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HealthSpring Preferred Full Savings (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HealthSpring Preferred Full 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 Full Savings (HMO) in 2026, please refer to our full plan details page.
HealthSpring Preferred Full Savings (HMO) is a HMO plan offered by Health Care Service Corporation available for enrollment in 2025 to people living in Houston. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that HealthSpring Preferred Full 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 Full 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 Full 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 $185.00. 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 $500.00 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 Full Savings (HMO) plan features an annual drug deductible of $500. For Tier 1 preferred generic and Tier 2 generic medications, you will pay no copay when using a preferred pharmacy or preferred mail-order service. Standard pharmacies and standard mail-order options require a copay starting at $5 for Tier 1 and $10 for Tier 2. Tier 3 preferred brand drugs have a flat $47 copay for a one-month supply across all pharmacy and mail-order options. For higher-tier medications, Tier 4 non-preferred drugs carry a 50% coinsurance, while Tier 5 specialty drugs require a 27% coinsurance for a one-month supply.
Additional Benefits
The HealthSpring Preferred Full Savings (HMO) plan offers comprehensive coverage with no copay for primary care visits, preventive services, and home health care. For hospital stays, members pay no coinsurance, though inpatient services require a $340 daily copay for the first six days and no copay for days seven through 90. Outpatient hospital services range from no copay up to a $350 copay, while specialist visits require a $50 copay. This plan also includes supplemental benefits, such as preventive dental care and routine eyewear with no copay, alongside routine hearing exams for a $40 copay. Emergency care carries a $115 copay, which is waived if you are admitted within 24 hours, while urgent care visits require a $35 copay. For specialized medical needs, dialysis and durable medical equipment require a 20% coinsurance with no copay.
Inpatient Hospital See details
HealthSpring Preferred Full Savings (HMO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $340 daily copay for days 1 through 6 and no copay for days 7 through 90. While unlimited additional acute care days are covered, additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by HealthSpring Preferred Full Savings (HMO) with no coinsurance across all categories, including ambulatory surgical center and blood services which also feature no copay. Outpatient hospital services require a copay of $0 to $350, observation services have a $350 copay per stay, and outpatient substance abuse individual or group sessions carry a $55 copay.
Partial Hospitalization See details
HealthSpring Preferred Full Savings (HMO) covers partial hospitalization services with a $105.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
HealthSpring Preferred Full Savings (HMO) covers ground ambulance services with a $250 copay and air ambulance services with a 20% coinsurance, both requiring prior authorization. Transportation services to health-related locations are not covered.
Emergency Services See details
HealthSpring Preferred Full Savings (HMO) covers emergency services with a $115 copay and no coinsurance, with the copay 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 Full Savings (HMO) provides primary care physician services with no copay and no coinsurance, while specialist visits require a $50 copay and therapy services require a $35 copay, both with no coinsurance. Telehealth and opioid treatment services are also covered with copays up to $55 and no coinsurance, though chiropractic, podiatry, psychiatric, and specialty mental health services are not covered.
Preventive Services See details
Preventive services are partially covered by HealthSpring Preferred Full Savings (HMO) with no copay and no coinsurance for covered options like annual physicals, kidney disease education, and fitness benefits. However, several additional services are not covered, including health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, chemotherapy wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, smoking cessation counseling, enhanced disease management, telemonitoring, remote access technologies, home safety devices, and counseling.
Hearing Services See details
Hearing services are covered by HealthSpring Preferred Full Savings (HMO), including routine exams and evaluations for a $40 copay and no coinsurance. Prescription hearing aids are partially covered with a copay between $399 and $1,800 and no coinsurance, as inner ear, outer ear, and over the ear devices are not covered, while over-the-counter hearing aids are covered with a $399 copay and no coinsurance.
Vision Services See details
HealthSpring Preferred Full Savings (HMO) offers partially covered vision services, as other eye exam services are not covered. Routine eye exams are covered once per year with a $0 to $50 copay and no coinsurance, and eyewear is covered with no copay or coinsurance up to a $150 annual limit.
Dental Services See details
HealthSpring Preferred Full Savings (HMO) offers partially covered dental services with a $20,000 annual maximum, featuring no copay and no coinsurance for preventive care. Medicare-covered dental services require a $50 copay and no coinsurance, while other covered comprehensive services have copays ranging from $0 to $675 and no coinsurance, excluding implants, orthodontics, and maxillofacial prosthetics.
Home Infusion bundled Services See details
HealthSpring Preferred Full Savings (HMO) covers Home Infusion bundled services with no copay, though prior authorization and step therapy are required. Associated Medicare Part B chemotherapy, radiation, and other drugs carry no copay and up to 20% coinsurance (with a minimum of no coinsurance), while Part B insulin drugs require a $35 copay and up to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the HealthSpring Preferred Full Savings (HMO) with no copay and a 20% coinsurance. Prior authorization and a referral are required to receive these covered services.
Medical Equipment See details
HealthSpring Preferred Full Savings (HMO) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance, with prior authorization required. Diabetic equipment is partially covered under the plan with no copay and a 20% coinsurance for therapeutic shoes and inserts, though diabetic supplies are not covered.
Diagnostic and Radiological Services See details
HealthSpring Preferred Full Savings (HMO) covers diagnostic and radiological services with no coinsurance, although prior authorization and referrals are required. There is no copay for lab services and some diagnostic radiological services, while outpatient x-rays have a $10 copay, diagnostic tests range from a $0 to $50 copay, and therapeutic radiological services require a copay starting at $85.
Home Health Services See details
The HealthSpring Preferred Full Savings (HMO) plan covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are offered by HealthSpring Preferred Full Savings (HMO) with no coinsurance, but in practice only some services are covered. Standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered under this plan.
Skilled Nursing Facility (SNF) See details
HealthSpring Preferred Full Savings (HMO) covers Skilled Nursing Facility (SNF) services 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, and while a three-day prior hospital stay is not needed, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by HealthSpring Preferred Full Savings (HMO), featuring a meal benefit and over-the-counter (OTC) items with no copay and no coinsurance, while acupuncture is not covered. Eligible members receive up to $40 every three months for OTC items, as well as a limited-duration meal benefit for qualifying chronic or medical conditions.
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