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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 Kansas City. 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 $500.00 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 $10100.00 (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 $10100.00 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:
Sign up for HealthSpring True Choice (PPO)
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Drug Coverage
The HealthSpring True Choice (PPO) Medicare plan features a $200 drug deductible and offers excellent savings on generic medications. For Tier 1 preferred generics, you pay no copay when using preferred pharmacies or preferred mail order services, 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 locations, with no copay for a three-month supply ordered through preferred mail delivery. For higher-tier medications, Tier 3 preferred brands require a flat $47 copay for a one-month supply across all pharmacy options. Tier 4 non-preferred drugs carry a 50% coinsurance, and Tier 5 specialty drugs require a 30% coinsurance for a one-month supply. This prescription drug coverage provides clear cost structures to help you manage your healthcare expenses effectively.
Additional Benefits
The HealthSpring True Choice (PPO) plan offers robust coverage with no copay and no coinsurance for primary care visits, preventive services, and home health care. For specialized care, members pay a $35 copay for specialist visits and physical therapy, while inpatient hospital stays require a daily copay for the first six days before transitioning to no copay. Outpatient hospital services and diagnostic tests feature variable copays with no coinsurance, ensuring predictable costs for common medical procedures. Additional benefits include comprehensive dental and vision care, featuring no copay and no coinsurance up to specified annual limits, alongside affordable routine hearing exams. Durable medical equipment and dialysis services are covered with no copay and a standard 20% coinsurance. Members also benefit from no-copay over-the-counter items up to a quarterly limit, making this plan a comprehensive option for managing everyday health expenses.
Inpatient Hospital See details
HealthSpring True Choice (PPO) covers inpatient hospital services with no coinsurance, though prior authorization is required. For acute care, you pay a $310 daily copay for days 1 through 6 and no copay for days 7 and beyond, whereas psychiatric stays require a $350 daily copay for days 1 through 6 and no copay for days 7 through 90. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
HealthSpring True Choice (PPO) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital and observation services have copays ranging from $0 to $335, while outpatient substance abuse individual and group sessions require a $35 copay.
Partial Hospitalization See details
Partial hospitalization is covered by HealthSpring True Choice (PPO) with a $70.00 copay and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
HealthSpring True Choice (PPO) covers ground ambulance services with a $265 copay and coinsurance, and air ambulance services with a 20% coinsurance and copay, both requiring prior authorization. For transportation services, some services are covered, but transportation to plan-approved health-related locations and any health-related locations are not covered.
Emergency Services See details
Emergency services are covered by HealthSpring True Choice (PPO) 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 with a $130 copay and no coinsurance.
Primary Care See details
HealthSpring True Choice (PPO) provides primary care physician services with no copay and no coinsurance, while specialist visits, physical therapy, occupational therapy, and speech-language pathology require a $35 copay and no coinsurance. Telehealth and other healthcare professional services feature a $0 to $35 copay with no coinsurance, but chiropractic, podiatry, psychiatric, and mental health specialty services are not covered.
Preventive Services See details
HealthSpring True Choice (PPO) covers preventive services, including annual physical exams, kidney disease education, and glaucoma screenings, with no copay and no coinsurance. Additional preventive services are partially covered; a fitness benefit is included, but health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, and counseling services are not covered.
Hearing Services See details
Hearing services are covered by HealthSpring True Choice (PPO), offering annual routine exams and fittings for a $25 copay and no coinsurance. The plan also covers up to two OTC hearing aids per year for a $399 copay and no coinsurance, and up to two prescription hearing aids with a copay between $399 and $1,800 and no coinsurance, though inner, outer, and over-the-ear models are not covered.
Vision Services See details
HealthSpring True Choice (PPO) provides partially covered vision services, including one routine eye exam per year with a $0 to $35 copay, no coinsurance, and no deductible, while other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and a $200 combined maximum annual benefit for contacts, frames, lenses, and upgrades.
Dental Services See details
HealthSpring True Choice (PPO) covers preventive and comprehensive dental services with no copay and no coinsurance, up to a combined annual maximum benefit of $850 for both in-network and out-of-network care. Medicare-covered dental services are also available under the plan for a $35 copay and no coinsurance, though prior authorization is required.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under HealthSpring True Choice (PPO) with no copay, though prior authorization is required. Covered Part B chemotherapy and other drugs have no copay and coinsurance ranging from no coinsurance up to 20%, while Part B insulin drugs require a $35 copay and coinsurance ranging from no coinsurance up to 20%.
Dialysis Services See details
HealthSpring True Choice (PPO) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required to receive coverage for these services.
Medical Equipment See details
Medical Equipment is covered under the HealthSpring True Choice (PPO) with no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes. This benefit is partially covered because diabetic supplies are not covered by the plan, and prior authorization is required for all covered equipment.
Diagnostic and Radiological Services See details
HealthSpring True Choice (PPO) covers diagnostic and radiological services, with prior authorization required for all care. Diagnostic tests and procedures carry no coinsurance and a copay ranging from no copay to $200, while lab services have no copay and no coinsurance. Outpatient X-rays require a $15 copay and coinsurance, diagnostic radiological services start at no copay, and therapeutic radiological services require a copay and a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered by HealthSpring True Choice (PPO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by HealthSpring True Choice (PPO) with no copay and no coinsurance, but only some services are covered. Standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by HealthSpring True Choice (PPO) with no coinsurance, requiring a $10 daily copay for days 1 through 20 and a $218 daily copay for days 21 through 100 per stay. Prior authorization is required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
HealthSpring True Choice (PPO) partially covers Other Services, providing over-the-counter (OTC) items with no copay and no coinsurance up to a $20 maximum benefit every three months. Acupuncture, meal benefits, and other additional services are not covered under this plan.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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