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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 does not have a health deductible. Your insurance coverage on covered health services will start immediately.
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
The HealthSpring True Choice (PPO) Medicare plan features an Enhanced Alternative drug benefit with a $300.00 annual prescription drug deductible. If you qualify for the low-income subsidy, also known as Extra Help, you will have no copay for your Part D premium. After meeting your deductible, you enter the initial coverage phase where costs depend on your drug tier and pharmacy choice until total drug costs reach $2,100.00. During the initial coverage phase, Tier 1 preferred generics require an $8.00 copay at preferred pharmacies and mail-order services, or a $20.00 copay at standard locations, while Tier 2 standard generics have a flat $47.00 copay. Tier 3 preferred brands require 50% coinsurance and Tier 4 non-preferred drugs require 29% coinsurance across all pharmacy options. Once your yearly out-of-pocket costs reach $2,100.00, you enter the catastrophic coverage phase and pay nothing for your covered Part D prescription drugs.
Additional Benefits
The HealthSpring True Choice (PPO) plan offers comprehensive medical coverage featuring predictable copayments and no coinsurance for most primary services. Preventive care, annual physicals, and laboratory tests are fully covered with no copay or coinsurance, while primary care and specialist visits range from no copay to a $40 copay. Emergency room visits require a $115 copay and urgent care requires a $40 copay, both with no coinsurance. This plan also includes key supplemental benefits, such as a $275 annual eyewear allowance and up to $650 for preventive and comprehensive dental services. Routine hearing exams have a $25 copay, and hearing aids are covered with fixed copays and no coinsurance. While inpatient hospital stays and skilled nursing care are covered with structured daily copays, specialized services like dialysis and durable medical equipment require a 20% coinsurance with no copay.
Inpatient Hospital See details
HealthSpring True Choice (PPO) partially covers inpatient hospital benefits with no coinsurance, but prior authorization is required. Acute care stays require a $375 copay for days 1 to 6 and no copay for days 7 to 90, though upgrades, additional days, and non-Medicare-covered stays are not covered. Psychiatric stays require a $345 copay for days 1 to 6 and no copay for days 7 to 90, while additional days and non-Medicare-covered stays are not covered.
Outpatient Services See details
HealthSpring True Choice (PPO) covers outpatient services with no coinsurance, featuring copays that range from no copay for ambulatory surgical center services up to $385 for outpatient hospital and observation stays. Patients also pay a $40 copay per session for outpatient substance abuse services, while outpatient blood services are covered with no deductible.
Partial Hospitalization See details
HealthSpring True Choice (PPO) covers partial hospitalization benefits with a $105.00 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 $240 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required. For transportation benefits, some services are covered but transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Emergency services are covered by HealthSpring True Choice (PPO) with a $115 copay, and urgently needed services are covered with a $40 copay, both with no coinsurance. Worldwide emergency, urgent, and transportation services are also covered up to a $50,000 maximum limit with a $115 copay and no coinsurance.
Primary Care See details
HealthSpring True Choice (PPO) covers primary care, specialist, and therapy services with copays ranging from no copay to $40 and no coinsurance, while podiatry is not covered. Chiropractic care is partially covered with a $15 copay and no coinsurance, excluding routine care, and some psychiatric and mental health specialty services are covered, though individual and group sessions for both are not covered.
Preventive Services See details
HealthSpring True Choice (PPO) covers Medicare-covered zero-dollar preventive services, annual physical exams, and kidney disease education with no copays or coinsurance. Additional preventive benefits are only partially covered, offering a fitness program while excluding services such as health education, weight management, and in-home safety assessments.
Hearing Services See details
HealthSpring True Choice (PPO) covers hearing services, including annual routine hearing exams and fittings for a $25 copay and no coinsurance, alongside up to two OTC hearing aids per year for a $399 copay and no coinsurance. Prescription hearing aids are partially covered with a $399 to $1,800 copay and no coinsurance, but inner ear, outer ear, and over the ear devices are not covered.
Vision Services See details
Vision services are covered by HealthSpring True Choice (PPO), including one annual routine eye exam with a copay ranging from no copay to $30 and no coinsurance. The plan also provides a $275 annual allowance for eyewear, including contacts, lenses, frames, and upgrades, with no deductible.
Dental Services See details
HealthSpring True Choice (PPO) covers Medicare-covered dental services with a $40 copay and no coinsurance, which require prior authorization. Other preventive and comprehensive dental services are covered up to a combined annual maximum of $650 for both in-network and out-of-network services.
Home Infusion bundled Services See details
HealthSpring True Choice (PPO) covers Home Infusion bundled Services with prior authorization, requiring no copay and no coinsurance to 20% coinsurance for chemotherapy, radiation, and other Part B drugs. Medicare Part B insulin drugs are covered under this benefit with a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
HealthSpring True Choice (PPO) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required to access these covered services.
Medical Equipment See details
HealthSpring True Choice (PPO) partially covers medical equipment, offering covered items like durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes with a 20% coinsurance and no copay. Diabetic supplies are not covered, and prior authorization is required for covered equipment.
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, a $50 copay for outpatient X-rays, a $60 copay for therapeutic radiology, and copays ranging from no copay up to $150 for diagnostic tests and $225 for diagnostic radiology.
Home Health Services See details
Home health services are covered under the HealthSpring True Choice (PPO) plan, though prior authorization is required before services can be received.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the HealthSpring True Choice (PPO) plan, 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, featuring no copay for days 1 through 20 and a $218 copay for days 21 through 100, with no coinsurance. Prior authorization is required, and additional days beyond the Medicare-covered limit 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 medical conditions requiring you to remain at home, with no maximum coverage limit. Acupuncture, over-the-counter (OTC) items, and dual-eligible SNP services are not covered under this plan.
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