A non-government entity
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 Philadelphia. 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 $175.00. 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 $590.00 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 $9000.00 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:
Sign up for HealthSpring Preferred Savings (HMO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The HealthSpring Preferred Savings (HMO) prescription drug plan has an annual drug deductible of $590. You can save on costs by utilizing preferred pharmacies or preferred mail-order services, which offer no copay for Tier 1 preferred generic drugs. Tier 2 generic medications are also highly budget-friendly, featuring a low $4 copay for a one-month supply at preferred pharmacies and no copay for a three-month supply via preferred mail order. For Tier 3 preferred brand-name drugs, you will pay a flat $47 copay for a one-month supply regardless of your pharmacy choice. Higher-tier medications transition to coinsurance, with Tier 4 non-preferred drugs requiring a 50% coinsurance and Tier 5 specialty drugs requiring a 26% coinsurance for a one-month supply. Standard pharmacies and standard mail-order options are available but generally carry higher copays for generic medications.
Additional Benefits
The HealthSpring Preferred Savings (HMO) plan offers robust core medical coverage, featuring no copays for primary care visits, annual physicals, and home health services. Specialist visits require a $45 copay, while inpatient hospital stays incur a daily copay for the first four days before transitioning to no copay. Emergency care is accessible with a $115 copay, which is waived if you are admitted to the hospital within 24 hours. For ancillary care, members benefit from dental coverage with no copay for preventive and comprehensive services up to a $700 annual limit, alongside routine hearing exams with a $30 copay. While diagnostic lab work and home infusions carry no copay, medical equipment and dialysis require a 20% coinsurance. Note that certain services like routine eyewear, transportation, and over-the-counter items are not covered under this plan.
Inpatient Hospital See details
HealthSpring Preferred Savings (HMO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring prior authorization. For acute stays, there is a $390 copay per day for days 1 through 4 and no copay for days 5 through 90, while psychiatric stays require a $440 copay per day for days 1 through 4 and no copay for days 5 through 90. This benefit is partially covered, as upgrades, additional days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
HealthSpring Preferred Savings (HMO) covers outpatient services with no coinsurance, offering ambulatory surgical center and blood services with no copay. Outpatient hospital services have a copay ranging from $0 to $425, while individual and group substance abuse sessions require a $45 copay, with prior authorization required for several services.
Partial Hospitalization See details
Partial hospitalization is covered by HealthSpring Preferred Savings (HMO) with a $105.00 copay and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
Ambulance and transportation services under the HealthSpring Preferred Savings (HMO) plan include ground ambulance services with a $230 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay. Prior authorization is required for ambulance services, while transportation services are 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 copays waived if admitted to the hospital within 24 hours. Worldwide emergency, urgent, and transportation services are also covered with a $115 copay and no coinsurance, up to a maximum plan benefit of $50,000.
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. Physical, occupational, and speech therapies require a $35 copay with no coinsurance, podiatry is not covered, and while some chiropractic services are covered, routine and other chiropractic care are not covered.
Preventive Services See details
HealthSpring Preferred Savings (HMO) covers preventive services, such as annual physical exams and kidney disease education, with no copay and no coinsurance. Additional preventive services are partially covered; fitness benefits and caregiver support are included, but health education, weight management, in-home safety assessments, and personal emergency response systems are not covered.
Hearing Services See details
HealthSpring Preferred Savings (HMO) covers annual routine hearing exams and fitting evaluations with a $30 copay and no coinsurance. OTC hearing aids require a $399 copay and no coinsurance, while prescription hearing aids are partially covered with a copay ranging from $399 to $1,800 and no coinsurance, excluding inner ear, outer ear, and over the ear models which are not covered.
Vision Services See details
HealthSpring Preferred Savings (HMO) covers one routine eye exam per year with a $0 to $45 copay, no coinsurance, and no deductible, while other eye exam services are not covered. Although eyewear is listed as covered with no copay or coinsurance, it is not covered in practice as contact lenses, eyeglasses, lenses, frames, and upgrades are all excluded.
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, including cleanings, fillings, and implants, are covered with no copay and no coinsurance up to a maximum plan benefit of $700 every year.
Home Infusion bundled Services See details
Home infusion bundled services are covered by HealthSpring Preferred Savings (HMO) with no copay, no coinsurance, and prior authorization required. Associated Medicare Part B chemotherapy, radiation, and other Part B drugs carry no copay and 0% to 20% coinsurance, while covered Medicare Part B insulin has a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
HealthSpring Preferred Savings (HMO) covers dialysis services with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Medical equipment is covered under the HealthSpring Preferred Savings (HMO) with no copay and a 20% coinsurance, subject to prior authorization. This benefit is partially covered as diabetic supplies are not covered, though durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes or inserts are covered.
Diagnostic and Radiological Services See details
HealthSpring Preferred Savings (HMO) covers diagnostic and radiological services with no coinsurance, subject to prior authorization. Lab services have no copay, while copays range from $0 to $75 for diagnostic tests, start at $0 for diagnostic radiology, cost $50 for outpatient X-rays, and have a minimum $85 copay 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
Cardiac Rehabilitation Services are covered by HealthSpring Preferred Savings (HMO) with no coinsurance and require prior authorization, though only some services are covered. Specifically, cardiac rehabilitation (with a $30 copay), intensive cardiac rehabilitation (with a $40 copay), pulmonary rehabilitation (with a $25 copay), and supervised exercise therapy for peripheral artery disease (with a $20 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by HealthSpring Preferred Savings (HMO), as additional days beyond the Medicare-covered limit are not covered. Covered stays require prior authorization with no coinsurance, featuring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100.
Other Services See details
HealthSpring Preferred Savings (HMO) covers some other services, but acupuncture, over-the-counter items, and meal benefits are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved