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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 $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 coverage begins immediately. For Tier 1 preferred generic drugs, you will pay no copay when using a preferred pharmacy or preferred mail-order service, while standard options charge a $10 copay for a one-month supply. Tier 2 generic drugs are also highly affordable, costing just a $4 copay for a one-month supply at preferred pharmacies and mail-order services. For brand-name and specialized medications, Tier 3 preferred brand drugs require a flat $47 copay for a one-month supply across all pharmacy networks. Higher-tier medications transition to coinsurance, with Tier 4 non-preferred drugs carrying a 50% coinsurance and Tier 5 specialty drugs requiring a 33% coinsurance for a one-month supply. This plan structure offers significant savings for policyholders who primarily rely on generic medications.
Additional Benefits
The HealthSpring Preferred Savings (HMO) plan offers affordable medical coverage with no copay and no coinsurance for primary care visits, preventive services, and home health care. Specialist visits, mental health care, and physical therapy are covered with a $40 copay and no coinsurance. For inpatient hospital stays, members pay a $350 daily copay for days 1 through 6 and no copay for days 7 through 90, with no coinsurance. Ancillary benefits include routine dental and eyewear coverage with no copay up to a $250 annual maximum, alongside routine hearing exams for a $30 copay. Emergency room visits require a $130 copay that is waived if admitted within 24 hours, while diagnostic lab tests and outpatient X-rays feature no copay. Additionally, medical equipment and dialysis services are covered with a 20% coinsurance and no copay.
Inpatient Hospital See details
HealthSpring Preferred Savings (HMO) covers inpatient acute hospital stays with no coinsurance, requiring a $350 daily copay for days 1 through 6 and no copay for days 7 through 90, though upgrades and non-Medicare-covered stays are not covered. Psychiatric inpatient stays are also covered with no coinsurance and require a $595 daily copay for days 1 through 3 and no copay for days 4 through 90, but additional psychiatric days are not covered.
Outpatient Services See details
HealthSpring Preferred Savings (HMO) covers outpatient services with no coinsurance, including ambulatory surgical center and blood services which also have no copay. Outpatient hospital services require a copay of $0 to $350 (including $350 per stay for observation services), while outpatient substance abuse sessions have a $40 copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by HealthSpring Preferred Savings (HMO) with a $140.00 copay and no coinsurance. Prior authorization is required to receive this covered benefit.
Ambulance and Transportation Services See details
Ambulance services are covered by HealthSpring Preferred Savings (HMO) with prior authorization required, featuring a $285 copay and no coinsurance for ground transport, and a 20% coinsurance with no copay for air transport, while transportation services are not covered.
Emergency Services See details
HealthSpring Preferred Savings (HMO) covers emergency services with a $130 copay and no coinsurance, and urgently needed services with a $50 copay and no coinsurance, with both copays waived if admitted to the hospital within 24 hours. Worldwide emergency, urgent, and transportation services are also covered with a $130 copay and no coinsurance, up to a maximum plan benefit of $50,000.
Primary Care See details
HealthSpring Preferred Savings (HMO) offers primary care physician services with no copay and no coinsurance, while specialist visits, physical and occupational therapy, and mental health care require a $40 copay and no coinsurance. Telehealth benefits are available with a $0 to $40 copay and no coinsurance, but chiropractic and podiatry services are not covered.
Preventive Services See details
HealthSpring Preferred Savings (HMO) covers preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, and fitness benefits. However, this benefit is partially covered, as exclusions include health education, in-home safety assessments, Personal Emergency Response Systems (PERS), medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, smoking cessation counseling, enhanced disease management, telemonitoring, remote access, home safety devices, and counseling.
Hearing Services See details
HealthSpring Preferred Savings (HMO) covers annual routine hearing exams and fitting evaluations for a $30 copay and no coinsurance, as well as up to two OTC hearing aids per year for a $399 copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and a copay ranging from $399 to $1,800, though inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered by HealthSpring Preferred Savings (HMO), 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, no coinsurance, and no deductible, providing up to a $250 annual combined maximum benefit for contacts, eyeglasses, and upgrades.
Dental Services See details
HealthSpring Preferred Savings (HMO) covers Medicare-covered dental services with a $40.00 copay and no coinsurance, though prior authorization is required. Preventive and comprehensive dental services are covered with no copay and no coinsurance, up to a maximum annual benefit of $250.00.
Home Infusion bundled Services See details
Home infusion bundled services are covered by HealthSpring Preferred Savings (HMO) with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy, radiation, and insulin, are covered with coinsurance ranging from no coinsurance to 20%, with insulin drugs carrying a $35 copay.
Dialysis Services See details
HealthSpring Preferred Savings (HMO) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Medical Equipment is partially covered by the HealthSpring Preferred Savings (HMO) with no copay and a 20% coinsurance, and prior authorization is required. While durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes are covered, diabetic supplies are not covered.
Diagnostic and Radiological Services See details
HealthSpring Preferred Savings (HMO) covers diagnostic services with no coinsurance, featuring no copay for lab services and a $0 to $20 copay for diagnostic tests. Radiological services are also covered with no copay for outpatient X-rays, diagnostic radiology copays starting at $0, and a 20% coinsurance for therapeutic radiology, with prior authorization required.
Home Health Services See details
HealthSpring Preferred Savings (HMO) covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by HealthSpring Preferred Savings (HMO) with no coinsurance, meaning some services are covered; however, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for peripheral artery disease are not covered.
Skilled Nursing Facility (SNF) See details
HealthSpring Preferred Savings (HMO) covers Skilled Nursing Facility (SNF) care with no coinsurance, featuring 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. Prior authorization is required, a prior three-day hospital stay is not required, and additional days beyond the standard 100 Medicare-covered days are not covered.
Other Services See details
Other Services are partially covered by HealthSpring Preferred Savings (HMO), which provides a meal benefit for chronic illnesses or qualifying medical conditions with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, and other supplemental services under this category are not covered.
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