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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 Texas. 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 $130.00. 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 $6900.00 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) Medicare plan features an annual prescription drug deductible of $300. For Tier 1 (Preferred Generic) and Tier 2 (Generic) drugs, there is no copay when you use a preferred pharmacy or preferred mail-order service. If you choose a standard pharmacy or standard mail order, a one-month supply costs a $5 copay for Tier 1 and a $10 copay for Tier 2. For Tier 3 (Preferred Brand) medications, you will pay a $47 copay for a one-month supply at both preferred and standard pharmacies. Higher-tier medications are subject to coinsurance rather than flat copays, with Tier 4 (Non-Preferred) drugs requiring a 50% coinsurance and Tier 5 (Specialty) drugs requiring a 29% coinsurance for a one-month supply.
Additional Benefits
The HealthSpring Preferred Savings (HMO) plan offers affordable coverage for essential medical services, featuring no copay for primary care visits, annual physicals, and home health services. For hospital care, members pay a daily copay of $325 for the first six days of inpatient stays, while outpatient hospital services range from no copay up to a $350 copay. Specialist visits require a $45 copay, emergency room visits have a $115 copay, and standard diagnostic lab services are available with no copay. This plan also includes valuable supplemental benefits, such as preventive dental care and routine eyewear up to a $275 annual limit with no copay. Members can take advantage of a $140 quarterly allowance for over-the-counter items and access routine hearing exams for a $45 copay. While many services feature no coinsurance, certain specialized care like dialysis and durable medical equipment require a 20% coinsurance.
Inpatient Hospital See details
Inpatient hospital care under HealthSpring Preferred Savings (HMO) is covered with no coinsurance, requiring a $325 copay per day for days 1 through 6 and no copay for days 7 through 90. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
HealthSpring Preferred Savings (HMO) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital services have a copay of $0 to $350 and no coinsurance, observation services require a $350 copay per stay and no coinsurance, and outpatient substance abuse sessions have a $45 copay and no coinsurance.
Partial Hospitalization See details
HealthSpring Preferred Savings (HMO) covers partial hospitalization services with a $105.00 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 $250 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required for both. Transportation services to health-related locations are not covered.
Emergency Services See details
HealthSpring Preferred Savings (HMO) covers emergency services with a $115 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours. Urgently needed services are covered with a $35 copay and no coinsurance, and worldwide emergency, urgent, and transportation services are covered up to a $50,000 maximum with a $115 copay and no coinsurance.
Primary Care See details
HealthSpring Preferred Savings (HMO) provides primary care physician services with no copay and no coinsurance, and specialist visits with a $45 copay and no coinsurance. Physical, occupational, and speech therapies require a $35 copay and no coinsurance, while podiatry is not covered, and chiropractic, mental health, and psychiatric services are not covered in practice due to excluded sub-services.
Preventive Services See details
Preventive Services are partially covered by HealthSpring Preferred Savings (HMO) with no copay and no coinsurance for services such as annual physicals, fitness benefits, and caregiver support. However, several services are not covered, including health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, smoking cessation, telemonitoring, and counseling.
Hearing Services See details
HealthSpring Preferred Savings (HMO) covers hearing services with a $45 copay and no coinsurance for annual routine exams and fittings, and a $399 copay and no coinsurance for up to two OTC hearing aids per year. Prescription hearing aids are partially covered with no coinsurance and copays from $399 to $1,800 for up to two devices yearly, though inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Vision services are partially covered by HealthSpring Preferred Savings (HMO) with no deductibles, featuring routine eye exams for a $0 to $45 copay and no coinsurance, though other eye exam services are not covered. Eyewear is covered with no copay or coinsurance up to a $275 annual maximum for contacts, lenses, frames, and upgrades.
Dental Services See details
HealthSpring Preferred Savings (HMO) partially covers dental services up to a $20,000 yearly maximum, offering preventive care with no copay or coinsurance and Medicare-covered dental services for a $45 copay and no coinsurance. Other covered comprehensive services require varying copays and no coinsurance, while maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
HealthSpring Preferred Savings (HMO) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other Part B 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
Dialysis Services are covered by HealthSpring Preferred Savings (HMO) with no copay and a 20% coinsurance. Prior authorization and a referral are required to receive these covered services.
Medical Equipment See details
HealthSpring Preferred Savings (HMO) partially covers medical equipment with no copay and a 20% coinsurance for durable medical equipment, prosthetics, and diabetic therapeutic shoes, though diabetic supplies are not covered. Prior authorization is required for these covered services.
Diagnostic and Radiological Services See details
HealthSpring Preferred Savings (HMO) covers diagnostic and radiological services with no coinsurance, requiring prior authorization and referrals for both. Under this plan, lab services and diagnostic radiology require no copay, while diagnostic tests range from $0 to $50, outpatient X-rays cost $10, and therapeutic radiology carries a minimum copay of $85.
Home Health Services See details
Home Health Services are covered by HealthSpring Preferred Savings (HMO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
HealthSpring Preferred Savings (HMO) offers Cardiac Rehabilitation Services with no coinsurance, but only some services are covered. Standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services are not covered under this plan.
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 additional days beyond the standard Medicare-covered 100 days are not covered.
Other Services See details
Other Services are partially covered by HealthSpring Preferred Savings (HMO), featuring a meal benefit and over-the-counter (OTC) items with no copay and no coinsurance, while acupuncture is not covered. Eligible members receive up to $140 every three months for OTC items and access to meals for qualifying medical conditions.
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