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HealthSpring TotalCare Plus (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HealthSpring TotalCare Plus (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 Plus (HMO D-SNP) in 2026, please refer to our full plan details page.
HealthSpring TotalCare Plus (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 Plus (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 Plus (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 Plus (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 Plus (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $6.50. 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 $5000.00 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 Plus (HMO D-SNP) plan features an Enhanced Alternative drug benefit with an annual prescription drug deductible of $615.00. During the initial coverage phase, you will pay a flat $20.00 copay for Tier 1 preferred generic drugs at both preferred and standard pharmacies. For other tiers, costs are based on coinsurance, including 23% for standard generics and 25% for preferred brand and non-preferred drugs. After your yearly out-of-pocket drug expenses reach $2,100.00, you enter the catastrophic coverage phase and will pay nothing for covered Part D prescriptions. Additionally, if you qualify for the low-income subsidy (LIS or Extra Help), your plan premium may be reduced, lowering your Part D cost to $6.50.
Additional Benefits
The HealthSpring TotalCare Plus (HMO D-SNP) plan offers comprehensive medical coverage with no copay and no coinsurance for inpatient hospital stays, emergency services, and preventive care. Outpatient services and vision care are also highly accessible with no deductibles, including a $425 annual allowance for eyewear. Additionally, skilled nursing facility stays are covered with no copay or coinsurance for the first 100 days. For supplemental health needs, the plan provides a generous $4,000 annual maximum benefit for dental services and no copay for routine hearing exams. Prescription hearing aids are available with copays ranging from $399 to $1,800, while members also receive a $300 quarterly allowance for over-the-counter items. Air ambulance services are covered with a 20% coinsurance, and unlimited transportation to plan-approved locations is included.
Inpatient Hospital See details
HealthSpring TotalCare Plus (HMO D-SNP) covers inpatient acute and psychiatric hospital stays with no copay and no coinsurance, though prior authorization is required. These benefits are partially covered, as additional days, non-Medicare-covered stays, and upgrades are not covered.
Outpatient Services See details
Outpatient services are covered by HealthSpring TotalCare Plus (HMO D-SNP), including outpatient hospital, observation, ambulatory surgical center, and blood services with no deductible. Outpatient substance abuse services are not covered, and specific copay and coinsurance details for the covered services are not specified.
Partial Hospitalization See details
Partial hospitalization benefits are covered by HealthSpring TotalCare Plus (HMO D-SNP), though prior authorization is required to access these services. No specific copay or coinsurance costs are listed in the plan benefits for this service.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are partially covered by HealthSpring TotalCare Plus (HMO D-SNP), as ground ambulance services and transportation to any health-related location are not covered. Covered air ambulance services require a 20% coinsurance and no copay, while unlimited one-way transportation to plan-approved health-related locations is also covered.
Emergency Services See details
Emergency and urgently needed services are covered by HealthSpring TotalCare Plus (HMO D-SNP) with no copay and no coinsurance. Worldwide emergency, urgent, and transportation services are also covered up to a $50,000 maximum limit with a $125 copay.
Primary Care See details
HealthSpring TotalCare Plus (HMO D-SNP) partially covers Primary Care benefits, though specific copay and coinsurance information is not provided. Most covered services require prior authorization, while routine chiropractic care, podiatry, and individual or group sessions for mental health and psychiatric services are not covered.
Preventive Services See details
Preventive services are covered by HealthSpring TotalCare Plus (HMO D-SNP) with no copay or coinsurance, including annual physical exams, kidney disease education, and screenings. Additional preventive benefits are partially covered; fitness benefits and caregiver support are included, but health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, 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, bathroom safety, and counseling are not covered.
Hearing Services See details
Hearing services are covered by HealthSpring TotalCare Plus (HMO D-SNP), including annual routine hearing exams and fitting evaluations with no copay or coinsurance. Prescription hearing aids are partially covered—excluding inner ear, outer ear, and over the ear types—with a copay of $399 to $1,800 and no coinsurance, while OTC hearing aids are covered with a $399 copay and no coinsurance.
Vision Services See details
HealthSpring TotalCare Plus (HMO D-SNP) covers vision services with no deductible, including one routine eye exam and a $425 annual maximum allowance for eyewear such as contacts, lenses, frames, and upgrades.
Dental Services See details
Dental services are covered by HealthSpring TotalCare Plus (HMO D-SNP) up to a maximum annual benefit of $4,000, including preventive, restorative, and orthodontic care. No copay or coinsurance details are specified for these covered services, which include unlimited exams, cleanings, and x-rays.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by HealthSpring TotalCare Plus (HMO D-SNP) with prior authorization, featuring no copay and ranging from no coinsurance to 20% coinsurance for chemotherapy, radiation, and other Medicare Part B drugs. Covered Medicare Part B insulin drugs require a $35 copay and range from no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the HealthSpring TotalCare Plus (HMO D-SNP) plan, though prior authorization is required before receiving treatment.
Medical Equipment See details
Medical Equipment is partially covered by HealthSpring TotalCare Plus (HMO D-SNP), which covers Durable Medical Equipment (DME) with prior authorization. However, prosthetic devices, medical supplies, diabetic supplies, and diabetic therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are partially covered by HealthSpring TotalCare Plus (HMO D-SNP), with prior authorization required for covered services. Lab services are covered with no copay and no coinsurance, but diagnostic procedures, diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services are not covered.
Home Health Services See details
Home Health Services are covered under the HealthSpring TotalCare Plus (HMO D-SNP) plan, although prior authorization is required to access these benefits.
Cardiac Rehabilitation Services See details
HealthSpring TotalCare Plus (HMO D-SNP) does not cover Cardiac Rehabilitation Services. None of the associated sub-services, including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation, are covered under this plan.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by HealthSpring TotalCare Plus (HMO D-SNP) with no copay and no coinsurance for days 1 through 100, though prior authorization is required. Additional days beyond the Medicare-covered limit are not covered by the plan.
Other Services See details
Other Services are partially covered by HealthSpring TotalCare Plus (HMO D-SNP), offering a $300 allowance every three months for over-the-counter (OTC) items and limited-duration meal benefits with no copay or coinsurance. Acupuncture and Dual Eligible SNPs with Highly Integrated Services are not covered.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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