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HealthSpring Preferred Plus (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HealthSpring Preferred Plus (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HealthSpring Preferred Plus (HMO) in 2026, please refer to our full plan details page.
HealthSpring Preferred Plus (HMO) is a HMO plan offered by Health Care Service Corporation available for enrollment in 2025 to people living in South Mississippi. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that HealthSpring Preferred Plus (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 Plus (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 Plus (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $16.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your 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 $6350.00 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 Plus (HMO) plan features a $200 annual drug deductible. Under this plan, you will pay no copay for Tier 1 preferred generic drugs when using a preferred pharmacy or preferred mail order service. For Tier 2 generic drugs, copays start as low as $4 at preferred pharmacies, and there is no copay for a three-month supply ordered through preferred mail order. Tier 3 preferred brand drugs require a $47 copay for a one-month supply across all pharmacy and mail order options. Higher-tier medications require coinsurance rather than flat copays, with Tier 4 non-preferred drugs carrying a 50% coinsurance and Tier 5 specialty drugs requiring a 30% coinsurance.
Additional Benefits
The HealthSpring Preferred Plus (HMO) plan offers comprehensive medical coverage with predictable costs, including no copay for primary care visits and a low $15 copay for specialist appointments. Inpatient hospital stays require a $295 daily copay for the first seven days and no copay for days 8 through 90, while outpatient hospital services range from no copay up to a $275 copay. Emergency care is covered with a $130 copay, which is waived if you are admitted to the hospital within 24 hours. This plan also includes valuable supplemental benefits, featuring preventive and comprehensive dental care with no copay up to a $2,050 annual maximum and a $250 yearly eyewear allowance with no copay. Routine hearing exams require a $15 copay, and diagnostic lab services, home health care, and qualifying over-the-counter items are all available with no copay. For specialized needs, durable medical equipment and dialysis services are covered with no copay and a 20% coinsurance.
Inpatient Hospital See details
HealthSpring Preferred Plus (HMO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $295 daily copay for days 1 through 7 and no copay for days 8 through 90. Unlimited additional days are covered for acute stays, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
HealthSpring Preferred Plus (HMO) covers outpatient services with no coinsurance, though prior authorization is required for most treatments. Outpatient hospital services have no copay to a $275 copay, observation services require a $250 copay per stay, and outpatient substance abuse sessions have a $25 copay, while ambulatory surgical center and blood services feature no copay.
Partial Hospitalization See details
Partial hospitalization is covered by HealthSpring Preferred Plus (HMO) with a $140.00 copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
HealthSpring Preferred Plus (HMO) covers ambulance services with prior authorization, requiring a $255 copay (no coinsurance) for ground ambulance and a 20% coinsurance (no copay) for air ambulance, neither of which is waived if you are admitted to the hospital. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
HealthSpring Preferred Plus (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 care, and emergency transportation are also covered up to a $50,000 maximum benefit with a $130 copay and no coinsurance.
Primary Care See details
HealthSpring Preferred Plus (HMO) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $15 copay and no coinsurance. Physical, occupational, and speech therapy require a $25 copay and no coinsurance, while podiatry, chiropractic care, and mental health or psychiatric sessions are not covered.
Preventive Services See details
HealthSpring Preferred Plus (HMO) offers partially covered preventive services with no copay and no coinsurance for covered benefits such as annual physicals, kidney disease education, and fitness programs. However, the plan does not cover health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, chemotherapy wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, extra smoking cessation counseling, enhanced disease management, telemonitoring, remote access technologies, home safety devices, or counseling.
Hearing Services See details
HealthSpring Preferred Plus (HMO) covers annual routine hearing exams and fittings for a $15 copay and no coinsurance, as well as up to two OTC hearing aids yearly 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 devices per year, though inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
HealthSpring Preferred Plus (HMO) partially covers vision services, offering one routine eye exam per year with a $0 to $15 copay, no coinsurance, and no deductible, while other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and no deductible up to a $250 annual maximum for contacts, eyeglasses, and upgrades.
Dental Services See details
HealthSpring Preferred Plus (HMO) covers Medicare-covered dental services for a $15 copay and no coinsurance, which requires prior authorization. Preventive and comprehensive dental services, such as exams, cleanings, and orthodontics, are covered with no copay and no coinsurance up to a maximum annual benefit of $2,050.
Home Infusion bundled Services See details
HealthSpring Preferred Plus (HMO) covers home infusion bundled services with no copay, subject to prior authorization and step therapy. Under this benefit, Medicare Part B chemotherapy and other drugs require no coinsurance to 20% coinsurance, while Part B insulin is covered with a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the HealthSpring Preferred Plus (HMO) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
HealthSpring Preferred Plus (HMO) provides partial coverage for medical equipment with no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes. Diabetic supplies are not covered under this benefit, and prior authorization is required for covered equipment.
Diagnostic and Radiological Services See details
HealthSpring Preferred Plus (HMO) covers diagnostic and radiological services with no coinsurance, although prior authorization is required. There is no copay for lab services and outpatient x-rays, while diagnostic procedures and tests range from a $0 to $75 copay, diagnostic radiological services start at a $0 copay, and therapeutic radiological services require a minimum copay of $80.
Home Health Services See details
Home Health Services are covered by HealthSpring Preferred Plus (HMO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
HealthSpring Preferred Plus (HMO) covers some Cardiac Rehabilitation Services with no coinsurance, but cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered. Covered services require a $10 copay and prior authorization.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by HealthSpring Preferred Plus (HMO) with no coinsurance, requiring a daily copay of $10 for days 1 through 20 and $218 for days 21 through 100 per stay. Prior authorization is required, a prior three-day hospital stay is not required, and additional days beyond the Medicare-covered 100 days are not covered.
Other Services See details
HealthSpring Preferred Plus (HMO) offers partially covered other services, which include over-the-counter (OTC) items and a meal benefit with no copay and no coinsurance, while acupuncture is not covered. The OTC benefit provides up to $45 every three months for health-related products, and the meal benefit is available for members with qualifying chronic or medical conditions.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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