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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 Corpus Christi. 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 $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 $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 $3400.00 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) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generics and Tier 2 generics, members enjoy no copay when utilizing a preferred pharmacy or preferred mail order service. If you choose a standard pharmacy or standard mail order, Tier 1 copays start at $5 and Tier 2 copays start at $10 for a one-month supply. For brand-name and specialty medications, costs are structured as coinsurance across all pharmacy types. Tier 3 preferred brands require a 24% coinsurance, while Tier 4 non-preferred drugs require a 25% coinsurance. Tier 5 specialty medications also carry a 25% coinsurance and are limited to a one-month supply.
Additional Benefits
HealthSpring TotalCare (HMO D-SNP) offers robust coverage for essential medical care, featuring no copay and no coinsurance for primary care, specialist visits, preventive services, and home health care. For hospital stays, members pay a $320 daily copay for the first five days of inpatient care with no copay thereafter, while emergency room visits carry a $150 copay. Outpatient services, skilled nursing, and ambulance transport are also covered, typically requiring set copays or coinsurance depending on the specific treatment. This plan also provides valuable supplemental benefits, including comprehensive dental care with no copay up to a $3,000 annual limit, and vision care that includes a routine exam and a $400 eyewear allowance. Members also benefit from no copay on routine hearing exams, a $300 quarterly allowance for over-the-counter items, and unlimited transportation to plan-approved medical locations. While some specialized services like dialysis and certain medical equipment require coinsurance, many routine health needs are covered with no out-of-pocket costs.
Inpatient Hospital See details
HealthSpring TotalCare (HMO D-SNP) covers inpatient hospital acute and psychiatric care with no coinsurance and a copay of $320 per day for days 1 through 5, followed by no copay for days 6 through 90. This benefit is partially covered, as additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
HealthSpring TotalCare (HMO D-SNP) outpatient services are covered with a $0 to $100 copay and no coinsurance for outpatient hospital and observation services, and no copay or coinsurance for ambulatory surgical center and blood services. Outpatient substance abuse services feature no copay but require a 20% coinsurance for individual and group sessions.
Partial Hospitalization See details
HealthSpring TotalCare (HMO D-SNP) covers partial hospitalization services with a $175.00 copay and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
HealthSpring TotalCare (HMO D-SNP) covers ambulance services with a $100 copay and no coinsurance for ground transport, and a 20% coinsurance with no copay for air transport, with prior authorization required. Transportation services are partially covered, offering unlimited one-way rides to plan-approved health-related locations with no copay or coinsurance, though transportation to any other health-related location is not covered.
Emergency Services See details
HealthSpring TotalCare (HMO D-SNP) covers emergency services with a $150 copay and no coinsurance, and urgently needed services with a $10 copay and no coinsurance, with copays waived if admitted to the hospital within 24 hours. Worldwide emergency, urgent, and transportation services are also covered up to a $50,000 maximum with a $150 copay and no coinsurance.
Primary Care See details
HealthSpring TotalCare (HMO D-SNP) covers primary care, specialist, therapy, and telehealth services with no copay and no coinsurance, while opioid treatment requires no copay and a 20% coinsurance. Podiatry is not covered, and though some chiropractic, mental health, and psychiatric services are covered, routine chiropractic care, other chiropractic services, and individual or group therapy sessions are not.
Preventive Services See details
Preventive Services are covered by HealthSpring TotalCare (HMO D-SNP) with no copay and no coinsurance for services such as annual physical exams, kidney disease education, and glaucoma screenings. While fitness benefits and caregiver support are included, additional preventive services like health education, weight management, nutritional/dietary benefits, and home safety modifications are not covered.
Hearing Services See details
Hearing services are covered by HealthSpring TotalCare (HMO D-SNP), featuring routine exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered—excluding inner ear, outer ear, and over the ear types—with no coinsurance and copays ranging from $399.00 to $1,800.00, while up to two OTC hearing aids are covered annually with a $399.00 copay and no coinsurance.
Vision Services See details
HealthSpring TotalCare (HMO D-SNP) partially covers vision services with no copay, no coinsurance, and no deductible, including one routine eye exam per year and a $400 annual allowance for eyewear. While contact lenses and eyeglasses are covered, other eye exam services are not covered.
Dental Services See details
Dental services are covered by HealthSpring TotalCare (HMO D-SNP) with no copay and no coinsurance for preventive and comprehensive care, up to a maximum yearly benefit of $3,000. Covered services include oral exams, cleanings, x-rays, restorative treatments, implants, and orthodontics, with prior authorization required for Medicare-covered dental services.
Home Infusion bundled Services See details
Home infusion bundled services are covered by HealthSpring TotalCare (HMO D-SNP) with no copay and no coinsurance, subject to prior authorization. Associated Medicare Part B chemotherapy, radiation, and other drugs have no copay and a 0% to 20% coinsurance, while Part B insulin requires a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
HealthSpring TotalCare (HMO D-SNP) covers Dialysis Services with no copay and a 15% coinsurance. Prior authorization and a referral are required to receive these services.
Medical Equipment See details
HealthSpring TotalCare (HMO D-SNP) partially covers medical equipment, offering durable medical equipment and diabetic equipment with no copay and no coinsurance. While Medicare-covered prosthetics and medical supplies require a 20% coinsurance with no copay, diabetic supplies and therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
HealthSpring TotalCare (HMO D-SNP) partially covers diagnostic and radiological services, requiring prior authorization and referrals for all care. Covered lab services require no copay and no coinsurance, and therapeutic radiological services have a 20% coinsurance and no copay, while diagnostic procedures, diagnostic radiological services, and outpatient X-ray services are not covered.
Home Health Services See details
Home Health Services are covered by HealthSpring TotalCare (HMO D-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
HealthSpring TotalCare (HMO D-SNP) does not cover Cardiac Rehabilitation Services, including standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services.
Skilled Nursing Facility (SNF) See details
HealthSpring TotalCare (HMO D-SNP) covers Skilled Nursing Facility (SNF) stays with no coinsurance, requiring a $20 daily copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, admission is allowed with less than a three-day prior hospital stay, and additional days beyond the standard Medicare limit are not covered.
Other Services See details
HealthSpring TotalCare (HMO D-SNP) partially covers other services, offering a meal benefit and over-the-counter (OTC) items with no copay and no coinsurance, including a $300 allowance every three months for OTC items. Acupuncture and other additional services under this category are not covered.
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