A non-government entity
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 Central Arizona. 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 $250.00 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 $9350.00 (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 $9350.00 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)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The HealthSpring True Choice (PPO) Medicare plan features an annual prescription drug deductible of $200.00 before coverage begins. During the initial coverage phase, Tier 1 preferred generic drugs cost a $4.00 copay at preferred pharmacies or a $20.00 copay at standard pharmacies, while Tier 2 standard generics require a $47.00 copay. For higher-tier prescriptions, Tier 3 preferred brands have a 50% coinsurance and Tier 4 non-preferred drugs have a 30% coinsurance. These initial coverage rates apply until your total drug costs reach $2,100.00. Once your yearly out-of-pocket costs hit this $2,100.00 threshold, you enter the catastrophic coverage phase and pay nothing for covered Part D drugs. Additionally, qualifying low-income subsidy recipients pay no cost for their Part D premium.
Additional Benefits
The HealthSpring True Choice (PPO) plan offers comprehensive medical coverage with predictable costs, featuring no copay for preventive services and doctor visits ranging from no copay up to a $30 copay. For hospital stays, members pay a $295 daily copay for the first six days of inpatient care and no copay for days 7 through 90, while outpatient hospital services range from no copay up to a $275 copay. Emergency care is covered with a $130 copay, and urgent care requires a $50 copay, both with no coinsurance. Additional benefits include dental care covered up to a $1,500 annual maximum and routine hearing exams with a $30 copay, alongside partial coverage for hearing aids. Annual routine vision exams range from no copay to a $30 copay, though eyewear is not covered under this plan. Durable medical equipment and prosthetic devices are covered with a 20% coinsurance and no copay, and members also receive a $25 quarterly allowance for over-the-counter items.
Inpatient Hospital See details
Inpatient hospital benefits are partially covered by HealthSpring True Choice (PPO), requiring a $295 daily copay for days 1 through 6, no copay for days 7 through 90, and no coinsurance. Hospital upgrades, non-Medicare-covered stays, and additional days for psychiatric stays are not covered under this plan.
Outpatient Services See details
Outpatient services are covered by HealthSpring True Choice (PPO) with no coinsurance, featuring a copay of $0 to $275 for outpatient hospital services, a $275 copay per stay for observation services, and no copay for ambulatory surgical center services. Outpatient substance abuse services require a $30 copay with no coinsurance, and outpatient blood services are covered with no deductible.
Partial Hospitalization See details
Partial hospitalization benefits are covered by the HealthSpring True Choice (PPO) plan with a $140.00 copay and no coinsurance. Prior authorization is required to receive coverage for these services.
Ambulance and Transportation Services See details
HealthSpring True Choice (PPO) partially covers ambulance and transportation services, though transportation to plan-approved or any health-related locations is not covered. Ground ambulance services require a $250 copay and no coinsurance, while air ambulance services require a 20% coinsurance and no copay.
Emergency Services See details
HealthSpring True Choice (PPO) covers emergency services with a $130 copay and urgently needed services with a $50 copay, both with no coinsurance. Worldwide emergency, urgent, and transportation services are also covered up to a $50,000 maximum with a $130 copay and no coinsurance.
Primary Care See details
HealthSpring True Choice (PPO) offers partially covered Primary Care benefits with no coinsurance and copays ranging from no copay up to $30. Covered services include primary care physician visits, physical therapy, and specialist services, while routine chiropractic care, psychiatric services, and mental health specialty services are not covered.
Preventive Services See details
HealthSpring True Choice (PPO) covers Medicare-approved preventive services and annual physical exams with no copay or coinsurance. Additional preventive benefits are only partially covered, offering physical and memory fitness benefits but excluding services such as health education, weight management, and in-home safety assessments.
Hearing Services See details
Hearing services are covered by HealthSpring True Choice (PPO), featuring a $30 copay and no coinsurance for annual routine hearing exams and fittings. Prescription hearing aids are partially covered with no coinsurance and a copay of $399 to $1,800 for up to two devices yearly, excluding inner ear, outer ear, and over the ear models. OTC hearing aids are also covered up to two per year for a $399 copay and no coinsurance.
Vision Services See details
Vision Services are partially covered under the HealthSpring True Choice (PPO) plan, which offers one routine eye exam annually with a copay ranging from no copay to $30 and no coinsurance. However, eyewear is not covered in practice, including contact lenses, eyeglasses, lenses, frames, and upgrades.
Dental Services See details
HealthSpring True Choice (PPO) covers Medicare-covered dental services with a $30 copay and no coinsurance, subject to prior authorization. A wide range of other preventive and comprehensive dental services, such as exams, cleanings, and restorative care, are also covered up to a combined $1,500 annual maximum for both in-network and out-of-network care.
Home Infusion bundled Services See details
HealthSpring True Choice (PPO) covers home infusion bundled services, requiring prior authorization and step therapy for covered Part B drugs. Medicare Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
HealthSpring True Choice (PPO) covers dialysis services with 20% coinsurance and no copay. Prior authorization is required to receive these covered services.
Medical Equipment See details
HealthSpring True Choice (PPO) covers medical equipment, including durable medical equipment, prosthetic devices, and diabetic therapeutic shoes, with no copay and a 20% coinsurance. Prior authorization is required for these services, and 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, requiring no coinsurance and copays ranging from no copay to $50 for diagnostic procedures and lab services. Radiological services feature a $20 copay for X-rays, up to a $150 copay with no coinsurance for diagnostic radiology, and a 20% coinsurance for therapeutic radiology.
Home Health Services See details
HealthSpring True Choice (PPO) covers home health services, though prior authorization is required before you can receive care.
Cardiac Rehabilitation Services See details
HealthSpring True Choice (PPO) does not cover Cardiac Rehabilitation Services, including intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD).
Skilled Nursing Facility (SNF) See details
HealthSpring True Choice (PPO) partially covers Skilled Nursing Facility (SNF) services, requiring prior authorization, no coinsurance, and daily copayments of $10 for days 1-20 and $218 for days 21-100. Additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by HealthSpring True Choice (PPO), featuring a $300 annual limit for acupuncture and a $25 quarterly allowance for over-the-counter items with no copays or coinsurance specified. Meal benefits are covered for qualifying medical conditions, but Dual Eligible SNPs with Highly Integrated Services are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved