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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 $145.00. 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 $6775.00 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 drug deductible of $300. You can enjoy no copay on Tier 1 preferred generic and Tier 2 generic drugs when using a preferred pharmacy or preferred mail-order service. Standard pharmacies and standard mail-order options are also available with copays starting at $5 for Tier 1 and $10 for Tier 2 prescriptions. For higher-tier medications, Tier 3 preferred brand drugs require a $47 copay for a one-month supply across all pharmacy and mail-order options. Tier 4 non-preferred drugs carry a 50% coinsurance, while Tier 5 specialty drugs require a 29% coinsurance for a one-month supply.
Additional Benefits
The HealthSpring Preferred Savings (HMO) plan offers comprehensive coverage with predictable out-of-pocket costs, featuring no copays for primary care visits, preventive care, and home health services. Members also benefit from no copays and no coinsurance for routine dental services like cleanings and x-rays up to a $2,500 annual limit, alongside a $250 eyewear allowance. Specialist visits require a $45 copay, while routine hearing exams are available with a $30 copay and no coinsurance. For acute care, inpatient hospital stays require a $320 daily copay for the first six days followed by no copay for days 7 through 90, while emergency room visits carry a $115 copay. Diagnostic lab services and over-the-counter health items are covered with no copay, whereas services like medical equipment and dialysis require a 20% coinsurance. This plan balances no copays for everyday wellness with clear cost-sharing for major medical needs.
Inpatient Hospital See details
HealthSpring Preferred Savings (HMO) covers inpatient hospital services with no coinsurance, requiring a $320 daily copay for days 1 through 6 and no copay for days 7 through 90. This benefit is partially covered, as 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 a $0 to $350 copay for outpatient hospital services and a $350 copay per stay for observation services. Ambulatory surgical center and outpatient blood services have no copay and no coinsurance, while outpatient substance abuse sessions require 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. Prior authorization is required to receive this covered benefit.
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. Transportation services to health-related locations are not covered under this plan.
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 require a $35 copay and no coinsurance, while 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) covers primary care physician services with no copay and no coinsurance, specialists for a $45 copay and no coinsurance, and physical, occupational, and speech therapies for a $35 copay and no coinsurance. Podiatry is not covered, telehealth and opioid treatments have no coinsurance with copays up to $45, and while some chiropractic, mental health, and psychiatric services are covered, routine chiropractic, individual sessions, and group sessions are not covered.
Preventive Services See details
HealthSpring Preferred Savings (HMO) covers preventive services, including annual physical exams and fitness benefits, with no copay and no coinsurance. Additional preventive services are only partially covered, as the plan excludes health education, in-home safety assessments, personal emergency response systems, and medical nutrition therapy.
Hearing Services See details
HealthSpring Preferred Savings (HMO) covers routine hearing exams and fittings for a $30 copay and no coinsurance, though a referral is required. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $399 to $1,800—excluding inner ear, outer ear, and over the ear models—while OTC hearing aids are covered with a $399 copay and no coinsurance.
Vision Services See details
Vision services are partially covered by HealthSpring Preferred Savings (HMO), which features one routine eye exam per year with a $0 to $45 copay and no coinsurance, though other eye exam services are not covered. Eyewear is also covered with no copay, no coinsurance, and no deductible, offering up to a $250 annual maximum for contacts, upgrades, and one pair of eyeglasses.
Dental Services See details
Dental services are covered by HealthSpring Preferred Savings (HMO), with Medicare-covered dental services requiring a $45 copay and no coinsurance. Other preventive and comprehensive dental services, such as cleanings, x-rays, and orthodontics, are covered with no copay and no coinsurance up to a maximum yearly benefit of $2,500.
Home Infusion bundled Services See details
Home infusion bundled services are covered by HealthSpring Preferred Savings (HMO) with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs have a coinsurance ranging from no coinsurance to 20%, while Part B insulin has a $35 copay and up to 20% coinsurance.
Dialysis Services See details
HealthSpring Preferred Savings (HMO) covers dialysis services 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) covers medical equipment, including durable medical equipment and prosthetics, with no copay and a 20% coinsurance, subject to prior authorization. This benefit is partially covered because diabetic therapeutic shoes and inserts are covered under these terms, but diabetic supplies are not covered by the plan.
Diagnostic and Radiological Services See details
HealthSpring Preferred Savings (HMO) covers diagnostic and radiological services with no coinsurance, though prior authorization and referrals are required. Outpatient lab services and diagnostic radiology have no copay, while diagnostic tests range from $0 to $50, outpatient X-rays cost $10, and therapeutic radiology copays start at $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) covers Cardiac Rehabilitation Services with no coinsurance, though prior authorization and referrals are required. While some services are covered, cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered, with copays ranging from $15 to $30.
Skilled Nursing Facility (SNF) See details
HealthSpring Preferred Savings (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
HealthSpring Preferred Savings (HMO) partially covers other services, offering over-the-counter (OTC) items and meal benefits with no copay and no coinsurance, while acupuncture is not covered. The OTC benefit provides up to $100 every three months for health-related items, and the meal benefit is available for members who must remain at home due to a medical condition.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
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