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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 Northeast Ohio. 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. Additionally, this plan comes with a Part B Premium reduction of $5.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan has a $275.00 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 $13300.00 (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 $13300.00 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. Tier 1 preferred generic drugs have no copay when filled through preferred pharmacies or preferred mail order services, though standard options require a $10 copay for a one-month supply. Tier 2 generic medications cost a $4 copay for a one-month supply at preferred pharmacies, with no copay for a three-month supply ordered through preferred mail delivery. For Tier 3 preferred brand drugs, you will pay a flat $47 copay for a one-month supply at both preferred and standard pharmacies. Higher-tier prescriptions require coinsurance, including a 50% coinsurance for Tier 4 non-preferred drugs and a 30% coinsurance for Tier 5 specialty drugs. Utilizing preferred pharmacies and mail-order services can significantly lower your out-of-pocket costs under this plan.
Additional Benefits
HealthSpring True Choice (PPO) offers robust medical coverage with no copay for primary care visits, home health services, and preventive care. For specialist visits, urgent care, and outpatient services, copays generally range from $40 to $350, while inpatient hospital stays require a $350 daily copay for the first five days and no copay thereafter. Emergency room visits carry a $115 copay, which is waived if you are admitted, and skilled nursing facility stays feature no copay for the first 20 days. The plan also features dental, vision, and hearing benefits, including preventive and comprehensive dental care with no copay up to a $1,000 annual limit. Routine eye exams and eyewear are covered with little to no copay, while hearing aids require a copay ranging from $399 to $1,800. For durable medical equipment and dialysis, members will pay a 20% coinsurance with no copay.
Inpatient Hospital See details
Inpatient hospital services under HealthSpring True Choice (PPO) are partially covered with no coinsurance, requiring a $350 copay per day for days 1 through 5 and no copay for days 6 through 90. However, additional hospital days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
HealthSpring True Choice (PPO) covers outpatient services with no coinsurance, offering outpatient hospital services with a $0 to $350 copay and observation services with a $350 copay per stay. Ambulatory surgical center and blood services are available with no copay or coinsurance, while outpatient substance abuse individual and group sessions carry a $40 copay.
Partial Hospitalization See details
HealthSpring True Choice (PPO) covers partial hospitalization services with an $80 copay and no coinsurance. Prior authorization is required to receive this covered benefit.
Ambulance and Transportation Services See details
HealthSpring True Choice (PPO) covers ambulance services with prior authorization, requiring a $230 copay and no coinsurance for ground transport, and a 20% coinsurance with no copay for air transport. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
HealthSpring True Choice (PPO) covers emergency services with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services carry a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $50,000 maximum with a $115 copay and no coinsurance.
Primary Care See details
HealthSpring True Choice (PPO) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $40 copay and no coinsurance. Occupational, physical, and speech therapy require a $35 copay and no coinsurance, while podiatry, routine chiropractic, and individual or group mental health and psychiatric sessions are not covered.
Preventive Services See details
HealthSpring True Choice (PPO) covers preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, and a fitness benefit. This benefit is partially covered, as sub-services such as health education, weight management programs, nutritional benefits, and in-home safety assessments are not covered.
Hearing Services See details
HealthSpring True Choice (PPO) covers routine hearing exams and fittings for a $25 copay and no coinsurance with no deductible. OTC hearing aids require a $399 copay and no coinsurance, while prescription hearing aids are partially covered with a $399 to $1,800 copay and no coinsurance, excluding inner ear, outer ear, and over the ear types.
Vision Services See details
HealthSpring True Choice (PPO) provides partially covered vision services, featuring routine eye exams with a $0 to $30 copay and no coinsurance, while other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and no deductible, up to a combined annual maximum of $300 for contacts, upgrades, and one pair of eyeglasses, lenses, or frames.
Dental Services See details
HealthSpring True Choice (PPO) covers preventive and comprehensive dental services with no copay and no coinsurance, up to a maximum annual benefit of $1,000 for both in- and out-of-network care. Medicare-covered dental services are also available with a $40 copay and no coinsurance, subject to prior authorization.
Home Infusion bundled Services See details
HealthSpring True Choice (PPO) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Under this plan, Medicare Part B chemotherapy, radiation, and other drugs carry a coinsurance ranging from no coinsurance to 20%, while Part B insulin is covered with a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis services are covered by the HealthSpring True Choice (PPO) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
HealthSpring True Choice (PPO) covers durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes with no copay and 20% coinsurance, subject to prior authorization. Medical equipment benefits are partially covered under this plan, as diabetic supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by HealthSpring True Choice (PPO) with no coinsurance, though prior authorization is required. Outpatient lab services and some diagnostic radiological services have no copay, while diagnostic tests range from a $0 to $50 copay, outpatient X-rays carry a $60 copay, and therapeutic radiological services have a minimum copay of $85.
Home Health Services See details
Home Health Services are covered by HealthSpring True Choice (PPO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
HealthSpring True Choice (PPO) covers some cardiac rehabilitation services with no copay, no coinsurance, and prior authorization required, but standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered.
Skilled Nursing Facility (SNF) See details
HealthSpring True Choice (PPO) partially covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and additional days beyond the Medicare-covered 100 days are not covered.
Other Services See details
HealthSpring True Choice (PPO) partially covers other services, offering over-the-counter (OTC) items with no copay and no coinsurance up to a maximum benefit of $15 every three months. Acupuncture, meal benefits, and other supplemental services 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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