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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 Pennsylvania. 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 $125.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
This plan has a $275.00 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 $10000.00 (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 $10000.00 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 prescription drug plan features an annual drug deductible of $275. For Tier 1 preferred generic drugs, members pay no copay when using a preferred pharmacy or preferred mail-order service. Tier 2 generic drugs cost as little as a $4 copay for a one-month supply at preferred locations, and there is no copay for a three-month supply filled through preferred mail order. For Tier 3 preferred brand drugs, members pay a flat $47 copay for a one-month supply at both standard and preferred pharmacies. Higher-tier medications require coinsurance, with Tier 4 non-preferred drugs requiring 50% coinsurance and Tier 5 specialty drugs requiring 29% coinsurance for a one-month supply.
Additional Benefits
HealthSpring True Choice (PPO) offers comprehensive medical coverage with no copays or coinsurance for primary care visits, preventive services, and home health care. For specialized care, members pay no coinsurance and predictable copays, such as $30 for specialist visits and $130 for emergency services, which is waived upon hospital admission. Inpatient hospital stays require daily copays for the first five days, after which there is no copay for the remainder of a stay up to 90 days. The plan also features valuable supplemental benefits, including dental care with no copays up to a $2,500 annual maximum and eyewear coverage with no copay up to a $275 yearly limit. Routine hearing exams require a $25 copay, while hearing aids are available with copays starting at $399. Additionally, members receive a quarterly $80 allowance for over-the-counter items and a meal benefit for qualifying conditions, both with no copays or coinsurance.
Inpatient Hospital See details
Inpatient hospital services are covered by HealthSpring True Choice (PPO) with no coinsurance, though prior authorization is required. For acute care, you will pay a $340 daily copay for days 1 through 5 and no copay for days 6 through 90, while psychiatric stays require a $295 daily copay for days 1 through 5 and no copay for days 6 through 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, offering outpatient hospital services with a $0 to $295 copay and observation services with a $295 copay per stay. Ambulatory surgical center and outpatient blood services have no copay and no coinsurance, while outpatient substance abuse sessions require a $30 copay with 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 for this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by HealthSpring True Choice (PPO), offering ground ambulance services for a $230 copay with no coinsurance and air ambulance services for a 20% coinsurance with no copay, both requiring prior authorization. Transportation services to plan-approved or any health-related locations are not covered.
Emergency Services See details
HealthSpring True Choice (PPO) covers emergency services with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $50,000 maximum 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 visits, physical, speech, occupational, mental health, psychiatric, and opioid treatment services require a $30 copay and no coinsurance. Telehealth services carry a $0 to $30 copay and no coinsurance, podiatry is not covered, and while some chiropractic services are covered with a $15 copay and no coinsurance, routine and other chiropractic care are not covered.
Preventive Services See details
HealthSpring True Choice (PPO) offers preventive services with no copay and no coinsurance, meaning you will pay nothing for covered services like annual physical exams, kidney disease education, and fitness benefits. However, this benefit is only partially covered, as the plan does not cover health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, remote access technologies, home and bathroom safety devices and modifications, and counseling services.
Hearing Services See details
HealthSpring True Choice (PPO) covers annual routine hearing exams and fittings for a $25 copay and no coinsurance, as well as OTC hearing aids for a $399 copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $399 to $1,800 for up to two aids per year, excluding inner ear, outer ear, and over the ear models.
Vision Services See details
Vision services are partially covered by HealthSpring True Choice (PPO), featuring routine eye exams with no copay to a $30 copay and no coinsurance, though other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and no deductible, offering a $275 combined annual maximum benefit 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, while Medicare-covered dental services require a $30 copay and no coinsurance. A maximum yearly benefit of $2,500 applies to both in-network and out-of-network dental care.
Home Infusion bundled Services See details
HealthSpring True Choice (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs have no copay and 0% (no coinsurance) to 20% coinsurance, while Medicare Part B insulin drugs require a $35 copay and 0% (no coinsurance) to 20% coinsurance.
Dialysis Services See details
HealthSpring True Choice (PPO) covers dialysis services 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 and a 20% coinsurance for durable medical equipment, prosthetic devices, and medical supplies, all requiring prior authorization. Diabetic equipment is partially covered with no copay and a 20% coinsurance for therapeutic shoes and inserts, 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 and diagnostic radiological services, while diagnostic tests have a copay of $0 to $50, outpatient X-rays have a $20 copay, and therapeutic radiological services require a minimum copay of $85.
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 coinsurance and a $10 copay, though some services are covered while standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) services are not covered. Prior authorization is required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by HealthSpring True Choice (PPO) with no coinsurance, requiring a $10 daily copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and while a prior three-day inpatient hospital stay is not necessary, additional days beyond the Medicare-covered limit are not covered.
Other Services See details
HealthSpring True Choice (PPO) partially covers other services, which include over-the-counter (OTC) items and a meal benefit with no copay and no coinsurance, while acupuncture is not covered. The OTC benefit provides up to $80 of coverage every three months, and the meal benefit is available for members with chronic illnesses or qualifying medical conditions.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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