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 Richmond. 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 $100.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
This plan has a $615.00 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)
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) plan features a $615 drug deductible. For Tier 1 preferred generics, you pay no copay when using a preferred pharmacy or preferred mail order service, compared to a $9 copay for a 1-month supply at standard pharmacies. Tier 2 generics cost a $4 copay for a 1-month supply at preferred pharmacies and a $15 copay at standard pharmacies. Tier 3 preferred brand drugs require a $47 copay for a 1-month supply across all pharmacy and mail order options. Tier 4 non-preferred drugs charge a 50% coinsurance, while Tier 5 specialty drugs require 25% coinsurance for a 1-month supply.
Additional Benefits
The HealthSpring True Choice (PPO) Medicare plan offers comprehensive coverage with no copay or coinsurance for primary care visits, routine preventive services, and home health care. For specialized medical care, members pay a $40 copay with no coinsurance for specialist visits and a $130 copay for emergency services. Inpatient hospital stays require a daily copay of $310 for acute care or $295 for psychiatric care during the first six days, after which there is no copay. This plan also includes dental, vision, and hearing benefits to help reduce out-of-pocket expenses. Preventive and comprehensive dental services are covered with no copay up to an $850 annual maximum, while routine eye exams range from no copay to a $35 copay alongside a $150 annual allowance for eyewear. Routine hearing exams carry a $30 copay, and ambulatory surgical center services are covered with no copay and no coinsurance.
Inpatient Hospital See details
HealthSpring True Choice (PPO) partially covers inpatient hospital services with no coinsurance, excluding upgrades, additional days, and non-Medicare-covered stays. Acute stays require a $310 daily copay for days 1 through 6 (no copay for days 7 through 90), while psychiatric stays require a $295 daily copay for days 1 through 6 (no copay for days 7 through 90), both requiring prior authorization.
Outpatient Services See details
Outpatient services are covered by HealthSpring True Choice (PPO) with no coinsurance, featuring a $0 to $275 copay for outpatient hospital services and a $275 copay per stay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions require a $40 copay and no coinsurance.
Partial Hospitalization See details
HealthSpring True Choice (PPO) covers partial hospitalization services with a $140.00 copay and no coinsurance. Prior authorization is required to receive these covered services.
Ambulance and Transportation Services See details
HealthSpring True Choice (PPO) covers ground ambulance services with a $225 copay and air ambulance services with a 20% coinsurance, with prior authorization required for both. Transportation services are not covered, including trips to plan-approved or any other health-related locations.
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 and cost-sharing that does not count toward the plan deductible. Worldwide emergency, urgent, and transportation services are also covered up to a $50,000 maximum limit with a $130 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, therapy, and mental health visits require a $40 copay and no coinsurance. Chiropractic and podiatry services are not covered.
Preventive Services See details
HealthSpring True Choice (PPO) covers preventive services, including annual physical exams and kidney disease education, with no copay and no coinsurance. Additional preventive services are partially covered, as the plan includes a fitness benefit but does not cover health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, remote access, home safety modifications, or counseling.
Hearing Services See details
Hearing services are partially covered by HealthSpring True Choice (PPO), excluding prescription hearing aids for the inner ear, outer ear, and over the ear. Covered benefits include one routine exam and fitting annually for a $30 copay and no coinsurance, up to two prescription hearing aids per year for a $399 to $1,800 copay and no coinsurance, and up to two OTC hearing aids per year for a $399 copay and no coinsurance.
Vision Services See details
HealthSpring True Choice (PPO) partially covers vision services, offering one routine eye exam per year with a $0 to $35 copay and no coinsurance, while other eye exam services are not covered. Eyewear is covered with no copay and no coinsurance up to a $150 combined annual limit for contact lenses or one pair of eyeglasses, lenses, and frames.
Dental Services See details
HealthSpring True Choice (PPO) covers dental services, offering Medicare-covered dental care with a $40 copay and no coinsurance, alongside preventive and comprehensive dental services with no copay and no coinsurance. These other dental services are subject to an annual maximum benefit of $850 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, although prior authorization is required. Covered Medicare Part B chemotherapy, radiation, and other drugs have no coinsurance to 15% coinsurance, while 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, although prior authorization is required.
Medical Equipment See details
HealthSpring True Choice (PPO) covers medical equipment with no copay, though prior authorization is required for all services. Under this partially covered benefit, durable medical equipment, prosthetic devices, and medical supplies require a 15% coinsurance, and diabetic therapeutic shoes and inserts require a 20% coinsurance, while diabetic supplies are not covered.
Diagnostic and Radiological Services See details
HealthSpring True Choice (PPO) covers diagnostic and radiological services with no coinsurance, though prior authorization is required. Lab services have no copay, diagnostic procedures and tests range from a $0 to $50 copay, outpatient X-rays have a $35 copay, and therapeutic radiological services carry a minimum copay of $85.
Home Health Services See details
HealthSpring True Choice (PPO) covers Home Health Services 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, but only some services are covered. Cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered, carrying copays ranging from $25 to $50.
Skilled Nursing Facility (SNF) See details
HealthSpring True Choice (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a $10.00 daily copay for days 1 through 20 and a $218.00 daily copay for days 21 through 100. Prior authorization is required for these services, and additional days beyond Medicare-covered stays are not covered.
Other Services See details
HealthSpring True Choice (PPO) partially covers other services, offering a limited-duration meal benefit for chronic illnesses or home-confining medical conditions with no copay and no coinsurance. Acupuncture and over-the-counter (OTC) items 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
*/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