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HealthSpring Achieve (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HealthSpring Achieve (HMO C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HealthSpring Achieve (HMO C-SNP) in 2026, please refer to our full plan details page.
HealthSpring Achieve (HMO C-SNP) is a HMO C-SNP plan offered by Health Care Service Corporation available for enrollment in 2026 to people living in Hattiesburg. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that HealthSpring Achieve (HMO C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
HealthSpring Achieve (HMO C-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about HealthSpring Achieve (HMO C-SNP).
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 Achieve (HMO C-SNP), 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 $3800.00 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 Achieve (HMO C-SNP) Medicare plan features a $200 annual drug deductible and offers significant savings on generic medications. Tier 1 preferred generic drugs have no copay when filled through preferred pharmacies or preferred mail order services. Tier 2 generic drugs cost $4 for a one-month supply at preferred pharmacies, and a three-month supply has no copay when using preferred mail order. Tier 3 preferred brand drugs require a $47 copay for a one-month supply at both standard and preferred pharmacies. Tier 4 non-preferred drugs carry a 50% coinsurance, while Tier 5 specialty drugs require a 30% coinsurance for a one-month supply. Tier 6 select diabetic drugs are highly accessible, featuring a $9 copay for a one-month supply at preferred pharmacies and mail-order services.
Additional Benefits
HealthSpring Achieve (HMO C-SNP) offers comprehensive healthcare coverage with no copay for primary care visits, preventive services, and home health care. Specialist visits, physical therapy, and Medicare-covered dental services require a low $20 copay, while inpatient hospital stays carry a $225 daily copay for the first seven days and no copay thereafter. Emergency room visits have a $150 copay, which is waived if you are admitted, and urgently needed services carry a $65 copay. This plan also includes valuable supplemental benefits, featuring no copay for preventive and comprehensive dental services up to a $1,200 annual limit. Routine vision exams and eyewear are covered with no deductible and no copay, offering up to a $325 annual allowance for glasses and contacts. Additionally, members benefit from a $70 quarterly over-the-counter allowance with no copay, while durable medical equipment and dialysis services require no copay and a 20% coinsurance.
Inpatient Hospital See details
HealthSpring Achieve (HMO C-SNP) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $225 daily copay for days 1 through 7 and no copay for days 8 through 90. Prior authorization is required, and while additional acute days are unlimited, psychiatric additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
HealthSpring Achieve (HMO C-SNP) covers outpatient services with no coinsurance, including no copay for ambulatory surgical center and blood services. Outpatient hospital services carry a copay of $0 to $175, observation services cost a $175 copay per stay, and outpatient substance abuse sessions require a $20 copay, all with no coinsurance.
Partial Hospitalization See details
HealthSpring Achieve (HMO C-SNP) covers partial hospitalization services with a $175.00 copay and no coinsurance. Prior authorization is required to receive coverage for these services.
Ambulance and Transportation Services See details
HealthSpring Achieve (HMO C-SNP) covers ground ambulance services with a $200 copay and coinsurance, and air ambulance services with a 20% coinsurance and copay, both requiring prior authorization. Transportation services are partially covered with no copay or coinsurance for plan-approved locations, but transportation to any other health-related location is not covered.
Emergency Services See details
HealthSpring Achieve (HMO C-SNP) covers emergency services with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services have a $65 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $50,000 limit with a $150 copay and no coinsurance.
Primary Care See details
HealthSpring Achieve (HMO C-SNP) provides primary care physician services with no copay and no coinsurance, while specialist, therapy, and opioid services require a $20 copay and no coinsurance. Chiropractic care is partially covered with a $20 copay and no coinsurance, but other chiropractic services are not covered. For mental health and psychiatric care, some services are covered but individual and group sessions are not covered, featuring no copay and no coinsurance.
Preventive Services See details
HealthSpring Achieve (HMO C-SNP) covers preventive services, including annual physical exams and kidney disease education, with no copay and no coinsurance. Additional preventive benefits are partially covered with no copay and no coinsurance, but do not cover health education, in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, readmission 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 modifications, and counseling.
Hearing Services See details
HealthSpring Achieve (HMO C-SNP) covers annual routine hearing exams and fittings for a $20 copay and no coinsurance. Prescription hearing aids are partially covered with a copay of $399 to $1,800 and no coinsurance—excluding inner ear, outer ear, and over the ear models—while OTC hearing aids are covered with a $399 copay and no coinsurance.
Vision Services See details
HealthSpring Achieve (HMO C-SNP) provides partially covered vision services, offering one annual routine eye exam with a $0 to $20 copay and no coinsurance, while other eye exam services are not covered. Covered eyewear features no copay, no coinsurance, and no deductible, with a combined maximum plan benefit of $325 per year for contacts, lenses, frames, and upgrades.
Dental Services See details
HealthSpring Achieve (HMO C-SNP) covers Medicare-covered dental services with a $20 copay and no coinsurance, while other preventive and comprehensive dental services are covered with no copay and no coinsurance up to a $1,200 annual maximum.
Home Infusion bundled Services See details
HealthSpring Achieve (HMO C-SNP) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Covered Medicare Part B drugs, including chemotherapy, radiation, and other drugs, carry a 0% to 20% coinsurance, while covered Part B insulin has a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the HealthSpring Achieve (HMO C-SNP) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
HealthSpring Achieve (HMO C-SNP) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance, requiring prior authorization. Diabetic equipment is partially covered with no copay and no coinsurance, though diabetic supplies and therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are partially covered by HealthSpring Achieve (HMO C-SNP), with prior authorization required for all covered services. There is no copay and no coinsurance for lab services and diagnostic radiological services, but outpatient X-rays require a $10 copay and coinsurance, therapeutic radiology requires a copay and 20% coinsurance, and diagnostic procedures and tests are not covered.
Home Health Services See details
Home Health Services are covered under the HealthSpring Achieve (HMO C-SNP) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by HealthSpring Achieve (HMO C-SNP) with no copay or coinsurance, and prior authorization is required. While some services are covered, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered under this plan.
Skilled Nursing Facility (SNF) See details
HealthSpring Achieve (HMO C-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a $20 daily copayment for days 1 through 20 and a $218 daily copayment for days 21 through 100. Prior authorization is required, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
HealthSpring Achieve (HMO C-SNP) partially covers other services, offering meal benefits and over-the-counter (OTC) items with a $70 quarterly limit at no copay and no coinsurance. Acupuncture and other extra services are not covered under this benefit.
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