A non-government entity
HealthSpring Courage (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HealthSpring Courage (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HealthSpring Courage (HMO) in 2026, please refer to our full plan details page.
HealthSpring Courage (HMO) is a HMO plan offered by Health Care Service Corporation available for enrollment in 2026 to people living in Washington DC. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that HealthSpring Courage (HMO) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about HealthSpring Courage (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 Courage (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 $90.00. 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.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
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
Prescription drugs are not covered by HealthSpring Courage (HMO).
Additional Benefits
The HealthSpring Courage (HMO) plan offers comprehensive medical coverage with no copay for primary care physician visits, home health services, and annual preventive screenings. Inpatient hospital stays require a $320 daily copay for the first seven days, while emergency room visits carry a $130 copay that is waived upon admission. Most outpatient hospital services and diagnostic lab tests are highly affordable, ranging from no copay to a maximum of $290. Specialist consultations, physical therapy, and mental health services require a standard $40 copay with no coinsurance. Preventive and comprehensive dental care is fully covered with no copay up to a $1,150 annual limit, and routine vision and hearing services feature low copays along with allowances for glasses and hearing aids. Durable medical equipment and dialysis services require no copay but are subject to a 15% to 20% coinsurance.
Inpatient Hospital See details
HealthSpring Courage (HMO) inpatient hospital benefits are partially covered with no coinsurance, requiring prior authorization for all stays. Acute care costs a $320 copay per day for days 1-7 and no copay for days 8-90 with unlimited additional days, while psychiatric care requires a $595 copay per day for days 1-3 and no copay for days 4-90. Non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
HealthSpring Courage (HMO) covers outpatient services with no coinsurance, including ambulatory surgical center and outpatient blood services which both feature no copays. Outpatient hospital services require a copay ranging from no copay to $290, observation services carry a $290 copay per stay, and outpatient substance abuse sessions require a $40 copay.
Partial Hospitalization See details
Partial hospitalization is covered under HealthSpring Courage (HMO) with a $140.00 copay and no coinsurance. Prior authorization is required to receive these benefits.
Ambulance and Transportation Services See details
Ambulance services under HealthSpring Courage (HMO) require prior authorization and carry a $270 copay for ground transport and a 20% coinsurance for air transport. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
HealthSpring Courage (HMO) covers emergency services with a $130 copay and no coinsurance, and urgently needed services with a $50 copay and no coinsurance, with copays waived if you are 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 Courage (HMO) primary care benefits feature no copay and no coinsurance for primary care physician services, while specialists, physical therapy, and mental health services require a $40 copay and no coinsurance. Chiropractic services are partially covered with a $15 copay and no coinsurance, but routine and other chiropractic services are not covered, and podiatry services are not covered.
Preventive Services See details
Preventive services are covered by HealthSpring Courage (HMO) with no copay and no coinsurance for annual physical exams, kidney disease education, and routine screenings. Additional preventive benefits are partially covered, offering fitness programs and caregiver support, but excluding 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 benefits, palliative care, in-home support, additional smoking cessation counseling, enhanced disease management, telemonitoring, remote access technologies, home and bathroom safety modifications, and counseling.
Hearing Services See details
Hearing services under HealthSpring Courage (HMO) are partially covered with no deductible, offering annual routine exams and fitting evaluations for a $40 copay and no coinsurance. Prescription hearing aids require a copay between $399 and $1,800 with no coinsurance for up to two devices per year, although inner ear, outer ear, and over-the-ear models are not covered. Up to two over-the-counter hearing aids are also covered each year with a $399 copay and no coinsurance.
Vision Services See details
HealthSpring Courage (HMO) partially covers vision services, offering one routine eye exam per year with a $0 to $50 copay and no coinsurance, though other eye exam services are not covered. Covered eyewear, including contacts and one pair of eyeglasses per year, features no copay or coinsurance up to a combined maximum plan benefit of $125 annually.
Dental Services See details
HealthSpring Courage (HMO) covers Medicare-covered dental services with a $40 copay and no coinsurance, while preventive and comprehensive dental services are covered with no copay and no coinsurance. These additional dental benefits, which include cleanings, x-rays, and restorative services, are subject to a maximum plan coverage limit of $1,150 every year.
Home Infusion bundled Services See details
HealthSpring Courage (HMO) covers home infusion bundled services with no copay, though prior authorization is required. Covered Medicare Part B chemotherapy, radiation, and other drugs require no coinsurance to 20% coinsurance, while Medicare Part B insulin has a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
HealthSpring Courage (HMO) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required for these covered services.
Medical Equipment See details
HealthSpring Courage (HMO) partially covers medical equipment with no copay, though diabetic supplies are not covered. Covered items require a 15% coinsurance for durable medical equipment, prosthetics, and medical supplies, and a 20% coinsurance for diabetic therapeutic shoes and inserts.
Diagnostic and Radiological Services See details
HealthSpring Courage (HMO) covers diagnostic and radiological services, requiring prior authorization for both. Lab services and outpatient X-rays have no copay, diagnostic procedures range from a $0 to $95 copay with no coinsurance, and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
HealthSpring Courage (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 Courage (HMO) plan, as all key sub-services—including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation—are listed as not covered.
Skilled Nursing Facility (SNF) See details
HealthSpring Courage (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization and a copay of $10 for days 1 to 20, $218 for days 21 to 60, and no copay for days 61 to 100. Additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
HealthSpring Courage (HMO) partially covers other services, offering a limited-duration meal benefit for chronic illnesses or medical conditions requiring you to remain at home with no copay and no coinsurance. Acupuncture and over-the-counter (OTC) items are not covered under this benefit.
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