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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 $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 no drug deductible. Your prescription medication coverage will start immediately.
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 Preferred Savings (HMO) plan features a $0 drug deductible, meaning your prescription drug coverage begins immediately. You will pay no copay for Tier 1 preferred generic drugs when using a preferred retail pharmacy or preferred mail-order service. Tier 2 generic drugs are also highly affordable, starting at a $4 copay for a one-month supply at preferred locations compared to a $20 copay at standard pharmacies. For brand-name and specialty medications, Tier 3 preferred brand drugs require a flat $47 copay for a one-month supply at both standard and preferred pharmacies. Tier 4 non-preferred drugs carry a 50% coinsurance, while Tier 5 specialty drugs require a 33% coinsurance for a one-month supply across all network pharmacies and mail-order options.
Additional Benefits
The HealthSpring Preferred Savings (HMO) plan offers affordable access to essential medical care, featuring no copay and no coinsurance for primary care visits, home health services, and preventive care. For specialized medical needs, specialist visits require a $45 copay with no coinsurance, while inpatient hospital stays require a $360 copay for days 1 to 5 of an acute stay with no coinsurance. Emergency room visits carry a $130 copay, which is waived if you are admitted, and outpatient hospital services range from no copay to a $375 copay with no coinsurance. This plan also includes valuable supplemental coverage, such as routine dental care with no copay and no coinsurance up to a $650 annual maximum. Vision exams and eyewear are highly accessible, featuring no copay for eyewear up to a $225 annual maximum, while routine hearing exams require a $30 copay. Additionally, durable medical equipment and dialysis services are covered with a 20% coinsurance and no copay, and diagnostic lab tests and outpatient X-rays are available with no copay and no coinsurance.
Inpatient Hospital See details
HealthSpring Preferred Savings (HMO) partially covers inpatient hospital services with no coinsurance, requiring a $360 copay for days 1 to 5 of an acute stay and a $595 copay for days 1 to 3 of a psychiatric stay, with no copay for subsequent days. Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by HealthSpring Preferred Savings (HMO) with no coinsurance, featuring copays of $0 to $375 for outpatient hospital services and $375 per stay for observation services. Outpatient substance abuse sessions require a $45 copay with no coinsurance, while ambulatory surgical center and blood services are covered with no copay and no coinsurance.
Partial Hospitalization See details
HealthSpring Preferred Savings (HMO) covers partial hospitalization services with a $140.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
HealthSpring Preferred Savings (HMO) covers ground ambulance services with a $270 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. Transportation services to health-related locations are not covered.
Emergency Services See details
HealthSpring Preferred Savings (HMO) covers emergency services with a $130 copay and no coinsurance, with the copay 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 benefit 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, physical therapy, occupational therapy, and opioid treatment require a $45 copay and no coinsurance. Mental health and psychiatric sessions have a $40 copay with no coinsurance, telehealth and other health professionals range from a $0 to $45 copay with no coinsurance, and podiatry and chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered by HealthSpring Preferred Savings (HMO) with no copay and no coinsurance for covered options such as annual physical exams, fitness benefits, and kidney disease education. However, several supplemental services are not covered, including health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, and weight management programs.
Hearing Services See details
HealthSpring Preferred Savings (HMO) covers annual routine hearing exams and fittings with no deductible for a $30 copay and no coinsurance, as well as OTC hearing aids for a $399 copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $399 to $1,800 for up to two aids yearly, though inner ear, outer ear, and over the ear types are not covered.
Vision Services See details
HealthSpring Preferred Savings (HMO) provides partially covered vision services, featuring eye exams with a $0 to $40 copay and no coinsurance, though other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and no deductible, up to a $225 combined annual maximum for contacts, eyeglasses, lenses, frames, and upgrades.
Dental Services See details
Dental services under HealthSpring Preferred Savings (HMO) are covered, with Medicare-covered dental care requiring a $45 copay and no coinsurance. Other preventive and comprehensive dental services, including cleanings, x-rays, and restorative care, are covered with no copay and no coinsurance up to a maximum annual benefit of $650.
Home Infusion bundled Services See details
HealthSpring Preferred Savings (HMO) covers home infusion bundled services with no copay, though prior authorization is required. Under this plan, Medicare Part B chemotherapy, radiation, and other drugs carry no copay and a 0% to 20% coinsurance, while Part B insulin drugs require a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
HealthSpring Preferred Savings (HMO) covers dialysis services with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
HealthSpring Preferred Savings (HMO) partially covers medical equipment with no copay and a 20% coinsurance, requiring prior authorization for covered items. Durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes are covered, but diabetic supplies are not covered.
Diagnostic and Radiological Services See details
HealthSpring Preferred Savings (HMO) covers diagnostic services with no coinsurance, offering lab services and outpatient X-rays at no copay, and other diagnostic tests with a $0 to $20 copay. Diagnostic radiological services have a copay starting at $0, while therapeutic radiological services require a minimum 20% coinsurance, with prior authorization required for these benefits.
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 under the HealthSpring Preferred Savings (HMO) require prior authorization and feature no copay and no coinsurance. In practice, only some services are covered, as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by HealthSpring Preferred Savings (HMO) with no coinsurance, requiring prior authorization but no prior three-day hospital stay. Cost-sharing consists of a $10 daily copay for days 1 to 20, a $218 daily copay for days 21 to 60, and no copay for days 61 to 100, while additional days beyond the Medicare-covered limit are not covered.
Other Services See details
HealthSpring Preferred Savings (HMO) partially covers Other Services, providing a limited-duration meal benefit for qualifying medical conditions with no copay and no coinsurance. Acupuncture and Over-the-Counter (OTC) items are not covered under this plan.
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