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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 South Carolina. 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 $128.00. 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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $6500.00 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 a $0 drug deductible, meaning your prescription drug coverage begins immediately. For Tier 1 preferred generic drugs, you will pay no copay when utilizing a preferred pharmacy or preferred mail-order service. Tier 2 generic drugs are also highly affordable, with a $4 copay for a one-month supply at preferred locations, or no copay for a three-month supply filled via preferred mail order. Tier 3 preferred brand-name medications have a consistent $47 copay for a one-month supply at both standard and preferred pharmacies. For higher-tier prescriptions, Tier 4 non-preferred drugs require 50% coinsurance, while Tier 5 specialty drugs carry a 33% coinsurance for a one-month supply. To maximize your savings, choosing preferred pharmacies and mail-order options is recommended, as standard pharmacy copays are higher for Tier 1 and Tier 2 medications.
Additional Benefits
The HealthSpring Preferred Savings (HMO) plan offers affordable healthcare coverage, featuring no copay for primary care visits, home health services, and annual physicals. If you require specialist visits or physical therapy, you will pay a $35 copay with no coinsurance, while inpatient hospital stays require daily copays for the first few days before transitioning to no copay. Additionally, emergency room visits carry a $130 copay, which is waived if you are admitted, and urgent care is available for a $50 copay. For extra benefits, the plan provides routine vision exams and dental care with no copay up to specified annual limits, while hearing exams require a $30 copay. Durable medical equipment, prosthetics, and dialysis services are covered with a 20% coinsurance and no copay. However, this plan does not cover routine chiropractic care, transportation services, or cardiac rehabilitation.
Inpatient Hospital See details
HealthSpring Preferred Savings (HMO) covers inpatient acute and psychiatric hospital stays with no coinsurance, though prior authorization is required. Acute stays require a $385 daily copay for days 1 to 5 (no copay for days 6 to 90 with unlimited additional days), while psychiatric stays require a $595 daily copay for days 1 to 3 (no copay for days 4 to 90). Non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
HealthSpring Preferred Savings (HMO) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital services require a copay of $0 to $375, observation services cost a $375 copay per stay, and outpatient substance abuse sessions have a $35 copay, all with no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by the HealthSpring Preferred Savings (HMO) plan with a $140.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
HealthSpring Preferred Savings (HMO) covers ground ambulance services with a $265 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 health-related locations are not covered.
Emergency Services See details
HealthSpring Preferred Savings (HMO) 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 $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $50,000 maximum limit with a $130 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 and physical, occupational, and speech therapies require a $35 copay and no coinsurance. Mental health and psychiatric services have a $40 copay and no coinsurance, but routine chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive services under the HealthSpring Preferred Savings (HMO) are partially covered with no copay and no coinsurance for services like annual physicals, fitness benefits, caregiver support, and kidney disease education. However, several additional preventive services are not covered, including health education, in-home safety assessments, personal emergency response systems, and nutritional therapy.
Hearing Services See details
HealthSpring Preferred Savings (HMO) covers routine hearing exams and fittings for a $30 copay and no coinsurance, and OTC hearing aids for a $399 copay and no coinsurance. Prescription hearing aids are partially covered with copays ranging from $399.00 to $1,800.00 and no coinsurance, but inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
HealthSpring Preferred Savings (HMO) partially covers vision services, offering routine eye exams with a $0 to $40 copay and no coinsurance, while other eye exam services are not covered. Eyewear is covered with no copay or coinsurance up to a $250 annual maximum benefit for contacts, eyeglasses, and upgrades.
Dental Services See details
Dental services are covered by HealthSpring Preferred Savings (HMO), featuring a $35 copay and no coinsurance for Medicare-covered dental care, which requires prior authorization. Other preventive and comprehensive dental services are covered with no copay and no coinsurance up to a maximum annual benefit of $600.
Home Infusion bundled Services See details
HealthSpring Preferred Savings (HMO) covers home infusion bundled services with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs have no copay and range from no coinsurance to 20% coinsurance, while Part B insulin has a $35 copay and ranges from no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by HealthSpring Preferred Savings (HMO) with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Medical equipment is covered by HealthSpring Preferred Savings (HMO) with no copays, though a 20% coinsurance and prior authorization are required for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes. This benefit is partially covered under the plan, as diabetic supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by HealthSpring Preferred Savings (HMO) with prior authorization required. Lab services and outpatient X-rays have no copay, diagnostic tests carry a $0 to $20 copay with no coinsurance, and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by HealthSpring Preferred Savings (HMO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the HealthSpring Preferred Savings (HMO) plan, as cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) rehabilitation services are all not covered in practice.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by HealthSpring Preferred Savings (HMO) with no coinsurance, requiring a daily copay of $10 for days 1 to 20, $218 for days 21 to 60, and no copay for days 61 to 100. Prior authorization is required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services under the HealthSpring Preferred Savings (HMO) are partially covered, featuring a limited-duration meal benefit with no copay and no coinsurance for chronic illnesses or medical conditions requiring you to remain at home. Acupuncture and over-the-counter (OTC) items are not covered under this plan.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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