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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 $6700.00 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 $300 annual drug deductible. You will pay no copay for Tier 1 preferred generic and Tier 2 generic drugs when using a preferred pharmacy or preferred mail order service. For standard pharmacies and standard mail order, Tier 1 copays start at $5 and Tier 2 copays start at $10 for a one-month supply. Tier 3 preferred brand drugs have a flat $47 copay for a one-month supply at both preferred and standard pharmacies or mail order services. For higher-tier medications, Tier 4 non-preferred drugs require a 50% coinsurance, and Tier 5 specialty drugs require a 29% coinsurance for a one-month supply.
Additional Benefits
The HealthSpring Preferred Savings (HMO) plan offers robust medical coverage featuring no copay for primary care visits and no coinsurance for inpatient hospital stays, which carry a 350 dollar daily copay for the first five days. Members also benefit from no copay for home health services and the first 20 days of skilled nursing facility care, while specialist visits require a 50 dollar copay. Emergency room visits have a 115 dollar copay, which is waived if admitted, and urgent care is available with a 35 dollar copay. For everyday wellness, this plan provides no copay for preventive dental care with up to a 20,000 dollar annual maximum benefit, alongside a routine vision allowance of up to 150 dollars for eyewear. Routine hearing exams are available with a 20 dollar copay, and members receive a quarterly 110 dollar allowance for over-the-counter items with no copay. Durable medical equipment and dialysis services are covered with a 20 percent coinsurance and no copay, helping keep out-of-pocket costs manageable.
Inpatient Hospital See details
HealthSpring Preferred Savings (HMO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $350 daily copay for days 1 through 5 and no copay for days 6 through 90. While unlimited additional days are covered for acute stays, 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 copays ranging from $0 to $350 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 $50 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 coverage for this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered under HealthSpring Preferred Savings (HMO), with prior-authorized ground ambulance requiring a $250 copay and no coinsurance, and air ambulance requiring a 20% coinsurance and no copay. While some transportation services are covered, trips to plan-approved health-related locations and any health-related locations are not covered.
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 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 limit 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, and specialist visits with a $50 copay and no coinsurance. Physical, occupational, and speech therapy require a $35 copay and no coinsurance, while podiatry, chiropractic, 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 for services like annual physicals, kidney disease education, and fitness benefits. This benefit is partially covered because it excludes health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, smoking cessation, disease management, telemonitoring, remote access, home safety devices, and counseling.
Hearing Services See details
Hearing services are covered by HealthSpring Preferred Savings (HMO), offering routine exams and fitting evaluations for a $20 copay and no coinsurance. Hearing aids are partially covered with no coinsurance and a limit of two per year, featuring a $399 copay for OTC models and a $399 to $1,800 copay for prescription models, though inner ear, outer ear, and over the ear prescription aids are not covered.
Vision Services See details
HealthSpring Preferred Savings (HMO) partially covers vision services with no deductibles, offering routine eye exams with 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 $150 annual limit for contact lenses or one pair of eyeglasses.
Dental Services See details
Dental services are partially covered by HealthSpring Preferred Savings (HMO), offering up to a $20,000 annual maximum benefit with no coinsurance for all covered services. Preventive care requires no copay, Medicare-covered dental has a $50 copay, and comprehensive services carry copays ranging from $0 to $675, 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, requiring prior authorization and step therapy. Medicare Part B chemotherapy, radiation, and other drugs have no copay and range from no coinsurance to 20% coinsurance, while Part B insulin has a $35 copay and up to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by the HealthSpring Preferred Savings (HMO) plan with no copay and a 20% coinsurance. Prior authorization and a referral are required to access this benefit.
Medical Equipment See details
HealthSpring Preferred Savings (HMO) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance, subject to prior authorization. Diabetic equipment is partially covered under this plan, offering therapeutic shoes and inserts with no copay and a 20% coinsurance, while 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, although referrals and prior authorizations are required. Members will pay no copay for lab services, a $10 copay for outpatient x-rays, a $0 to $50 copay for diagnostic procedures, and a minimum $85 copay for therapeutic radiological services.
Home Health Services See details
Home Health Services are fully covered under the HealthSpring Preferred Savings (HMO) plan 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, meaning there is no coverage for intensive cardiac, pulmonary, or SET for PAD rehabilitation. Consequently, there are no copays or coinsurance benefits associated with these services under this plan.
Skilled Nursing Facility (SNF) See details
Skilled nursing facility (SNF) care is covered by HealthSpring Preferred Savings (HMO) with no coinsurance, and prior authorization is required. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, though additional days beyond the Medicare limit are not covered.
Other Services See details
HealthSpring Preferred Savings (HMO) partially covers other services, offering over-the-counter (OTC) items and a meal benefit with no copay and no coinsurance, while acupuncture is not covered. The plan provides up to $110 every three months for OTC items and covers health-related meals for members who must remain at home due to a chronic illness or medical condition.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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