, and psychiatric therapies with copays ranging from $30 to $35 and no coinsurance, while chiropractic and podiatry services are not covered.
Preventive Services See details
HealthSpring Preferred Savings (HMO) partially covers preventive services with no copay and no coinsurance for covered care, such as annual physicals, kidney disease education, caregiver support, and fitness benefits. Uncovered services include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, smoking cessation, disease management, telemonitoring, remote access, home safety devices, and counseling. Other preventive care, including glaucoma and diabetes screenings, is also covered with no copay and no coinsurance.
Hearing Services See details
HealthSpring Preferred Savings (HMO) covers annual routine hearing exams and fitting evaluations for a $25 copay and no coinsurance, alongside OTC hearing aids for a $399 copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $399 to $1,800 for up to two aids per year, but inner ear, outer ear, and over the ear types are not covered.
Vision Services See details
Vision services are partially covered by HealthSpring Preferred Savings (HMO), offering one routine eye exam annually with a $0 to $40 copay and no coinsurance, while other eye exam services are not covered. Eyewear is also covered with no copay and no coinsurance up to a $100 annual maximum for contacts, eyeglasses, and upgrades.
Dental Services See details
HealthSpring Preferred Savings (HMO) covers Medicare-covered dental services for a $45.00 copay and no coinsurance, while other preventive and comprehensive dental services are covered with no copay and no coinsurance up to a $500.00 annual maximum.
Home Infusion bundled Services See details
Home infusion bundled services are covered by HealthSpring Preferred Savings (HMO) with no copay, though prior authorization and step therapy are required. Covered Medicare Part B chemotherapy and other drugs carry 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 by HealthSpring Preferred Savings (HMO) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Medical equipment is partially covered by HealthSpring Preferred Savings (HMO), featuring no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes and inserts. Diabetic supplies are not covered under this benefit, and prior authorization is required for all covered equipment.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by HealthSpring Preferred Savings (HMO), featuring no copay or coinsurance for lab services, and a $0 to $95 copay with no coinsurance for diagnostic procedures. Radiological services require a $10 copay for outpatient X-rays, a $0 minimum copay for diagnostic radiology, and a minimum 20% coinsurance for therapeutic radiology.
Home Health Services See details
HealthSpring Preferred Savings (HMO) covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
HealthSpring Preferred Savings (HMO) offers Cardiac Rehabilitation Services with no coinsurance and prior authorization. While some services are covered, the plan does not cover specific sub-services, including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation, which require a $15 copay.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by HealthSpring Preferred Savings (HMO) 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 while a prior three-day hospital stay is not required, additional days beyond standard Medicare-covered days are not covered.
Other Services See details
HealthSpring Preferred Savings (HMO) partially covers other services, offering a limited-duration meal benefit with no copay and no coinsurance for qualifying chronic or medical conditions. Acupuncture and over-the-counter (OTC) items are not covered under this plan.
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