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HealthSpring Premier (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HealthSpring Premier (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HealthSpring Premier (HMO-POS) in 2026, please refer to our full plan details page.
HealthSpring Premier (HMO-POS) is a HMO-POS plan offered by Health Care Service Corporation available for enrollment in 2026 to people living in Las Vegas. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that HealthSpring Premier (HMO-POS) 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 Premier (HMO-POS).
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 Premier (HMO-POS), 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.
This plan does not come with a Part B Premium reduction. You must continue to pay your 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 $200.00 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 $2000.00 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 Premier (HMO-POS) prescription drug plan features an annual drug deductible of $200. Under this plan, Tier 1 preferred generic drugs have no copay when filled through a preferred pharmacy or preferred mail order service. For Tier 2 generic drugs, you will pay a low $4 copay for a one-month supply at preferred pharmacies, with no copay for a three-month supply filled through preferred mail order. Tier 3 preferred brand drugs require a flat $47 copay per month across all pharmacy types. Higher-tier prescriptions, such as Tier 4 non-preferred drugs and Tier 5 specialty drugs, incur a 50% and 30% coinsurance respectively. Choosing standard pharmacies or standard mail order will generally result in higher copays for your generic medications.
Additional Benefits
HealthSpring Premier (HMO-POS) offers comprehensive medical coverage featuring no copay and no coinsurance for primary care, specialist visits, and home health services. Inpatient hospital stays require a $75 daily copay for the first four days and no copay for days five through 90, while emergency room visits carry a $140 copay. Outpatient hospital services are highly affordable, ranging from no copay to a $50 copay with no coinsurance. Supplemental benefits include preventive and comprehensive dental care with no copay up to a $3,500 annual limit, alongside routine hearing exams with no copay. Vision coverage features exams ranging from no copay to a $35 copay, plus a $350 annual allowance for eyewear. Additionally, members can access a $110 quarterly over-the-counter benefit with no copay, while durable medical equipment and dialysis require a 20% coinsurance.
Inpatient Hospital See details
HealthSpring Premier (HMO-POS) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $75 daily copay for days 1 through 4 and no copay for days 5 through 90. This benefit is partially covered because additional days, upgrades, and non-Medicare-covered stays are not covered, and prior authorization is required.
Outpatient Services See details
HealthSpring Premier (HMO-POS) covers outpatient services with no coinsurance, featuring a $0 to $50 copay for outpatient hospital services, a $50 copay per stay for observation services, and no copay for ambulatory surgical center and blood services. For outpatient substance abuse services, some services are covered with no copay or coinsurance, but individual and group sessions are not covered.
Partial Hospitalization See details
HealthSpring Premier (HMO-POS) covers partial hospitalization services with a $130.00 copay and no coinsurance. Prior authorization is required to access this covered benefit.
Ambulance and Transportation Services See details
HealthSpring Premier (HMO-POS) covers ground ambulance services with a $255 copay and air ambulance services with a 20% coinsurance, with prior authorization required. Transportation services to plan-approved health-related locations are partially covered with no copay and no coinsurance for up to 30 one-way trips per year, though transportation to any health-related location is not covered.
Emergency Services See details
HealthSpring Premier (HMO-POS) covers emergency services with a $140 copay and no coinsurance, and urgently needed services with a $10 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 $140 copay and no coinsurance.
Primary Care See details
HealthSpring Premier (HMO-POS) provides primary care, specialist, physical and occupational therapy, telehealth, and opioid treatment services with no copay and no coinsurance. Podiatry is not covered, and only some chiropractic, mental health, and psychiatric services are covered, as routine chiropractic care, other chiropractic services, and individual or group sessions are not covered.
Preventive Services See details
HealthSpring Premier (HMO-POS) covers preventive services with no copay and no coinsurance, including annual physical exams and kidney disease education. However, additional preventive services are only partially covered, excluding health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs for chemotherapy hair loss, 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/bathroom safety devices, and counseling.
Hearing Services See details
Hearing services are partially covered by HealthSpring Premier (HMO-POS), offering one routine exam and fitting evaluation annually with no copay and no coinsurance. Up to two OTC hearing aids (with a $399 copay and no coinsurance) and two prescription hearing aids (with a $399 to $1,800 copay and no coinsurance) are covered per year, though inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
Vision Services are partially covered by HealthSpring Premier (HMO-POS), offering one routine eye exam per year with a $0 to $35 copay and no coinsurance, though other eye exam services are not covered. Eyewear is covered with no copay and no coinsurance up to a $350 annual maximum for contact lenses, upgrades, and one pair of eyeglasses per year.
Dental Services See details
Dental services are covered by HealthSpring Premier (HMO-POS) with no copay and no coinsurance for preventive and comprehensive care, including cleanings, implants, and orthodontics, up to a $3,500 annual maximum. Medicare-covered dental services also have no copay and no coinsurance, but require prior authorization.
Home Infusion bundled Services See details
HealthSpring Premier (HMO-POS) covers Home Infusion bundled Services with no copay, though prior authorization and step therapy are required. Medicare Part B chemotherapy, radiation, and other drugs are covered with 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
HealthSpring Premier (HMO-POS) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization and a referral are required to receive these covered services.
Medical Equipment See details
Medical equipment is partially covered by HealthSpring Premier (HMO-POS), offering no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes and inserts. While these covered services require prior authorization, diabetic supplies are not covered under this plan.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by HealthSpring Premier (HMO-POS) with prior authorization and referrals required. Diagnostic services feature no coinsurance, offering no copay for lab services and a $0 to $50 copay for procedures, while radiological services require a $10 copay plus coinsurance for X-rays, a copay starting at $0 with no coinsurance for diagnostic radiology, and a minimum 20% coinsurance plus a copay for therapeutic radiology.
Home Health Services See details
Home Health Services are covered by HealthSpring Premier (HMO-POS) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by HealthSpring Premier (HMO-POS), as cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation services are all excluded from coverage.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by HealthSpring Premier (HMO-POS) with no coinsurance, requiring a daily copay of $20 for days 1 through 20 and $214 for days 21 through 100. Prior authorization is required, a prior three-day hospital stay is not necessary for admission, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
HealthSpring Premier (HMO-POS) partially covers other services, offering over-the-counter (OTC) items and meal benefits with no copay and no coinsurance, while acupuncture is not covered. The OTC benefit provides up to $110 of coverage every three months, and the meal benefit is available for members with qualifying chronic or medical conditions.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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