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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) prescription drug plan features an annual drug deductible of $300. You can enjoy no copay for Tier 1 preferred generic and Tier 2 generic drugs when filled through preferred pharmacies or preferred mail-order services. If you use standard pharmacies or standard mail order, copays for these generic tiers range from $5 to $10 for a one-month supply. For Tier 3 preferred brand drugs, the plan charges a consistent $47 copay for a one-month supply regardless of whether you use preferred or standard pharmacies and mail-order services. Higher-tier medications are subject to coinsurance, 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 robust medical coverage featuring no copay and no coinsurance for primary care visits, preventive services, and home health care. For hospital stays, members pay a $320 daily copay for the first six days of inpatient care and no copay for days 7 through 90, alongside a $45 copay for specialist visits. Emergency care is accessible with a $115 copay, which is waived upon hospital admission, and urgent care carries a $35 copay. This plan also includes valuable supplemental benefits, such as preventive and comprehensive dental care with no copay up to a $2,500 annual limit. Vision services feature an annual routine exam with copays ranging from no copay up to $45, plus no copay for eyewear up to a $250 yearly maximum. Additionally, members can access a $100 quarterly over-the-counter allowance and chronic condition meal benefits, both with no copay or coinsurance.
Inpatient Hospital See details
Inpatient hospital care is covered by HealthSpring Preferred Savings (HMO) with no coinsurance, requiring a $320 daily copay for days 1 through 6 and no copay for days 7 through 90 per stay. The 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. There is no copay or coinsurance for ambulatory surgical center and outpatient blood services, while outpatient substance abuse sessions require a $10 copay.
Partial Hospitalization See details
Partial hospitalization is covered under the HealthSpring Preferred Savings (HMO) plan with a $105.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
HealthSpring Preferred Savings (HMO) covers ground ambulance services with a $240 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required for both. Transportation services to plan-approved or other 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, and urgently needed services with a $35 copay and no coinsurance, with both copays waived if you are admitted to the hospital within 24 hours. Worldwide emergency, urgent, and transportation services are also covered up to a $50,000 maximum benefit with a $115 copay and no coinsurance.
Primary Care See details
HealthSpring Preferred Savings (HMO) covers primary care with no copay and no coinsurance, specialist visits with a $45 copay and no coinsurance, and therapy services with a $35 copay and no coinsurance. While podiatry is not covered, some chiropractic services are covered with a $15 copay and no coinsurance, and some mental health and psychiatric services are covered with no copay and no coinsurance. However, routine chiropractic care as well as individual and group sessions for mental health and psychiatric services are not covered.
Preventive Services See details
Preventive services are covered by HealthSpring Preferred Savings (HMO) with no copay and no coinsurance, including annual physical exams, kidney disease education, and fitness benefits. However, additional preventive services are only partially covered, excluding options such as health education, weight management programs, in-home safety assessments, personal emergency response systems, and nutritional benefits.
Hearing Services See details
Hearing services covered by the HealthSpring Preferred Savings (HMO) include annual routine exams for a $30 copay and no coinsurance, and OTC hearing aids for a $399 copay and no coinsurance. Prescription hearing aids are partially covered with copays ranging from $399 to $1,800 and no coinsurance, though inner ear, outer ear, and over the ear models are not covered.
Vision Services See details
Vision services are partially covered by HealthSpring Preferred Savings (HMO), featuring one annual routine eye exam with no deductible, no coinsurance, and a copay ranging from no copay to $45, while other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and no deductible, offering a $250 yearly maximum for contacts, frames, lenses, and upgrades.
Dental Services See details
HealthSpring Preferred Savings (HMO) covers Medicare-covered dental services with a $45 copay and no coinsurance, which requires prior authorization. All other preventive and comprehensive dental services, such as cleanings, exams, implants, and orthodontics, are covered with no copay and no coinsurance up to a maximum annual benefit of $2,500.
Home Infusion bundled Services See details
HealthSpring Preferred Savings (HMO) covers home infusion bundled services with no copay, although prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs carry no copay and a 0% to 20% coinsurance, while Part B insulin drugs require 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. Both prior authorization and a referral are required to receive these covered services.
Medical Equipment See details
HealthSpring Preferred Savings (HMO) provides partially covered medical equipment with no copay and a 20% coinsurance for durable medical equipment, prosthetic devices, and diabetic therapeutic shoes, though diabetic supplies are not covered. Prior authorization is required for these services, and diabetic equipment is limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under HealthSpring Preferred Savings (HMO) with no coinsurance, though prior authorization and referrals are required. There is no copay for lab services, a $10 copay for outpatient X-rays, a minimum copay of $85 for therapeutic radiology, and copays ranging from no copay up to $50 for diagnostic procedures.
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) does not cover Cardiac Rehabilitation Services, including cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by HealthSpring Preferred Savings (HMO) 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, no prior three-day hospital stay is needed for admission, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
HealthSpring Preferred Savings (HMO) partially covers Other Services, which excludes acupuncture. Covered benefits include a meal benefit for chronic or medical conditions and over-the-counter (OTC) items up to $100 every three months, both of which feature no copay and no coinsurance.
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