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HealthSpring Preferred Savings (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HealthSpring Preferred Savings (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HealthSpring Preferred Savings (HMO) in 2026, please refer to our full plan details page.
HealthSpring Preferred Savings (HMO) is a HMO plan offered by Health Care Service Corporation available for enrollment in 2025 to people living in Tennessee. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that HealthSpring Preferred Savings (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 Savings (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 Savings (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. Additionally, this plan comes with a Part B Premium reduction of $100.00. You must continue to pay paying your reduced 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 $300.00 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 $6750.00 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 Savings (HMO) plan features a $300 drug deductible before coverage begins. For Tier 1 preferred generic drugs, members pay no copay when using a preferred pharmacy or preferred mail-order service. Tier 2 generic drugs are also cost-effective, with copays starting at $8 for a one-month supply at preferred pharmacies, or no copay for a three-month supply through preferred mail order. Tier 3 preferred brand drugs require a flat $47 copay for a one-month supply at all standard and preferred pharmacies. For higher-tier medications, the plan charges a 50% coinsurance for Tier 4 non-preferred drugs and a 29% coinsurance for Tier 5 specialty drugs, regardless of whether you use standard or preferred services.
Additional Benefits
The HealthSpring Preferred Savings (HMO) plan provides cost-effective coverage for core medical services, featuring no copay for primary care doctor visits and a $35 copay for specialist consultations. For inpatient hospital stays, members pay a $330 daily copay for days 1 through 6 and no copay for days 7 through 90 with no coinsurance. Emergency room care carries a $130 copay, which is waived upon admission, while skilled nursing facility stays require no copay for the first 20 days. Supplemental benefits include dental coverage with no copay up to an $800 annual limit, alongside no copay for eyewear up to a $100 yearly maximum. Routine hearing exams carry a $35 copay, while home health services are fully covered with no copay and no coinsurance. Additionally, diagnostic lab work and outpatient X-rays require no copay, whereas durable medical equipment and dialysis services are subject to a 20% coinsurance.
Inpatient Hospital See details
HealthSpring Preferred Savings (HMO) covers acute and psychiatric inpatient hospital stays with no coinsurance, requiring a $330 daily copay for days 1 through 6 and no copay for days 7 through 90. These services are partially covered, as additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
HealthSpring Preferred Savings (HMO) covers outpatient services with no coinsurance, featuring copays ranging from $0 to $370 for outpatient hospital services and a $370 copay per stay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions have a $35 copay and no coinsurance.
Partial Hospitalization See details
HealthSpring Preferred Savings (HMO) covers partial hospitalization services with a $140.00 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
HealthSpring Preferred Savings (HMO) covers ground ambulance services with a $230 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Emergency services under the HealthSpring Preferred Savings (HMO) plan are covered with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $50,000 maximum with a $130 copay and no coinsurance.
Primary Care See details
HealthSpring Preferred Savings (HMO) offers primary care physician services with no copay and no coinsurance, and specialist visits with a $35 copay and no coinsurance. Physical, occupational, and speech therapies are covered with a $30 copay and no coinsurance, while chiropractic, podiatry, mental health, and psychiatric services are not covered.
Preventive Services See details
Preventive services are covered under the HealthSpring Preferred Savings (HMO) with no copay and no coinsurance for services like annual physicals, kidney disease education, and fitness benefits. However, this benefit is partially covered as it excludes health education, in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, additional smoking cessation, enhanced disease management, telemonitoring, remote access, home safety modifications, and counseling.
Hearing Services See details
Hearing services covered by the HealthSpring Preferred Savings (HMO) plan include annual routine exams and fitting evaluations for a $35 copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and copays between $399 and $1,800 for up to two devices yearly, excluding inner ear, outer ear, and over the ear models. Up to two over-the-counter (OTC) hearing aids are also covered each year with a $399 copay and no coinsurance.
Vision Services See details
HealthSpring Preferred Savings (HMO) partially covers vision services, offering one routine eye exam per year with a $0 to $35 copay, no coinsurance, and no deductible, while other eye exam services are not covered. Eyewear is covered with no copay, coinsurance, or deductible up to a $100 annual maximum for contacts, eyeglasses, lenses, frames, and upgrades.
Dental Services See details
HealthSpring Preferred Savings (HMO) covers Medicare-covered dental services with a $35 copay and no coinsurance, subject to prior authorization. Other preventive and comprehensive dental services, including cleanings, x-rays, and restorative treatments, are covered with no copay and no coinsurance up to a maximum annual benefit of $800.
Home Infusion bundled Services See details
HealthSpring Preferred Savings (HMO) covers home infusion bundled services with no copay and no coinsurance, though prior authorization is required. Covered Medicare Part B drugs, including chemotherapy and insulin, feature coinsurance ranging from no coinsurance to 20%, with insulin carrying a $35 copay and other drugs requiring no copay.
Dialysis Services See details
HealthSpring Preferred Savings (HMO) covers Dialysis Services with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
HealthSpring Preferred Savings (HMO) partially covers medical equipment with no copay and a 20% coinsurance, requiring prior authorization for durable medical equipment, prosthetics, and diabetic therapeutic shoes. While diabetic therapeutic shoes and inserts are covered, diabetic supplies are not covered by this plan.
Diagnostic and Radiological Services See details
HealthSpring Preferred Savings (HMO) covers diagnostic and radiological services with prior authorization, offering no coinsurance and a $0 to $150 copay for diagnostic tests, alongside no copay for lab services. Diagnostic radiological services and outpatient X-rays have no copay, though Medicare-covered X-rays require coinsurance and therapeutic radiological services carry a minimum 20% coinsurance.
Home Health Services See details
HealthSpring Preferred Savings (HMO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by HealthSpring Preferred Savings (HMO) with no coinsurance, but prior authorization is required. While some services are covered, specific programs like cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) rehabilitation are not covered in practice, though they carry a $10 copay.
Skilled Nursing Facility (SNF) See details
HealthSpring Preferred Savings (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and while a three-day prior hospital stay is not required, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
HealthSpring Preferred Savings (HMO) partially covers other services, offering a meal benefit for chronic illnesses or medical conditions requiring you to remain at home with no copay and no coinsurance. Acupuncture and over-the-counter (OTC) items are not covered under this benefit.
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