HealthSpring True Choice (PPO)

HealthSpring True Choice (PPO) is a PPO plan offered by Health Care Service Corporation available for enrollment in 2025 to people living in North Carolina. 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.

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:

Drug Coverage

The HealthSpring True Choice (PPO) Medicare plan features a $615 drug deductible before coverage begins. For Tier 1 preferred generic drugs, you will pay no copay when using preferred pharmacies or preferred mail order services, compared to a $10 copay for a one-month supply at standard pharmacies. Tier 2 generic drugs start at a $5 copay for a one-month supply at preferred locations, with no copay for a three-month supply filled through preferred mail order. Tier 3 preferred brand drugs have a consistent $47 copay for a one-month supply at both standard and preferred pharmacies. For higher-tier prescriptions, Tier 4 non-preferred drugs require a 50% coinsurance and Tier 5 specialty drugs require a 25% coinsurance across all pharmacy networks. Utilizing preferred network pharmacies and mail-order options offers the lowest out-of-pocket costs on this plan.

Additional Benefits

The HealthSpring True Choice (PPO) plan offers robust medical coverage with no copay or coinsurance for primary care visits, annual physicals, home health services, and laboratory tests. For specialized care, members pay no coinsurance and affordable copays, such as $30 for specialist visits and $130 for emergency room care. Hospital stays are also covered without coinsurance, featuring a $295 daily copay for the first seven days of acute inpatient care and copays ranging up to $275 for outpatient services. Additional benefits include dental care with no copay for preventive services up to a $1,400 annual limit, and vision care providing routine exams alongside a $175 yearly eyewear allowance. Hearing exams require a $25 copay, while durable medical equipment and dialysis services are covered with a 20% coinsurance and no copay. Skilled nursing facility stays are also covered with no coinsurance, requiring low daily copays for the first 60 days and no copay for days 61 through 100.