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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 2026 to people living in South Mississippi. 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 $415.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
This plan has a $250.00 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 $11000.00 (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 $11000.00 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) plan features a $250 annual prescription drug deductible. For Tier 1 preferred generic drugs, you will pay no copay when using a preferred pharmacy or preferred mail order service, while standard options require a $10 copay for a one-month supply. Tier 2 generic drugs cost as little as a $5 copay for a one-month supply at preferred locations, with no copay for a three-month supply filled via preferred mail order. Tier 3 preferred brand drugs carry a consistent copay of $47 for a one-month supply across all pharmacy and mail order options. For higher-tier medications, you will pay a 50% coinsurance for Tier 4 non-preferred drugs and a 30% coinsurance for Tier 5 specialty drugs.
Additional Benefits
The HealthSpring True Choice (PPO) plan offers comprehensive healthcare coverage with no copay for primary care visits, preventive screenings, and home health services. For specialist visits, physical therapy, and emergency care, members pay fixed copayments, including a $40 copay for specialists and a $115 copay for emergency room visits. Inpatient hospital stays require a $265 daily copay for the first four days, with no copay for days five through ninety. Ancillary benefits include routine dental and vision care, featuring dental coverage with no copay up to a $500 annual limit and routine eye exams with no copay to a $40 copay. Hearing services, diagnostic labs, and routine x-rays are also covered with low to no copays. Furthermore, durable medical equipment and dialysis services are covered with a 20% coinsurance and no copay.
Inpatient Hospital See details
Inpatient hospital services are partially covered by HealthSpring True Choice (PPO) with no coinsurance and require prior authorization. For both acute and psychiatric admissions, there is a $265 daily copay for days 1 through 4 and no copay for days 5 through 90, while additional days, non-Medicare-covered stays, and upgrades are not covered.
Outpatient Services See details
HealthSpring True Choice (PPO) covers outpatient services with no coinsurance, offering ambulatory surgical center and blood services with no copay, and outpatient hospital services with a copay of $0 to $375. Outpatient substance abuse services require a $40 copay per session with no coinsurance, and observation services have a $375 copay per stay.
Partial Hospitalization See details
Partial hospitalization is covered by HealthSpring True Choice (PPO) with a $105.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance services are covered by HealthSpring True Choice (PPO) with prior authorization, requiring a $295 copay for ground transport and a 20% coinsurance for air transport, while routine transportation services are not covered.
Emergency Services See details
HealthSpring True Choice (PPO) covers emergency services with a $115 copay and urgently needed services with a $40 copay, with no coinsurance for either service and copays waived if admitted to the hospital within 24 hours. Worldwide emergency, urgent, and transportation services are also covered with a $115 copay and no coinsurance, up to a maximum plan benefit of $50,000.
Primary Care See details
HealthSpring True Choice (PPO) covers primary care physician services with no copay and no coinsurance, while specialist, psychiatric, and mental health services require a $40 copay with no coinsurance. Physical, occupational, and speech therapy services have a $35 copay and no coinsurance, whereas chiropractic and podiatry services are not covered.
Preventive Services See details
HealthSpring True Choice (PPO) covers preventive services, including annual physical exams, kidney disease education, and screenings, with no copay and no coinsurance. Additional preventive services are partially covered, offering a fitness benefit with no copay or coinsurance, while other sub-services like health education, personal emergency response systems, and nutritional training are not covered.
Hearing Services See details
Hearing services covered by HealthSpring True Choice (PPO) include annual routine hearing exams and fitting evaluations for a $20 copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $399 to $1,800, though inner ear, outer ear, and over the ear models are not covered. OTC hearing aids are also covered for a $399 copay and no coinsurance.
Vision Services See details
HealthSpring True Choice (PPO) offers partially covered vision services, as other eye exam services are not covered. Routine eye exams are covered with a $0 to $40 copay and no coinsurance, while eyewear is covered with no copay and no coinsurance up to a combined annual maximum of $200.
Dental Services See details
HealthSpring True Choice (PPO) covers preventive and comprehensive dental services with no copay and no coinsurance, up to a combined in- and out-of-network maximum benefit of $500 annually. Medicare-covered dental services are also available with a $40 copay and no coinsurance.
Home Infusion bundled Services See details
HealthSpring True Choice (PPO) covers Home Infusion bundled Services with no copay, although prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs require no coinsurance to 20% coinsurance, while Medicare 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 copays, though prior authorization and a 20% coinsurance apply to durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes. This benefit is partially covered because diabetic supplies are not covered under the plan.
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 and diagnostic radiological services, a $0 to $150 copay for diagnostic procedures, a $50 copay for outpatient X-rays, and a minimum $60 copay for therapeutic radiology.
Home Health Services See details
HealthSpring True Choice (PPO) covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
HealthSpring True Choice (PPO) covers Cardiac Rehabilitation Services with no coinsurance, though prior authorization is required. While some services are covered, standard cardiac, intensive cardiac, and pulmonary rehabilitation services (requiring a $25 copay) along with SET for PAD services (requiring a $20 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by HealthSpring True Choice (PPO) with no coinsurance, though prior authorization is required. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100 per stay, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
HealthSpring True Choice (PPO) partially covers other services, offering over-the-counter (OTC) items and meal benefits with no copay and no coinsurance, while acupuncture is not covered. Eligible members receive up to $30 every three months for OTC items and access to limited-duration meals for qualifying chronic or medical conditions.
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