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HealthSpring Achieve (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HealthSpring Achieve (HMO C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HealthSpring Achieve (HMO C-SNP) in 2026, please refer to our full plan details page.
HealthSpring Achieve (HMO C-SNP) is a HMO C-SNP plan offered by Health Care Service Corporation available for enrollment in 2026 to people living in Nashville. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that HealthSpring Achieve (HMO C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
HealthSpring Achieve (HMO C-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about HealthSpring Achieve (HMO C-SNP).
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 Achieve (HMO C-SNP), 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 $250.00 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 $6700.00 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 Achieve (HMO C-SNP) Medicare prescription drug plan features an annual drug deductible of $250. For Tier 1 preferred generic drugs, members pay no copay when using a preferred pharmacy or preferred mail order service. Tier 2 generic drugs are also highly affordable, starting at a low $4 copay for a one-month supply at preferred locations. Tier 3 preferred brand drugs require a flat $47 copay for a one-month supply, while Tier 6 select diabetic drugs range from a $9 to $11 copay. Higher tier prescription medications, such as Tier 4 non-preferred drugs and Tier 5 specialty drugs, incur a 50% and 30% coinsurance, respectively.
Additional Benefits
The HealthSpring Achieve (HMO C-SNP) plan offers robust medical coverage with no copay or coinsurance for primary care visits, annual physicals, and home health services. For specialist consultations, urgent care, and Medicare-covered dental services, members pay a budget-friendly $20 copay with no coinsurance. Inpatient hospital stays require a $350 daily copay for the first six days, followed by no copay for days 7 through 90, while emergency room visits have a $130 copay that is waived if you are admitted. Supplemental benefits include a generous $1,500 annual limit for preventive and comprehensive dental care with no copay, alongside up to $250 yearly for eyewear. Members also benefit from no copay on routine vision exams, home infusion services, and up to 24 one-way trips to approved health locations. For specialized medical needs, a 20% coinsurance applies to dialysis, durable medical equipment, and select Part B drugs, while over-the-counter items are covered with no copay up to a $70 quarterly limit.
Inpatient Hospital See details
HealthSpring Achieve (HMO C-SNP) covers inpatient hospital services with no coinsurance and a copay of $350 per day for days 1 through 6, and no copay for days 7 through 90. The benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered under HealthSpring Achieve (HMO C-SNP) with no coinsurance, featuring a $0 to $350 copay for outpatient hospital services and a $350 copay per stay for observation services. Outpatient substance abuse sessions require a $20 copay, while ambulatory surgical center and outpatient blood services are covered with no copays or coinsurance.
Partial Hospitalization See details
HealthSpring Achieve (HMO C-SNP) covers partial hospitalization services with a $140.00 copay and no coinsurance. Prior authorization is required to receive this covered benefit.
Ambulance and Transportation Services See details
HealthSpring Achieve (HMO C-SNP) partially covers ambulance and transportation services, with prior authorization required for both. Ground ambulance services require a $200 copay and no coinsurance, air ambulance services require a 20% coinsurance and no copay, and up to 24 one-way trips per year to plan-approved health locations are covered with no copay or coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
HealthSpring Achieve (HMO C-SNP) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $20 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $50,000 maximum with a $130 copay and no coinsurance.
Primary Care See details
HealthSpring Achieve (HMO C-SNP) offers primary care physician services with no copay and no coinsurance, and specialist, physical therapy, and occupational therapy visits with a $20 copay and no coinsurance. While chiropractic, mental health, and psychiatric services are covered with no coinsurance, their primary sub-services—such as routine chiropractic care and individual or group therapy sessions—are not covered.
Preventive Services See details
HealthSpring Achieve (HMO C-SNP) covers preventive services, including annual physical exams, kidney disease education, and diabetes self-management training, with no copay and no coinsurance. Additional preventive services are partially covered under the plan, which includes fitness and caregiver support benefits, but excludes services like health education, medical nutrition therapy, and weight management programs.
Hearing Services See details
HealthSpring Achieve (HMO C-SNP) covers hearing services, including one routine hearing exam and fitting evaluation annually for a $20 copay and no coinsurance. Prescription hearing aids are partially covered with a copay of $399 to $1,800 and no coinsurance for up to two devices per year, but inner ear, outer ear, and over the ear types are not covered. Up to two OTC hearing aids are also covered each year with a $399 copay and no coinsurance.
Vision Services See details
Vision Services are partially covered under HealthSpring Achieve (HMO C-SNP) as other eye exam services are not covered, though routine exams are covered with a $0 to $20 copay, no coinsurance, and no deductible. Eyewear is covered with no copay, no coinsurance, and no deductible, providing up to a $250 annual maximum for contacts, eyeglasses, frames, lenses, and upgrades.
Dental Services See details
Dental services are covered by HealthSpring Achieve (HMO C-SNP), featuring Medicare-covered dental care for a $20 copay and no coinsurance. Other preventive and comprehensive dental services are covered with no copay and no coinsurance up to a maximum benefit of $1,500 every year.
Home Infusion bundled Services See details
Home infusion bundled services are covered under HealthSpring Achieve (HMO C-SNP) with no copay, though prior authorization and step therapy are required. Medicare Part B chemotherapy, radiation, and other Part B drugs require 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 Achieve (HMO C-SNP) covers dialysis services with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
HealthSpring Achieve (HMO C-SNP) covers durable medical equipment, prosthetic devices, and medical supplies with no copay, a 20% coinsurance, and prior authorization requirements. Diabetic equipment is partially covered with no copay and no coinsurance, though diabetic supplies and therapeutic shoes or inserts are not covered under this benefit.
Diagnostic and Radiological Services See details
HealthSpring Achieve (HMO C-SNP) partially covers diagnostic and radiological services with prior authorization required, though diagnostic procedures and tests are not covered. Covered lab services and diagnostic radiological services require no copay and no coinsurance, while outpatient X-rays require a $10 copay plus coinsurance, and therapeutic radiological services require a copay and a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the HealthSpring Achieve (HMO C-SNP) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Although Cardiac Rehabilitation Services are technically covered by HealthSpring Achieve (HMO C-SNP) with no coinsurance, the benefit is not covered in practice because standard cardiac, intensive cardiac, pulmonary, and SET for PAD services are not covered and require a $10 copay.
Skilled Nursing Facility (SNF) See details
HealthSpring Achieve (HMO C-SNP) 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. This benefit is partially covered because prior authorization is required and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
HealthSpring Achieve (HMO C-SNP) partially covers other services, featuring over-the-counter (OTC) items with a $70 quarterly limit and meal benefits for qualifying medical conditions, both with no copay and no coinsurance. Acupuncture is not covered under this benefit.
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