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HealthSpring True Choice (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HealthSpring True Choice (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HealthSpring True Choice (PPO) in 2026, please refer to our full plan details page.
HealthSpring True Choice (PPO) is a PPO plan offered by Health Care Service Corporation available for enrollment in 2025 to people living in Chicago. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that HealthSpring True Choice (PPO) 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 True Choice (PPO).
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 True Choice (PPO), 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 has a $200.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
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 combined Maximum Out-Of-Pocket cost of $6200.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $6200.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 True Choice (PPO) prescription drug plan features an annual drug deductible of $200. Under this plan, Tier 1 preferred generic drugs have no copay when filled at preferred pharmacies or through preferred mail order, while standard pharmacies charge a $10 copay for a one-month supply. Tier 2 generic drugs cost as little as a $4 copay for a one-month supply at preferred pharmacies, and you can get a three-month supply with no copay through preferred mail order. For Tier 3 preferred brand drugs, you will pay a $47 copay for a one-month supply across all pharmacy and mail-order options. Tier 4 non-preferred drugs require a 50% coinsurance across all channels, while Tier 5 specialty drugs require 30% coinsurance for a one-month supply.
Additional Benefits
HealthSpring True Choice (PPO) offers comprehensive healthcare coverage with no copay for primary care visits, preventive screenings, and home health services. For hospital care, members pay a $255 copay for days 1 through 7 of inpatient stays, while outpatient hospital services range from no copay up to a $275 copay. Emergency room visits require a $150 copay, which is waived if you are admitted to the hospital within 24 hours. Specialist consultations and outpatient therapy sessions are covered with a $50 copay, while routine dental and vision services feature no copay. Hearing benefits include routine exams for a $25 copay and hearing aids starting at a $399 copay. For durable medical equipment and dialysis services, members will pay a 20% coinsurance with no copay.
Inpatient Hospital See details
HealthSpring True Choice (PPO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $255 copay for days 1 to 7 and no copay for days 8 to 90. This benefit is partially covered, as additional days, non-Medicare-covered stays, and acute upgrades are not covered.
Outpatient Services See details
HealthSpring True Choice (PPO) covers outpatient services with no coinsurance, including ambulatory surgical center and blood services with no copay. Outpatient hospital services require a $0 to $275 copay, observation services cost a $275 copay per stay, and outpatient substance abuse sessions have a $50 copay, with prior authorization required for most services.
Partial Hospitalization See details
HealthSpring True Choice (PPO) covers partial hospitalization services with a $100.00 copay and no coinsurance. Prior authorization is required to receive coverage for this benefit.
Ambulance and Transportation Services See details
HealthSpring True Choice (PPO) covers ground ambulance services with a $255 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required. Some transportation services are covered, but transportation to plan-approved health-related locations and any other health-related locations is not covered.
Emergency Services See details
HealthSpring True Choice (PPO) covers emergency services with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $65 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $150 copay and no coinsurance up to a $50,000 maximum benefit.
Primary Care See details
HealthSpring True Choice (PPO) covers primary care physician services with no copay and no coinsurance, and specialist, physical, and occupational therapy services with a $50 copay and no coinsurance. Chiropractic services are partially covered with a $15 copay and no coinsurance, while mental health and psychiatric services are partially covered with no copay and no coinsurance, excluding routine chiropractic and individual or group therapy sessions. Podiatry services are not covered.
Preventive Services See details
HealthSpring True Choice (PPO) covers preventive services, including annual physical exams, kidney disease education, and screenings, with no copay and no coinsurance. Additional preventive services are partially covered, offering a physical and memory fitness benefit, while sub-services like health education, weight management programs, and in-home safety assessments are not covered.
Hearing Services See details
HealthSpring True Choice (PPO) covers hearing services with no coinsurance, offering routine hearing exams for a $25 copay and OTC hearing aids for a $399 copay. Prescription hearing aids are partially covered with copays ranging from $399 to $1,800 and no coinsurance, excluding inner ear, outer ear, and over-the-ear hearing aids.
Vision Services See details
HealthSpring True Choice (PPO) offers partially covered vision services, with other eye exam services not covered. Routine eye exams are covered once yearly with a $0 to $30 copay and no coinsurance, while eyewear is covered with no copay, no coinsurance, and a $150 annual combined maximum limit.
Dental Services See details
HealthSpring True Choice (PPO) covers Medicare-covered dental services with a $50 copay and no coinsurance, while other preventive and comprehensive dental services have no copay and no coinsurance. Non-Medicare dental services, including cleanings, x-rays, implants, and orthodontics, are covered up to an annual maximum benefit of $800 for both in-network and out-of-network care.
Home Infusion bundled Services See details
Home infusion bundled services are covered by HealthSpring True Choice (PPO) with no copay, though prior authorization is required. Covered Medicare Part B drugs, including chemotherapy, radiation, and insulin, carry no coinsurance to 20% coinsurance, with insulin also requiring a $35 copay.
Dialysis Services See details
HealthSpring True Choice (PPO) covers dialysis services with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Medical equipment is covered by HealthSpring True Choice (PPO) with no copay and a 20% coinsurance, though prior authorization is required. This benefit is partially covered, as durable medical equipment, prosthetics, and diabetic therapeutic shoes are covered, while diabetic supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by HealthSpring True Choice (PPO) with prior authorization required. Under this plan, lab services and diagnostic radiological services feature no copay and no coinsurance, diagnostic procedures have a $0 to $50 copay with no coinsurance, while outpatient X-rays require a $10 copay plus coinsurance and therapeutic radiological services carry a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered under HealthSpring True Choice (PPO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by HealthSpring True Choice (PPO) with no coinsurance and prior authorization required, though only some services are covered in practice. Standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation services are not covered and carry a $10 copay.
Skilled Nursing Facility (SNF) See details
HealthSpring True Choice (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a $20 daily copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and while a prior three-day inpatient hospital stay is not required, additional days beyond the Medicare-covered limit are not covered.
Other Services See details
HealthSpring True Choice (PPO) partially covers other services, offering a meal benefit for chronic or home-restricting medical conditions with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, and other miscellaneous services are not covered under this plan.
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