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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 El Paso. 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 $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 Full Savings (HMO) plan features a $500 drug deductible. For Tier 1 preferred generic and Tier 2 generic medications, you will pay no copay when using preferred pharmacies or preferred mail-order services. Standard pharmacies and standard mail-order options carry copays starting at $5 for Tier 1 and $10 for Tier 2 for a one-month supply. For brand-name and specialty medications, Tier 3 preferred brand drugs require a flat $47 copay for a one-month supply regardless of the pharmacy type. Tier 4 non-preferred drugs are subject to a 50% coinsurance, and Tier 5 specialty drugs require a 27% coinsurance for a one-month supply. These structured costs help you budget your healthcare expenses depending on the tier of your prescriptions.
Additional Benefits
The HealthSpring Preferred Full Savings (HMO) plan offers comprehensive medical coverage featuring no copay for primary care visits, preventive services, and home health care. Specialist visits require a $50 copay, while emergency services carry a $115 copay that is waived upon hospital admission. For hospital stays, inpatient acute care requires a $375 daily copay for the first six days, while outpatient hospital services range from no copay up to a $350 copay. In addition to basic medical care, the plan provides routine dental and vision benefits with no copay up to set annual limits, as well as hearing exams and hearing aid coverage. Members also benefit from a $30 quarterly over-the-counter allowance and up to 10 free one-way transportation trips per year with no copay. Essential medical equipment and dialysis services are covered with a 20% coinsurance and no copay.
Inpatient Hospital See details
Inpatient hospital services are partially covered by HealthSpring Preferred Full Savings (HMO) with no coinsurance, requiring a $375 daily copay for days 1 to 6 of acute stays and a $320 daily copay for days 1 to 6 of psychiatric stays. There is no copay for days 7 through 90, but upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by HealthSpring Preferred Full Savings (HMO) with no coinsurance, featuring a $0 to $350 copay for outpatient hospital services and a $350 copay per stay for observation services. Ambulatory surgical center and outpatient blood services are available with no copay and no coinsurance, while outpatient substance abuse individual and group sessions require a $10 copay.
Partial Hospitalization See details
Partial hospitalization is covered by HealthSpring Preferred Full Savings (HMO) 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 $240 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered, offering up to 10 one-way trips per year to plan-approved locations with no copay or coinsurance, though transportation to any health-related location is not covered.
Emergency Services See details
HealthSpring Preferred Full Savings (HMO) covers emergency services with a $115 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours, and urgently needed services with a $35 copay and no coinsurance. Worldwide emergency, urgent, and transportation services are also covered up to a $50,000 lifetime maximum with a $115 copay and no coinsurance per service.
Primary Care See details
HealthSpring Preferred Full Savings (HMO) covers primary care with no copay and specialist visits with a $50 copay, both featuring no coinsurance. Physical, occupational, and speech therapies require a $35 copay, telehealth and other professional services range from a $0 to $50 copay, and opioid treatment has a $10 copay, all with no coinsurance, while chiropractic, podiatry, psychiatric, and mental health services are not covered.
Preventive Services See details
HealthSpring Preferred Full Savings (HMO) partially covers preventive services with no copay and no coinsurance, including annual physical exams, fitness benefits, and kidney disease education. However, several supplemental services are not covered, such as health education, personal emergency response systems, in-home safety assessments, and medical nutrition therapy.
Hearing Services See details
HealthSpring Preferred Full Savings (HMO) covers routine hearing exams and fitting evaluations with a $25 copay, no coinsurance, and a required referral. Prescription hearing aids are partially covered with no coinsurance and copays from $399 to $1,800, excluding inner ear, outer ear, and over-the-ear models, while OTC hearing aids are covered with a $399 copay and no coinsurance.
Vision Services See details
HealthSpring Preferred Full Savings (HMO) covers vision services with no deductibles, including one routine eye exam annually with a $0.00 to $50.00 copay and no coinsurance, while other eye exam services are not covered. Eyewear is covered with no copay or coinsurance up to a $125.00 annual maximum for contacts, lenses, frames, and upgrades.
Dental Services See details
HealthSpring Preferred Full Savings (HMO) covers Medicare-approved dental services with a $50 copay and no coinsurance, requiring prior authorization. Other preventive and comprehensive dental services, including exams, cleanings, and implants, are covered with no copay and no coinsurance up to a $1,200 annual maximum.
Home Infusion bundled Services See details
HealthSpring Preferred Full Savings (HMO) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs require no coinsurance to 20% coinsurance, while Medicare Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
HealthSpring Preferred Full Savings (HMO) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization and a referral are required to access this covered benefit.
Medical Equipment See details
Medical equipment is partially covered by HealthSpring Preferred Full Savings (HMO) with no copay and a 20% coinsurance, though prior authorization is required. While durable medical equipment, prosthetics, and diabetic therapeutic shoes are covered, diabetic supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the HealthSpring Preferred Full Savings (HMO) with no coinsurance, though prior authorizations and referrals are required. Under this benefit, lab services have no copay, outpatient X-rays require a $10 copay, therapeutic radiological services have a minimum $85 copay, and diagnostic procedures and tests range from no copay to a $50 copay.
Home Health Services See details
HealthSpring Preferred Full Savings (HMO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
HealthSpring Preferred Full Savings (HMO) covers some cardiac rehabilitation services with no coinsurance, but key sub-services including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered.
Skilled Nursing Facility (SNF) See details
HealthSpring Preferred Full Savings (HMO) 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 per stay, though additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
HealthSpring Preferred Full Savings (HMO) partially covers other services, offering over-the-counter (OTC) items and meal benefits with no copay and no coinsurance, while acupuncture is not covered. Eligible members receive up to $30 every three months for OTC items, and meal benefits are available for chronic illnesses or medical conditions requiring recovery at home.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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