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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 $140.00. 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 drug deductible of $300. For Tier 1 preferred generics and Tier 2 generics, there is no copay when filled through a preferred pharmacy or preferred mail-order service. If you use standard retail pharmacies or standard mail order, you will pay a $5 copay for Tier 1 drugs and a $10 copay for Tier 2 drugs for a one-month supply. For Tier 3 preferred brand drugs, the plan charges a $47 copay for a one-month supply regardless of whether you use a preferred or standard pharmacy. Tier 4 non-preferred drugs require a 50% coinsurance, while Tier 5 specialty drugs require a 29% coinsurance for a one-month supply across all pharmacy networks.
Additional Benefits
The HealthSpring Preferred Savings (HMO) plan offers robust coverage with no copay and no coinsurance for primary care doctor visits, preventive services, and home health care. For specialized care, members pay a predictable $35 copay with no coinsurance for specialist visits, physical therapy, and urgent care. Inpatient hospital stays require a daily copay of $325 for acute care and $320 for psychiatric care during the first six days, with no copay for additional days up to day 90. This Medicare plan also features valuable supplemental benefits, including no copay and no coinsurance for routine eye exams, eyewear up to a $350 annual limit, and preventive dental care. Prescription hearing aids are available with copays ranging from $399 to $1,800, while eligible members receive a $165 quarterly allowance for over-the-counter items with no copay. Skilled nursing facility services are covered with no copay for the first 20 days, followed by a $218 daily copay for days 21 through 100.
Inpatient Hospital See details
HealthSpring Preferred Savings (HMO) covers inpatient hospital services with no coinsurance, requiring a $325 daily copay for days 1 through 6 for acute care and a $320 daily copay for days 1 through 6 for psychiatric care, with 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, including no copay for outpatient blood and Ambulatory Surgical Center (ASC) services. Outpatient hospital services incur a copay of $0 to $350 (including $350 per stay for observation services) with no coinsurance, and outpatient substance abuse sessions have a $35 copay with no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by HealthSpring Preferred Savings (HMO) with a $105.00 copay and no coinsurance, although prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by HealthSpring Preferred Savings (HMO), with ground ambulance services requiring a $250 copay and air ambulance services requiring a 20% coinsurance, both of which require prior authorization. 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, which is waived if you are 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 lifetime maximum with a $115 copay and no coinsurance.
Primary Care See details
HealthSpring Preferred Savings (HMO) features primary care physician services with no copay and no coinsurance, while specialist visits, physical therapy, occupational therapy, and opioid treatment require a $35 copay and no coinsurance. Telehealth and other health professional services carry a $0 to $35 copay and no coinsurance, but chiropractic, podiatry, mental health, and psychiatric services are not covered.
Preventive Services See details
HealthSpring Preferred Savings (HMO) covers preventive services with no copay and no coinsurance, including annual physicals, kidney disease education, and glaucoma screenings. This benefit is partially covered because sub-services such as 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 are not covered.
Hearing Services See details
HealthSpring Preferred Savings (HMO) covers annual routine hearing exams and fittings for a $35 copay and no coinsurance, with a referral required. Prescription hearing aids are partially covered with copays from $399 to $1,800 and no coinsurance, though inner ear, outer ear, and over-the-ear models are not covered, while OTC hearing aids are covered for a $399 copay and no coinsurance.
Vision Services See details
Vision services under HealthSpring Preferred Savings (HMO) are partially covered, featuring one routine eye exam per year with no copay and no coinsurance, though other eye exam services are not covered. Eyewear is covered with no copay and no coinsurance, offering up to a $350 annual maximum benefit for contacts, frames, lenses, and upgrades.
Dental Services See details
Dental Services are partially covered under the HealthSpring Preferred Savings (HMO) plan, with maxillofacial prosthetics, implant services, and orthodontics not covered. Medicare-covered dental services require a $35 copay and no coinsurance, while preventive dental care has no copay and no coinsurance, and other covered comprehensive services range from no copay up to a $675 copay with no coinsurance under a $20,000 annual maximum.
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. Medicare Part B chemotherapy, radiation, and other drugs incur no coinsurance to 20% coinsurance, while Part B insulin drugs require a $35 copay and no coinsurance 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 for these services.
Medical Equipment See details
HealthSpring Preferred Savings (HMO) covers durable medical equipment, prosthetics, and medical supplies with no copay and 20% coinsurance, subject to prior authorization. This benefit is partially covered, as diabetic therapeutic shoes and inserts are covered under these same cost-sharing terms, but diabetic supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by HealthSpring Preferred Savings (HMO) with no coinsurance, though prior authorization and referrals are required. There is no copay for lab services and diagnostic radiology, while outpatient X-rays have a $10 copay, diagnostic procedures range from no copay to a $50 copay, and therapeutic radiology requires a minimum $85 copay.
Home Health Services See details
Home Health Services are covered by the HealthSpring Preferred Savings (HMO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under HealthSpring Preferred Savings (HMO) with no copay and no coinsurance, though prior authorization and referrals are required. While some services are covered, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered.
Skilled Nursing Facility (SNF) See details
HealthSpring Preferred Savings (HMO) covers skilled nursing facility (SNF) services with no coinsurance and no prior three-day hospital stay required, though prior authorization is necessary. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and 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 up to $165 every three months and qualifying meal benefits with no copay and no coinsurance. Acupuncture is not covered under this plan.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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