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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 2025 to people living in Northeast Ohio. This plan received an overall rating of 3 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 $95.00. 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 $200.00 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 $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 features an annual drug deductible of $200. For Tier 1 preferred generic and Tier 2 generic medications, you will pay no copay when utilizing a preferred pharmacy or preferred mail order service. If you use a standard pharmacy or standard mail order, Tier 1 copays start at $5 and Tier 2 copays start at $10 for a one-month supply. Tier 3 preferred brand drugs require a $47 copay for a one-month supply regardless of your pharmacy choice. For higher-tier medications, Tier 4 non-preferred drugs carry a 50% coinsurance, and Tier 5 specialty drugs require a 30% coinsurance. This plan offers strong savings on common generics while maintaining predictable costs for brand-name and specialty prescriptions.
Additional Benefits
The HealthSpring Preferred Savings (HMO) plan offers affordable healthcare coverage featuring no copay and no coinsurance for primary care visits, preventive services, and home health care. For emergency care, members pay a $130 copay with no coinsurance, which is waived if admitted to the hospital within 24 hours. Inpatient hospital stays require a $380 daily copay for days one through six, followed by no copay for days seven through 90, all with no coinsurance. Specialist visits and Medicare-covered dental services carry a $40 copay and no coinsurance, while other preventive and comprehensive dental benefits are covered with no copay up to a $1,000 annual limit. Vision care includes routine eye exams and up to $200 in eyewear with no copay or coinsurance, while routine hearing exams require a $25 copay. Durable medical equipment and dialysis services are covered with a 20% coinsurance and no copay.
Inpatient Hospital See details
HealthSpring Preferred Savings (HMO) partially covers inpatient acute and psychiatric hospital services with no coinsurance, requiring a $380 daily copay for days 1 through 6 and no copay for days 7 through 90. Prior authorization is required, and 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 for all services, and no copay for ambulatory surgical center or blood services. Outpatient hospital services have a copay ranging from $0 to $360, observation services require a $340 copay per stay, and outpatient substance abuse sessions carry a $40 copay, with prior authorization required for several services.
Partial Hospitalization See details
Partial hospitalization is covered by HealthSpring Preferred Savings (HMO) with an $85.00 copay and no coinsurance. Prior authorization is required to access these services.
Ambulance and Transportation Services See details
Ambulance and Transportation Services under HealthSpring Preferred Savings (HMO) cover ground ambulance services with a $220 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, requiring prior authorization. Although some transportation services are covered, transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
HealthSpring Preferred Savings (HMO) covers emergency services with a $130 copay and urgently needed services with a $50 copay, both with no coinsurance and 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 limit with a $130 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 and physical, occupational, and speech therapies require a $40 copay and no coinsurance. Podiatry is not covered, and although chiropractic, mental health, and psychiatric services are covered, their routine care and individual or group sessions are not covered.
Preventive Services See details
Preventive services are covered by HealthSpring Preferred Savings (HMO) with no copay and no coinsurance, including annual physical exams, kidney disease education, and fitness benefits. This benefit is partially covered because several sub-services, including health education, in-home safety assessments, personal emergency response systems, and weight management programs, are not covered.
Hearing Services See details
HealthSpring Preferred Savings (HMO) covers hearing services, including routine hearing exams for a $25 copay and no coinsurance, and OTC hearing aids for 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 hearing aids are not covered.
Vision Services See details
Vision services are partially covered by HealthSpring Preferred Savings (HMO), offering one routine eye exam per year with a $0 to $40 copay and no coinsurance, though other eye exam services are not covered. Covered eyewear, including contacts, frames, lenses, and upgrades, has no copay or coinsurance up to a $200 annual maximum.
Dental Services See details
Dental services are covered by HealthSpring Preferred Savings (HMO), featuring a $40 copay and no coinsurance for Medicare-covered dental care. Other preventive and comprehensive dental services are covered with no copay and no coinsurance up to a maximum plan benefit of $1,000 every year.
Home Infusion bundled Services See details
HealthSpring Preferred Savings (HMO) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs require no copay and 0% (no coinsurance) to 20% coinsurance, while Part B insulin drugs carry a $35 copay and 0% (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 for these services.
Medical Equipment See details
HealthSpring Preferred Savings (HMO) covers medical equipment with no copay and 20% coinsurance, subject to prior authorization. This benefit is partially covered because diabetic supplies are not covered, while durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes or inserts are covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by HealthSpring Preferred Savings (HMO) with no coinsurance, although prior authorization is required. Members pay no copay for lab services, a $0 to $100 copay for diagnostic tests, a $60 copay for outpatient X-rays, and a copay starting at $85 for therapeutic radiological services.
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 covered under HealthSpring Preferred Savings (HMO) with no coinsurance, though prior authorization is required. While some services are covered, standard cardiac rehabilitation (with a $30 copay), intensive cardiac rehabilitation (with a $30 copay), pulmonary rehabilitation (with a $15 copay), and supervised exercise therapy for peripheral artery disease (with a $25 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is partially covered by HealthSpring Preferred Savings (HMO) 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, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
HealthSpring Preferred Savings (HMO) partially covers Other Services, offering a meal benefit for chronic 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 plan.
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