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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 $125.00. 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 $7200.00 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. Beneficiaries enjoy no copay for Tier 1 preferred generic and Tier 2 generic medications when using a preferred pharmacy or preferred mail-order service. If standard pharmacies or standard mail-order services are used, Tier 1 copays range from $5 to $15, and Tier 2 copays range from $10 to $30, depending on the supply. For Tier 3 preferred brand drugs, there is a consistent $47 copay for a one-month supply at all standard and preferred pharmacies or mail-order options. Higher-tier medications require coinsurance, with Tier 4 non-preferred drugs at 50% coinsurance and Tier 5 specialty drugs at 29% coinsurance for a one-month supply. This structured coverage offers clear cost expectations for your Medicare prescription drug needs.
Additional Benefits
The HealthSpring Preferred Savings (HMO) plan offers comprehensive medical coverage featuring no copays for primary care doctor visits, preventive services, and home health care. Specialists, physical therapy, and diagnostic lab tests are accessible with low, fixed copayments and no coinsurance. For inpatient hospital stays, members pay a daily copayment for the first six days, followed by no copays for the remainder of a standard stay. Additional benefits include dental, vision, and hearing services, which feature no copayments for preventive dental care and routine eyewear up to an annual maximum. Hearing aids and routine hearing exams are covered with flat copayments and no coinsurance, while durable medical equipment and dialysis services require a twenty percent coinsurance. Members also receive eligible meals and a quarterly over-the-counter allowance with no copays.
Inpatient Hospital See details
HealthSpring Preferred Savings (HMO) covers inpatient hospital services with no coinsurance, requiring a $335 daily copay for days 1 to 6 of acute care and a $320 daily copay for days 1 to 6 of psychiatric care, with no copay for days 7 to 90. 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, offering ambulatory surgical center and blood services with no copay. Outpatient hospital services have a copay of $0 to $350, observation services require a $350 copay per stay, and outpatient substance abuse sessions carry a $45 copay.
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 these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by HealthSpring Preferred Savings (HMO), featuring a $250 copay (no coinsurance) for ground ambulance and a 20% coinsurance (no copay) for air ambulance, both of which require prior authorization. Transportation services to plan-approved or any other 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 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 maximum with a $115 copay and no coinsurance.
Primary Care See details
HealthSpring Preferred Savings (HMO) offers primary care physician services with no copay and no coinsurance, and specialist, physical, occupational, and speech therapy visits for a $30 copay and no coinsurance. Telehealth services require a $0 to $30 copay and opioid treatments require a $45 copay, both with no coinsurance, but podiatry is not covered, and while some chiropractic, mental health, and psychiatric services are covered, routine chiropractic, other chiropractic, and individual or group sessions are not.
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. This benefit is partially covered, as several sub-services such as health education, weight management programs, and in-home safety assessments are not covered.
Hearing Services See details
HealthSpring Preferred Savings (HMO) covers annual routine hearing exams and fitting evaluations 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 for up to two devices per year, excluding inner ear, outer ear, and over the ear models. OTC hearing aids are also covered up to two per year with a $399 copay and no coinsurance.
Vision Services See details
Vision services are partially covered under HealthSpring Preferred Savings (HMO) because other eye exam services are not covered. Routine eye exams are covered with a $0 to $30 copay and no coinsurance (limited to one per year), while eyewear is covered with no copay and no coinsurance up to a $200 annual maximum.
Dental Services See details
HealthSpring Preferred Savings (HMO) covers Medicare-covered dental services with a $30 copay and no coinsurance, which require prior authorization. Other preventive and comprehensive dental services are covered with no copay and no coinsurance, up to a maximum benefit of $1,500 per year.
Home Infusion bundled Services See details
HealthSpring Preferred Savings (HMO) covers home infusion bundled services with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs have no coinsurance to 20% coinsurance, while covered Part B insulin requires a $35 copay and ranges from no coinsurance to 20% coinsurance.
Dialysis Services See details
HealthSpring Preferred Savings (HMO) covers dialysis services with no copay and a 20% coinsurance, though prior authorization and a referral are required.
Medical Equipment See details
Medical Equipment is covered by HealthSpring Preferred Savings (HMO) with no copays and 20% coinsurance, with prior authorization required. This benefit is partially covered, as durable medical equipment, prosthetic devices, medical supplies, and diabetic therapeutic shoes are covered, 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, but require prior authorization and referrals. There is no copay for lab services, a $10 copay for outpatient x-rays, a $0 to $50 copay for diagnostic procedures and tests, a minimum $85 copay for therapeutic radiology, and a copay starting at $0 for diagnostic radiology.
Home Health Services See details
HealthSpring Preferred Savings (HMO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are partially covered under the HealthSpring Preferred Savings (HMO) plan with no coinsurance, although referrals and prior authorization are required. Standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation 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, requiring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, a prior three-day inpatient hospital stay is not required, and additional days beyond the standard 100-day limit are not covered.
Other Services See details
HealthSpring Preferred Savings (HMO) partially covers other services, offering no copay and no coinsurance for eligible meal benefits and over-the-counter items up to $105 every three months. Acupuncture and other miscellaneous services are not covered under this benefit.
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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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