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HealthSpring TotalCare (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HealthSpring TotalCare (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HealthSpring TotalCare (HMO D-SNP) in 2026, please refer to our full plan details page.
HealthSpring TotalCare (HMO D-SNP) is a HMO D-SNP plan offered by Health Care Service Corporation available for enrollment in 2025 to people living in Alabama. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that HealthSpring TotalCare (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
HealthSpring TotalCare (HMO D-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 TotalCare (HMO D-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 TotalCare (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $3.30. 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 $615.00 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 TotalCare (HMO D-SNP) plan offers an Enhanced Alternative drug benefit with a $615.00 annual prescription drug deductible. If you qualify for the Low-Income Subsidy (Extra Help), your Part D premium cost may be reduced to $3.30. After meeting your deductible, you will pay set copayments or coinsurance during the initial coverage phase until your total drug costs reach $2,100.00. During the initial coverage phase, Tier 1 preferred generic drugs require a $20.00 copay, while Tier 2 standard generics carry a 24% coinsurance. Tier 3 preferred brands and Tier 4 non-preferred drugs both have a 25% coinsurance for retail and mail-order options. Once your yearly out-of-pocket drug costs reach $2,100.00, you will enter the catastrophic coverage phase and pay nothing for Medicare Part D covered drugs.
Additional Benefits
The HealthSpring TotalCare (HMO D-SNP) plan offers comprehensive medical coverage with predictable cost-sharing, featuring low copays and no coinsurance for inpatient hospital stays, outpatient services, and skilled nursing facility care. Emergency and urgent care are covered with flat copayments, while primary care is accessible and diagnostic services range from no copay to a 20% coinsurance. Additionally, the plan includes up to 50 one-way transportation trips per year to approved locations and preventive care with no copay. Supplemental benefits include comprehensive dental coverage up to a $3,000 annual limit and a $350 yearly allowance for eyewear with no deductibles. Routine hearing exams have no copay, and hearing aids are covered with copayments ranging from $399 to $1,800. Members also benefit from a $200 quarterly allowance for over-the-counter items and a limited-duration meal benefit for chronic illnesses.
Inpatient Hospital See details
Inpatient hospital benefits are partially covered by HealthSpring TotalCare (HMO D-SNP) with no coinsurance, requiring a $150 daily copay for days 1 through 5 of acute stays (no copay for days 6 through 90) and a $1,850 copay per psychiatric stay. Additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
HealthSpring TotalCare (HMO D-SNP) covers outpatient hospital services with a $0 to $95 copay and observation services with a $95 copay per stay, both with no coinsurance. Ambulatory surgical center services are covered with no copay and no coinsurance, while outpatient substance abuse sessions require a 20% coinsurance and no copay.
Partial Hospitalization See details
HealthSpring TotalCare (HMO D-SNP) covers partial hospitalization benefits with a $140.00 copay and no coinsurance. Prior authorization is required to receive these covered services.
Ambulance and Transportation Services See details
HealthSpring TotalCare (HMO D-SNP) covers ground ambulance services with a $255 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, both of which require prior authorization. Transportation services are partially covered, offering up to 50 one-way trips per year to plan-approved locations, though transportation to any health-related location is not covered.
Emergency Services See details
HealthSpring TotalCare (HMO D-SNP) covers emergency services with a $130 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours. Urgently needed services require a $50 copay and no coinsurance, while worldwide emergency services are covered up to $50,000 with a $130 copay and no coinsurance.
Primary Care See details
HealthSpring TotalCare (HMO D-SNP) covers primary care, specialist, therapy, and telehealth services, while podiatry is not covered. Chiropractic care is partially covered with a $15 copay and no coinsurance (excluding routine care), opioid treatment has a 20% coinsurance and no copay, and for mental health and psychiatric services, some services are covered but individual and group sessions are not.
Preventive Services See details
Preventive services are partially covered by HealthSpring TotalCare (HMO D-SNP) with no copay and no coinsurance for covered benefits like annual physical exams, caregiver support, and fitness programs. However, the plan does not cover health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, readmission prevention, chemotherapy wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, additional smoking cessation, disease management, telemonitoring, remote access, bathroom safety devices, or counseling.
Hearing Services See details
HealthSpring TotalCare (HMO D-SNP) covers annual routine hearing exams and fitting evaluations with no copay, no deductible, and no coinsurance. Hearing aids are partially covered for up to two devices per year with copays ranging from $399 to $1,800 and no coinsurance, though prescription hearing aids for the inner ear, outer ear, and over the ear are not covered.
Vision Services See details
HealthSpring TotalCare (HMO D-SNP) covers vision services with no deductibles, including one routine eye exam every year. The plan also features a $350 combined annual maximum benefit for eyewear, which covers contact lenses, eyeglass lenses, frames, and upgrades.
Dental Services See details
Dental services are covered by HealthSpring TotalCare (HMO D-SNP), including Medicare dental services which require prior authorization. The plan also covers a wide range of preventive, restorative, and orthodontic services up to a maximum benefit of $3,000 every year.
Home Infusion bundled Services See details
HealthSpring TotalCare (HMO D-SNP) covers home infusion bundled services with prior authorization, featuring no coinsurance to 20% coinsurance on all covered Medicare Part B drugs. Medicare Part B insulin drugs require a $35 copay, while chemotherapy, radiation, and other Part B drugs have no copay.
Dialysis Services See details
HealthSpring TotalCare (HMO D-SNP) covers Dialysis Services with 20% coinsurance and no copay. Prior authorization is required for these services.
Medical Equipment See details
HealthSpring TotalCare (HMO D-SNP) partially covers medical equipment with a 20% coinsurance and no copay for durable medical equipment, prosthetic devices, and diabetic therapeutic shoes, while diabetic supplies are not covered.
Diagnostic and Radiological Services See details
HealthSpring TotalCare (HMO D-SNP) covers diagnostic and radiological services, which require prior authorization. Lab services are covered with no copay, while diagnostic tests, x-rays, and radiological services range from no coinsurance to 20% coinsurance with no copays.
Home Health Services See details
Home Health Services are covered by HealthSpring TotalCare (HMO D-SNP), though prior authorization is required before you can receive these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by HealthSpring TotalCare (HMO D-SNP), as none of the sub-services—including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation—are covered in practice.
Skilled Nursing Facility (SNF) See details
HealthSpring TotalCare (HMO D-SNP) covers Skilled Nursing Facility (SNF) stays with a $10 copay for days 1 to 20 and a $218 copay for days 21 to 100, with no coinsurance required. Prior authorization is required for these services, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by HealthSpring TotalCare (HMO D-SNP), featuring a $200 quarterly allowance for over-the-counter items and a limited-duration meal benefit for chronic illnesses, while acupuncture and highly integrated services are not covered.
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