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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 South 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.
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 $700.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
This plan has a $615.00 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 $10100.00 (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 $10100.00 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 annual drug deductible of $615. For Tier 1 preferred generic drugs, there is no copay when using a preferred pharmacy or preferred mail order service. Tier 2 generic medications cost as little as a $4 copay for a one-month supply at preferred pharmacies, and a three-month supply has no copay when ordered through preferred mail delivery. Tier 3 preferred brand drugs require a $47 copay for a one-month supply at both standard and preferred pharmacies. Tier 4 non-preferred drugs carry a 50% coinsurance, while Tier 5 specialty medications require a 25% coinsurance for a one-month supply.
Additional Benefits
The HealthSpring True Choice (PPO) plan offers comprehensive coverage with no copay for primary care doctor visits, annual physical exams, and home health services. Specialist visits, therapy sessions, and Medicare-covered dental services require a $35 copay, while emergency care has a $130 copay that is waived upon hospital admission. For inpatient hospital stays, there is a $315 daily copay for days one through seven, followed by no copay for days eight through ninety. Members also benefit from no copay for routine lab work, outpatient X-rays, and preventive dental care up to an $800 annual maximum. Routine vision exams carry a $0 to $25 copay with a $150 annual allowance for eyewear, while hearing aids are covered with copays ranging from $399 to $1,800. Durable medical equipment and dialysis services require a 20% coinsurance, while most outpatient services feature no coinsurance.
Inpatient Hospital See details
HealthSpring True Choice (PPO) partially covers inpatient hospital services with no coinsurance, requiring a $315 daily copay for days 1-7 of acute stays (no copay for days 8-90) and a $595 daily copay for days 1-3 of psychiatric stays (no copay for days 4-90). Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered under the HealthSpring True Choice (PPO) with no coinsurance, featuring no copays for ambulatory surgical center and blood services. Medicare-covered outpatient hospital services require a $0 to $315 copay, observation services carry a $315 copay per stay, and outpatient substance abuse sessions have a $35 copay.
Partial Hospitalization See details
Partial hospitalization is covered under the HealthSpring True Choice (PPO) plan with a $140.00 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Ambulance services are covered by HealthSpring True Choice (PPO) with prior authorization, requiring a $255 copay for ground transport and 20% coinsurance for air transport. Transportation services to health-related locations are not covered.
Emergency Services See details
HealthSpring True Choice (PPO) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services have a $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to $50,000 with a $130 copay and no coinsurance.
Primary Care See details
HealthSpring True Choice (PPO) provides primary care physician services with no copay and no coinsurance, while specialist visits, mental health services, and physical, occupational, and speech therapies require a $35 copay and no coinsurance. Podiatry and chiropractic services are not covered under this plan, and prior authorization is required for most specialized services.
Preventive Services See details
HealthSpring True Choice (PPO) covers preventive services, including annual physical exams, kidney disease education, and diabetes self-management training, with no copay and no coinsurance. While a fitness benefit is covered, additional preventive services are only partially covered, with services such as health education, weight management, in-home safety assessments, and nutritional therapy not covered by the plan.
Hearing Services See details
Hearing services are partially covered by HealthSpring True Choice (PPO), featuring a $30 copay and no coinsurance for annual routine exams and fitting evaluations. Up to two prescription hearing aids per year are covered with no coinsurance and copays ranging from $399 to $1,800, though inner ear, outer ear, and over the ear types are not covered, while OTC hearing aids require a $399 copay and no coinsurance.
Vision Services See details
HealthSpring True Choice (PPO) provides partially covered vision services, which include one routine eye exam per year with a $0 to $25 copay and no coinsurance, while other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and no deductible, up to a combined annual maximum of $150 for contacts, lenses, frames, and upgrades.
Dental Services See details
HealthSpring True Choice (PPO) covers Medicare-covered dental services with a $35 copay and no coinsurance. Other preventive and comprehensive dental services are covered with no copay and no coinsurance up to an annual maximum of $800 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 no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs feature no copay and no coinsurance to 20% coinsurance, while Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the HealthSpring True Choice (PPO) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
HealthSpring True Choice (PPO) partially covers medical equipment with no copay and a 20% coinsurance, though prior authorization is required for these services. While durable medical equipment, prosthetics, and diabetic therapeutic shoes are covered, diabetic supplies are not covered under this benefit.
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 outpatient X-rays, while diagnostic procedures cost between no copay and $95, diagnostic radiological services start at no copay, and therapeutic radiological services require a minimum copay of $85.
Home Health Services See details
HealthSpring True Choice (PPO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
HealthSpring True Choice (PPO) covers cardiac rehabilitation services with no coinsurance and requires prior authorization. Some services are covered, but cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
HealthSpring True Choice (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a $10 daily copay for days 1 to 20, a $218 daily copay for days 21 to 60, and no copay for days 61 to 100. 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, providing a limited-duration meal benefit for chronic or medical conditions requiring home recovery with no copay and no coinsurance. Acupuncture and over-the-counter (OTC) items are not covered.
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