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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 St. Louis. 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 $105.00. 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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $6750.00 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 offers a $0 prescription drug deductible, allowing your coverage to start immediately without any out-of-pocket deductible costs. For Tier 1 preferred generic drugs, you will pay no copay when utilizing a preferred pharmacy or preferred mail-order service, compared to a $10 copay for a one-month supply at standard pharmacies. Tier 2 generic drugs are also highly affordable, costing a $4 copay for a one-month supply at preferred locations and a $20 copay at standard locations. For Tier 3 preferred brand drugs, the plan charges a flat $47 copay for a one-month supply at both preferred and standard pharmacies. More expensive medications are subject to coinsurance, with Tier 4 non-preferred drugs requiring 50% coinsurance and Tier 5 specialty drugs requiring 33% coinsurance for a one-month supply.
Additional Benefits
The HealthSpring Preferred Savings (HMO) plan offers comprehensive medical coverage featuring no copay for primary care visits and routine preventive services. Specialist visits and outpatient procedures are covered with flat copayments, including a $40 copay for specialists, while emergency room visits require a $130 copay. For inpatient hospital stays, members pay a $420 daily copay for the first five days, followed by no copay for days six through ninety. This plan also includes key supplemental benefits, such as dental care up to a $500 annual limit with no copay, and eyewear coverage up to a $150 annual limit. While home health services require no copay, dialysis and durable medical equipment require a 20% coinsurance. Please note that cardiac rehabilitation services and transportation to health-related locations are not covered under this plan.
Inpatient Hospital See details
Inpatient hospital services are covered by HealthSpring Preferred Savings (HMO) with no coinsurance, though prior authorization is required. Acute stays require a $420 copay for days 1-5 and no copay for days 6-90 with unlimited additional days, while psychiatric stays require a $440 copay for days 1-5 and no copay for days 6-90. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered under this plan.
Outpatient Services See details
HealthSpring Preferred Savings (HMO) covers outpatient services with no coinsurance, including no copays for ambulatory surgical center and outpatient blood services. Medicare-covered outpatient hospital services have a copay ranging from $0 to $425, observation services require a $425 copay per stay, and outpatient substance abuse sessions have a $40 copay.
Partial Hospitalization See details
Partial hospitalization is covered under the HealthSpring Preferred Savings (HMO) plan with a $105.00 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by HealthSpring Preferred Savings (HMO), which features ground ambulance services with a $250 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay. Prior authorization is required for all ambulance services, and transportation services to health-related locations are not covered.
Emergency Services See details
HealthSpring Preferred Savings (HMO) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours, and urgently needed services with a $50 copay and no coinsurance. Worldwide emergency, urgent, and transportation services are also covered up to a $50,000 maximum with a $130 copay and no coinsurance.
Primary Care See details
Primary care benefits under the HealthSpring Preferred Savings (HMO) plan feature no copay and no coinsurance for primary care physician services, while specialist visits, physical therapy, and occupational therapy require a $40 copay and no coinsurance. Some psychiatric, mental health, and chiropractic services are covered, but their individual, group, and routine sub-services are not covered, and podiatry is not covered.
Preventive Services See details
HealthSpring Preferred Savings (HMO) covers preventive services, such as annual physicals and kidney disease education, with no copay and no coinsurance. Additional preventive services are partially covered with no copay and no coinsurance, excluding health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, smoking cessation, disease management, telemonitoring, remote access, home safety modifications, and counseling.
Hearing Services See details
HealthSpring Preferred Savings (HMO) covers routine hearing exams with a $25 copay and no coinsurance, and OTC hearing aids with a $399 copay and no coinsurance. Prescription hearing aids are partially covered with copays ranging from $399 to $1,800 and no coinsurance, though inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by HealthSpring Preferred Savings (HMO), as other eye exam services are not covered. Routine eye exams are covered once per year with a $0 to $40 copay and no coinsurance, while eyewear is covered with no copay, no coinsurance, and no deductibles up to a $150 annual maximum.
Dental Services See details
HealthSpring Preferred Savings (HMO) covers Medicare-covered dental services with a $40 copay and no coinsurance, though prior authorization is required. Other preventive and comprehensive dental services, including cleanings, exams, x-rays, restorative work, and orthodontics, are covered with no copay and no coinsurance up to a $500 annual maximum.
Home Infusion bundled Services See details
HealthSpring Preferred Savings (HMO) covers home infusion bundled services with no copay and no coinsurance, although prior authorization is required. Covered Medicare Part B chemotherapy, radiation, and other drugs require no copay and 0% to 20% coinsurance, while Medicare Part B insulin drugs have a $35 copay and 0% 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, though prior authorization is required.
Medical Equipment See details
HealthSpring Preferred Savings (HMO) covers medical equipment with no copay and a 20% coinsurance for durable medical equipment, prosthetic devices, medical supplies, and diabetic therapeutic shoes, though prior authorization is required. This benefit is partially covered under the plan because diabetic supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under HealthSpring Preferred Savings (HMO) with prior authorization required. Diagnostic procedures and tests carry a copay of $0 to $50 with no coinsurance, while lab services, outpatient X-rays, and diagnostic radiological services have no copay, and therapeutic radiological services require a 20% coinsurance.
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
Cardiac Rehabilitation Services are not covered under the HealthSpring Preferred Savings (HMO) plan, as all sub-services—including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation—are excluded from coverage.
Skilled Nursing Facility (SNF) See details
HealthSpring Preferred Savings (HMO) covers skilled nursing facility (SNF) services with no coinsurance, requiring a $10 daily copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, a prior three-day hospital stay is not needed, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
HealthSpring Preferred Savings (HMO) partially covers Other Services, providing a limited-duration meal benefit for chronic illnesses or qualifying medical conditions with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, and other additional services are not covered under this benefit.
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