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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 Arkansas. 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 $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 $300.00 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 $9550.00 (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 $9550.00 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
HealthSpring True Choice (PPO) offers an Enhanced Alternative prescription drug plan with an annual drug deductible of $300. During the initial coverage phase, preferred generic drugs require an $8 copay at preferred pharmacies and mail-order services, or a $20 copay at standard pharmacies. Standard generics carry a $47 copay, while preferred brands and non-preferred drugs require 50% and 29% coinsurance respectively. Once your yearly out-of-pocket drug costs reach $2,100, you enter the catastrophic coverage phase and will pay no copay for covered Part D prescriptions. Additionally, individuals who qualify for the full low-income subsidy will benefit from no copay for their Part D coverage.
Additional Benefits
The HealthSpring True Choice (PPO) plan provides comprehensive medical coverage, featuring no copay for primary care visits and Medicare-covered preventive services. Specialist visits require a $50 copay, while inpatient acute hospital stays incur a $375 daily copay for the first six days, followed by no copay for days seven through 90. Outpatient services are also highly accessible, with no copay for ambulatory surgical center procedures and no coinsurance for diagnostic lab tests. In addition to core medical care, this plan offers valuable dental, vision, and hearing benefits to help lower your out-of-pocket costs. Preventive and comprehensive dental services are covered with no copay up to a $700 annual maximum, and eyewear is covered with no copay up to a $175 yearly limit. Emergency care is available with a $115 copay, while durable medical equipment and dialysis services require a 20% coinsurance with no copay.
Inpatient Hospital See details
HealthSpring True Choice (PPO) partially covers inpatient hospital services with no coinsurance, requiring a $375 copay for days 1-6 of acute stays and a $345 copay for days 1-6 of psychiatric stays, with no copay for days 7-90. 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 ambulatory surgical center services with no copay and outpatient substance abuse sessions for a $50 copay. Outpatient hospital services feature a copay ranging from no copay to $375, while observation services require a $375 copay per stay.
Partial Hospitalization See details
HealthSpring True Choice (PPO) covers partial hospitalization services with a $105.00 copay and no coinsurance. Prior authorization is required to access these benefits.
Ambulance and Transportation Services See details
HealthSpring True Choice (PPO) provides partial coverage for ambulance and transportation services, as transportation services to plan-approved and any other health-related locations are not covered. Under this plan, covered ground ambulance services require a $300 copay and no coinsurance, while air ambulance services require a 20% coinsurance and no copay, with prior authorization required.
Emergency Services See details
HealthSpring True Choice (PPO) covers emergency services with a $115 copay and urgently needed services with a $40 copay, both with no coinsurance. Worldwide emergency, urgent, and transportation services are also covered up to a $50,000 maximum benefit with a $115 copay and no coinsurance.
Primary Care See details
HealthSpring True Choice (PPO) covers primary care with no copay, specialist visits for a $50 copay, and therapy services for a $35 copay, all with no coinsurance. Chiropractic care is partially covered for a $15 copay and no coinsurance, excluding routine care, while telehealth ranges from no copay to a $50 copay with no coinsurance. For mental health and psychiatric specialty services, some services are covered but individual and group sessions are not, and podiatry is not covered.
Preventive Services See details
HealthSpring True Choice (PPO) covers preventive services, including Medicare-covered zero-dollar preventive services with no copay or coinsurance, annual physical exams, and kidney disease education. Additional preventive benefits are partially covered, offering physical and memory fitness programs, while sub-services such as health education, weight management, and alternative therapies are not covered.
Hearing Services See details
HealthSpring True Choice (PPO) covers annual routine hearing exams and fittings for a $20 copay and no coinsurance. Prescription hearing aids are partially covered up to two per year with a $399 to $1,800 copay and no coinsurance, though inner ear, outer ear, and over the ear models are not covered. Over-the-counter (OTC) hearing aids are also covered up to two per year with a $399 copay and no coinsurance.
Vision Services See details
Vision services are covered by HealthSpring True Choice (PPO), which includes one routine eye exam per year with no copay to a $50 copay and no coinsurance. The plan also covers eyewear, including contacts and eyeglasses, with no copay or coinsurance up to a combined annual maximum benefit of $175.
Dental Services See details
HealthSpring True Choice (PPO) covers Medicare-covered dental services with a $50 copay and no coinsurance, subject to prior authorization. Other preventive, comprehensive, and orthodontic dental services are covered with no copay and no coinsurance, up to a combined $700 annual maximum for both in-network and out-of-network services.
Home Infusion bundled Services See details
Home infusion bundled services are covered by HealthSpring True Choice (PPO) with prior authorization and step therapy requirements. Under this benefit, Medicare Part B insulin drugs require a $35 copay and 0% to 20% coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under HealthSpring True Choice (PPO) with a 20% coinsurance and no copay, although prior authorization is required.
Medical Equipment See details
HealthSpring True Choice (PPO) covers medical equipment, including durable medical equipment, prosthetics, and medical supplies, with no copay and 20% coinsurance. Diabetic equipment is partially covered under this plan, as diabetic therapeutic shoes and inserts are covered with no copay and 20% coinsurance, but diabetic supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by HealthSpring True Choice (PPO) with no coinsurance, though prior authorization is required. There is no copay for lab services, while copays range from no copay to $150 for diagnostic tests, no copay to $225 for diagnostic radiology, $60 for therapeutic radiology, and $50 for outpatient X-rays.
Home Health Services See details
Home Health Services are covered under the HealthSpring True Choice (PPO) plan, but prior authorization is required to receive these services.
Cardiac Rehabilitation Services See details
HealthSpring True Choice (PPO) does not cover Cardiac Rehabilitation Services, as none of the sub-services, including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation, are covered under this plan.
Skilled Nursing Facility (SNF) See details
HealthSpring True Choice (PPO) partially covers Skilled Nursing Facility (SNF) services, as additional days beyond Medicare-covered limits are not covered and prior authorization is required. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, with no coinsurance required for covered stays.
Other Services See details
HealthSpring True Choice (PPO) offers partial coverage for Other Services, which includes a meal benefit for chronic illnesses or medical conditions requiring you to remain at home, with no maximum plan coverage limit. Acupuncture, over-the-counter (OTC) items, and dual eligible SNPs with highly integrated services are not covered under this plan.
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