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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 Salt Lake 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 $450.00 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 $10000.00 (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 $10000.00 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) plan features a $200 annual drug deductible and offers significant savings on generic medications. For Tier 1 preferred generic drugs, you will pay no copay when using a preferred pharmacy or preferred mail order service. Tier 2 generic drugs are also highly affordable, costing as little as a $4 copay for a one-month supply at preferred locations, or no copay for a three-month supply filled through preferred mail order. For brand-name and specialty medications, the plan utilizes flat copays or percentage-based coinsurance. 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 across all pharmacy options, while Tier 5 specialty drugs require a 30% coinsurance for a one-month supply.
Additional Benefits
The HealthSpring True Choice (PPO) plan offers comprehensive medical coverage with no copay for primary care visits, routine preventive services, and home health care. For inpatient hospital stays, members pay a $325 daily copay for the first five days and no copay for days six through ninety. Outpatient hospital services and specialist visits carry low to moderate copays, while emergency room care requires a $125 copay that is waived if you are admitted within twenty-four hours. This plan also includes key supplemental benefits like preventive and comprehensive dental care with no copay up to a $500 annual limit. Vision and hearing needs are supported with no copay on eyewear up to $100 annually, a $25 copay for routine hearing exams, and set copays for hearing aids. Additionally, durable medical equipment is covered with a 15% coinsurance, and members receive a $20 allowance every three months for over-the-counter items.
Inpatient Hospital See details
Inpatient hospital services are covered by HealthSpring True Choice (PPO) with no coinsurance, requiring a $325 daily copay for days 1 through 5 and no copay for days 6 through 90 per stay. This benefit is partially covered because unlimited additional days are included for acute care, but additional psychiatric days, upgrades, and non-Medicare-covered stays 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 copay of $0 to $305, observation services carry a $305 copay per stay, and outpatient substance abuse sessions have a $30 copay.
Partial Hospitalization See details
HealthSpring True Choice (PPO) covers partial hospitalization services with a $105.00 copay and no coinsurance. Prior authorization is required for this covered benefit.
Ambulance and Transportation Services See details
HealthSpring True Choice (PPO) covers ground ambulance services with a $160 copay and air ambulance services with a 20% coinsurance, with prior authorization required for both. Transportation services to plan-approved or health-related locations are not covered.
Emergency Services See details
HealthSpring True Choice (PPO) covers emergency services with a $125 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $30 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to $50,000 with a $125 copay and no coinsurance.
Primary Care See details
HealthSpring True Choice (PPO) covers primary care physician services with no copay and no coinsurance, while specialist visits, therapies, and opioid treatments require a $30 copay and no coinsurance. Telehealth and other healthcare professional services range from a $0 to $30 copay with no coinsurance, but chiropractic, mental health, psychiatric, and 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 benefits are partially covered, offering a fitness benefit with no copay and no coinsurance, while other sub-services like health education, weight management, and in-home safety assessments are not covered.
Hearing Services See details
Hearing services are covered by HealthSpring True Choice (PPO), offering routine hearing exams for a $25 copay and no coinsurance, and 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 between $399 and $1,800 for up to two devices annually, though inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
HealthSpring True Choice (PPO) vision services are partially covered, offering one annual routine eye exam with a $0 to $30 copay, no coinsurance, and no deductible, while other eye exam services are not covered. Eyewear, including contacts, eyeglasses, and upgrades, is covered with no copay, no coinsurance, and no deductible up to a combined annual maximum benefit of $100.
Dental Services See details
Dental services are covered by HealthSpring True Choice (PPO), which requires a $30 copay and no coinsurance for Medicare-covered dental care. Other preventive and comprehensive dental services are covered with no copay and no coinsurance, up to a combined annual maximum of $500 for both in-network and out-of-network care.
Home Infusion bundled Services See details
HealthSpring True Choice (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs have no copay and no coinsurance to 20% coinsurance, while Medicare Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by HealthSpring True Choice (PPO) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
HealthSpring True Choice (PPO) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 15% coinsurance, subject to prior authorization. Diabetic equipment is partially covered with no copay and a 15% coinsurance for therapeutic shoes and inserts, but diabetic supplies are not covered under this benefit.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by HealthSpring True Choice (PPO) with prior authorization required. Lab services and outpatient X-rays have no copay, diagnostic procedures and tests carry a $0 to $25 copay with no coinsurance, and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the HealthSpring True Choice (PPO) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
HealthSpring True Choice (PPO) provides Cardiac Rehabilitation Services with no coinsurance, meaning some services are covered, but intensive cardiac, pulmonary, and supervised exercise therapy (SET) are not covered. These excluded sub-services require prior authorization and carry a copay of $10.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by HealthSpring True Choice (PPO) with no coinsurance, featuring no copay for days 1 through 20 and a $214 daily copay for days 21 through 100. Prior authorization is required, a prior three-day hospital stay is not necessary, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
HealthSpring True Choice (PPO) partially covers other services, as acupuncture and meal benefits are not covered. Over-the-counter (OTC) items are covered with no copay and no coinsurance, providing a maximum benefit of $20 every three months.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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