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HealthSpring Preferred (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HealthSpring Preferred (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HealthSpring Preferred (HMO) in 2026, please refer to our full plan details page.
HealthSpring Preferred (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 (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 (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 (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.
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 $5900.00 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 (HMO) prescription drug plan features a $200 annual drug deductible with significant savings on generic medications. For Tier 1 preferred generics, you will pay no copay when utilizing a preferred pharmacy or preferred mail-order service. Tier 2 generic drugs are also highly affordable, requiring only a $5 copay for a one-month supply at preferred pharmacies, or no copay for a three-month supply through preferred mail order. Higher-tier medications under this plan are subject to flat copays or coinsurance rates regardless of which pharmacy you choose. Tier 3 preferred brand drugs carry a $47 copay for a one-month supply, while Tier 4 non-preferred drugs require a 50% coinsurance. Specialty prescriptions in Tier 5 are covered at a 30% coinsurance for a one-month supply.
Additional Benefits
The HealthSpring Preferred (HMO) plan offers comprehensive medical coverage featuring no copays or coinsurance for primary care visits and routine preventive services. For inpatient hospital stays, members pay a daily copay of $290 for the first six days and no copay for additional days, while emergency room visits require a $130 copay. Specialist visits, physical therapy, and outpatient substance abuse sessions are available with a $30 copay and no coinsurance. This plan also includes key ancillary benefits, such as dental coverage with no copay up to a $2,250 annual limit and a $250 yearly allowance for eyewear. While home health services require no copay or coinsurance, durable medical equipment and dialysis services are subject to a 20% coinsurance. Additionally, members can take advantage of a $45 quarterly over-the-counter allowance and prescription hearing aid coverage with copays ranging from $399 to $1,800.
Inpatient Hospital See details
HealthSpring Preferred (HMO) covers inpatient hospital services with no coinsurance, though prior authorization is required. For acute stays, you will pay a $290 daily copay for days 1-6 and no copay for days 7-90, while psychiatric stays require a $298 daily copay for days 1-7 and no copay for days 8-90.
Outpatient Services See details
HealthSpring Preferred (HMO) covers outpatient hospital services with no coinsurance and a copay of $0 to $295, while observation services require a $295 copay per stay with no coinsurance. Ambulatory surgical center and outpatient blood services are offered with no copay and no coinsurance, and outpatient substance abuse sessions have a $30 copay with no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by HealthSpring Preferred (HMO) with a $140.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by HealthSpring Preferred (HMO), featuring a $255 copay for ground ambulance services and a 20% coinsurance for air ambulance services, with prior authorization required. Transportation services to plan-approved or any other health-related locations are not covered.
Emergency Services See details
HealthSpring Preferred (HMO) covers emergency services with a $130 copay and urgently needed services with a $50 copay, with no coinsurance for either and 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 with a $130 copay and no coinsurance.
Primary Care See details
HealthSpring Preferred (HMO) covers primary care physician services with no copay and no coinsurance, whereas specialist visits, physical therapy, occupational therapy, and opioid treatment require a $30 copay and no coinsurance. Podiatry is not covered, some chiropractic services are covered with a $15 copay and no coinsurance but routine care is not, and some mental health and psychiatric services have no copay and no coinsurance but individual and group sessions are not covered.
Preventive Services See details
HealthSpring Preferred (HMO) covers preventive services, including annual physical exams and kidney disease education, with no copay and no coinsurance. However, additional preventive benefits are only partially covered, as the plan excludes 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, smoking cessation, disease management, telemonitoring, remote access, home safety devices, and counseling.
Hearing Services See details
HealthSpring Preferred (HMO) offers coverage for hearing services, including annual routine exams and fitting evaluations for a $25 copay and no coinsurance. Prescription hearing aids are partially covered with copays ranging from $399 to $1,800 and no coinsurance for up to two aids per year, though inner ear, outer ear, and over the ear models are not covered. Up to two over-the-counter (OTC) hearing aids are covered annually with a $399 copay and no coinsurance.
Vision Services See details
HealthSpring Preferred (HMO) provides partially covered vision services, offering one routine eye exam per year with a copay of $0 to $30, no coinsurance, and no deductible, though other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and no deductible, providing a $250 annual allowance for contacts, upgrades, or one pair of eyeglasses, lenses, and frames.
Dental Services See details
Dental services are covered by HealthSpring Preferred (HMO), including Medicare-covered dental services for a $30 copay and no coinsurance. Other preventive and comprehensive dental services are covered with no copay and no coinsurance, up to a maximum annual plan benefit of $2,250.
Home Infusion bundled Services See details
HealthSpring Preferred (HMO) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs have no copay and coinsurance ranging from no coinsurance to 20%, while Part B insulin has a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
HealthSpring Preferred (HMO) covers Dialysis Services with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
HealthSpring Preferred (HMO) partially covers medical equipment with no copay and 20% coinsurance, and prior authorization is required for these services. Covered items include durable medical equipment, prosthetics, and diabetic therapeutic shoes or inserts, while diabetic supplies are not covered.
Diagnostic and Radiological Services See details
HealthSpring Preferred (HMO) covers diagnostic and radiological services with no coinsurance, although prior authorization is required. Members will pay no copay for lab services and outpatient X-rays, while diagnostic procedures range from a $0 to $75 copay and therapeutic radiology services require a minimum copay of $80.
Home Health Services See details
HealthSpring Preferred (HMO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
HealthSpring Preferred (HMO) covers Cardiac Rehabilitation Services with no coinsurance, though prior authorization is required. While some services are covered, specific sub-services including Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD are not covered and require a $10 copay.
Skilled Nursing Facility (SNF) See details
HealthSpring Preferred (HMO) covers Skilled Nursing Facility (SNF) care with no coinsurance, requiring a $10 daily copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, a three-day prior hospital stay is not needed, and additional days beyond the standard 100 days are not covered.
Other Services See details
HealthSpring Preferred (HMO) partially covers other services, offering over-the-counter (OTC) items and meal benefits with no copay and no coinsurance, while acupuncture is not covered. Eligible members receive a $45 allowance every three months for OTC items, and limited-duration meal benefits are covered at no cost for qualifying medical conditions.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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