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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 $7500.00 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 an annual drug deductible of $300. You will pay no copay for Tier 1 preferred generic and Tier 2 generic medications when using a preferred pharmacy or preferred mail-order service. If you use standard pharmacies or standard mail order, a one-month supply costs a $5 copay for Tier 1 and a $10 copay for Tier 2. For Tier 3 preferred brand drugs, you will pay a $47 copay for a one-month supply regardless of whether you use preferred or standard pharmacy options. Higher-tier medications require coinsurance, with Tier 4 non-preferred drugs costing 50% coinsurance and Tier 5 specialty drugs costing 29% coinsurance for a one-month supply.
Additional Benefits
The HealthSpring Preferred Savings (HMO) plan offers comprehensive medical coverage with predictable out-of-pocket costs, including no copay and no coinsurance for primary care visits and preventive services. For specialized medical care, members pay a $45 copay for specialist visits, while inpatient hospital stays require a $300 daily copay for the first six days and no copay thereafter. Emergency services are available with a $115 copay, which is waived if you are admitted to the hospital within 24 hours. This plan also features robust supplemental benefits, including preventive dental services and home health care with no copay and no coinsurance. Vision care includes eyewear coverage up to a $150 annual limit, while routine hearing exams are available for a $40 copay. Additionally, members receive an over-the-counter benefit of up to $90 every three months with no copay, and standard durable medical equipment is covered with a 20% coinsurance and no copay.
Inpatient Hospital See details
HealthSpring Preferred Savings (HMO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $300 daily copay for days 1 through 6 and no copay for days 7 through 90. This benefit is partially covered as it excludes upgrades, psychiatric additional days, and non-Medicare-covered stays, though unlimited additional acute care days are 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 carry a copay of $0 to $350, observation services cost a $350 copay per stay, and individual or group outpatient substance abuse sessions require a $35 copay.
Partial Hospitalization See details
Partial hospitalization is covered by HealthSpring Preferred Savings (HMO) with a $105.00 copay and no coinsurance. Prior authorization is required to access these services.
Ambulance and Transportation Services See details
Ambulance and Transportation Services under HealthSpring Preferred Savings (HMO) cover ground ambulance services with a $250 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay. Prior authorization is required for ambulance services, and transportation services to plan-approved or 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, 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 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, while specialist visits require a $45 copay and no coinsurance. Physical, occupational, speech, and opioid treatment therapies have a $35 copay with no coinsurance, but chiropractic, podiatry, mental health specialty, and psychiatric services are not covered.
Preventive Services See details
HealthSpring Preferred Savings (HMO) covers preventive services, including annual physical exams, kidney disease education, and fitness benefits, with no copay and no coinsurance. Additional preventive services are only partially covered, with exclusions such as health education, in-home safety assessments, personal emergency response systems, and weight management programs.
Hearing Services See details
Hearing services are covered by HealthSpring Preferred Savings (HMO) with a $40 copay and no coinsurance for annual routine hearing exams and fittings, which require a referral. Up to two OTC hearing aids per year are covered with a $399 copay and no coinsurance, while 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.
Vision Services See details
HealthSpring Preferred Savings (HMO) offers partially covered vision services, featuring eye exams with a copay ranging from no copay to $45 and no coinsurance, though other eye exam services are not covered. Eyewear is covered with no copay and no coinsurance, providing up to a $150 annual maximum benefit for contact lenses, eyeglasses, frames, and upgrades.
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 copay and no coinsurance for preventive care, diagnostic services, and oral surgery. Medicare-covered dental services require a $45 copay and no coinsurance, while covered comprehensive services have copays ranging from $0 to $675 and no coinsurance. 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 and no coinsurance, although prior authorization is required. Covered Medicare Part B chemotherapy, radiation, and other drugs carry no copay and no coinsurance to 20% coinsurance, while Part B insulin is covered with a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the HealthSpring Preferred Savings (HMO) plan with no copay and a 20% coinsurance. Prior authorization and a referral are required to obtain these services.
Medical Equipment See details
HealthSpring Preferred Savings (HMO) covers medical equipment with no copay and a 20% coinsurance for durable medical equipment, prosthetic devices, medical supplies, and diabetic therapeutic shoes, subject to prior authorization. Diabetic equipment is only partially covered under this plan, as diabetic supplies are not covered.
Diagnostic and Radiological Services See details
HealthSpring Preferred Savings (HMO) covers diagnostic and radiological services with no coinsurance, though referrals and prior authorizations are required. Members pay no copay for lab services, a $0 to $50 copay for diagnostic tests, a $10 copay for outpatient X-rays, and a minimum $85 copay for therapeutic radiological services.
Home Health Services See details
Home Health Services are covered under 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 by HealthSpring Preferred Savings (HMO) with no coinsurance, but in practice only some services are covered. Standard cardiac rehabilitation ($30 copay), intensive cardiac rehabilitation ($30 copay), pulmonary rehabilitation ($15 copay), and SET for PAD services ($20 copay) are not covered, and prior authorization and referrals are required.
Skilled Nursing Facility (SNF) See details
HealthSpring Preferred Savings (HMO) partially 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, while 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 a meal benefit with no copay and no coinsurance, while acupuncture is not covered. The OTC benefit provides up to $90 every three months for health-related items, and the meal benefit supports members recovering from medical conditions or managing chronic illnesses.
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