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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 Southwest Ohio/North Kentucky. 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 $300.00 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 $13900.00 (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 $13900.00 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 a $200 annual deductible and offers significant savings on generic medications. For Tier 1 preferred generics, you will pay no copay when utilizing a preferred pharmacy or preferred mail-order service. Tier 2 generic drugs are also highly affordable, with copays starting at $4 for a one-month supply, and no copay for a three-month supply filled via preferred mail order. For brand-name and specialty medications, Tier 3 preferred brands require a flat $47 copay for a one-month supply at any network pharmacy. Tier 4 non-preferred drugs carry a 50% coinsurance, while Tier 5 specialty drugs require a 30% coinsurance for a one-month supply. Utilizing preferred pharmacies and mail-order services with this PPO plan is the most effective way to minimize your out-of-pocket prescription costs.
Additional Benefits
The HealthSpring True Choice (PPO) plan offers comprehensive medical coverage with no copay for primary care doctor visits, while specialist visits require a $50 copay and no coinsurance. For inpatient hospital stays, members pay a $400 daily copay for the first five days and no copay for days six through 90. Outpatient hospital services range from no copay up to a $385 copay, and emergency room visits require a $115 copay with no coinsurance. This plan also includes dental, vision, and hearing benefits to help minimize your out-of-pocket healthcare costs. Preventive and comprehensive dental care features no copay up to a $900 annual maximum, while routine eye exams require up to a $40 copay alongside a $100 annual allowance for eyewear. Additionally, routine hearing exams and fittings require a $25 copay, and hearing aids are covered with copayments starting at $399.
Inpatient Hospital See details
HealthSpring True Choice (PPO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $400 daily copay for days 1 through 5 and no copay for days 6 through 90. Prior authorization is required, and certain services such as additional 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 outpatient hospital services with a $0 to $385 copay and ambulatory surgical center services with no copay. Outpatient substance abuse individual and group sessions require a $50 copay with no coinsurance, while outpatient blood services are covered with no copay or coinsurance.
Partial Hospitalization See details
HealthSpring True Choice (PPO) covers partial hospitalization services with an $80.00 copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
HealthSpring True Choice (PPO) covers ground ambulance services with a $245 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, both of which require prior authorization. Transportation services to health-related locations are not covered.
Emergency Services See details
HealthSpring True Choice (PPO) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require 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, while specialist visits require a $50 copay and physical, occupational, and speech therapies require a $35 copay, all with no coinsurance. Telehealth, opioid treatment, and other healthcare professional services are covered with copays up to $50 and no coinsurance, while podiatry, chiropractic, psychiatric, and mental health specialty services are not covered.
Preventive Services See details
Preventive services are partially covered under HealthSpring True Choice (PPO) with no copay and no coinsurance for covered benefits, which include annual physical exams, kidney disease education, fitness benefits, and select screenings. However, many supplemental preventive services, such as health education, nutritional therapy, and in-home safety assessments, are not covered.
Hearing Services See details
HealthSpring True Choice (PPO) hearing services are covered, including annual routine exams and fittings for a $25 copay and no coinsurance. OTC hearing aids are covered with a $399 copay and no coinsurance, while prescription hearing aids are partially covered with a copay between $399 and $1,800 and no coinsurance, excluding inner ear, outer ear, and over the ear models.
Vision Services See details
HealthSpring True Choice (PPO) covers routine eye exams with a $0 to $40 copay and no coinsurance, though other eye exam services are not covered. Eyewear is covered with no copay or coinsurance up to a $100 annual maximum for contacts, eyeglasses, frames, lenses, and upgrades.
Dental Services See details
HealthSpring True Choice (PPO) covers dental services with no copay and no coinsurance for preventive and comprehensive care, up to a $900 annual maximum benefit for combined in-network and out-of-network services. Medicare-covered dental services are also covered with a $50 copay and no coinsurance.
Home Infusion bundled Services See details
HealthSpring True Choice (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B drugs—including chemotherapy, radiation, and insulin—have coinsurance ranging from no coinsurance up to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
Dialysis Services are covered under the HealthSpring True Choice (PPO) plan with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
HealthSpring True Choice (PPO) partially covers medical equipment with no copays, requiring a 20% coinsurance and prior authorization for durable medical equipment, prosthetic devices, medical supplies, and diabetic therapeutic shoes. While diabetic shoes and inserts are covered, diabetic supplies are not covered under this plan, and diabetic equipment is limited to specified manufacturers.
Diagnostic and Radiological Services See details
HealthSpring True Choice (PPO) covers diagnostic and radiological services with no coinsurance, though prior authorization is required. Members pay no copay for lab services, between $0 and $150 for diagnostic procedures, a $30 copay for outpatient X-rays, and a minimum $85 copay for therapeutic radiological services.
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
Cardiac Rehabilitation Services are covered by HealthSpring True Choice (PPO) with no copay and no coinsurance, but in practice only some services are covered as standard cardiac, intensive cardiac, pulmonary, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
HealthSpring True Choice (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100 per stay, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services are covered under the HealthSpring True Choice (PPO) plan, though only some services are covered while acupuncture, over-the-counter (OTC) items, and meal benefits are not covered. Because these specific benefits are not covered by the plan, there are no associated copayments or coinsurance.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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