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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 Georgia. 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 $375.00 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) Medicare plan features an annual prescription drug deductible of $250.00 before coverage begins. During the initial coverage phase, you will pay a $5.00 copay for Tier 1 preferred generic drugs at preferred pharmacies, while Tier 2 standard generic drugs require a $47.00 copay. Tier 3 preferred brands and Tier 4 non-preferred drugs are subject to 50% and 30% coinsurance respectively, until your total drug costs reach $2,100.00. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase where you pay nothing for covered Part D prescription drugs. Additionally, beneficiaries who qualify for the low-income subsidy (LIS) will benefit from no cost for their Part D coverage. Be sure to review the plan's formulary to verify if your specific medications are covered.
Additional Benefits
The HealthSpring True Choice (PPO) plan offers robust coverage for essential medical services with predictable copays and no coinsurance for inpatient, outpatient, and emergency care. Inpatient hospital stays require a daily copay of $375 for days 1 to 6 followed by no copay for days 7 to 90, while doctor visits range from no copay up to $40. Emergency room visits carry a $115 copay, which is waived upon admission, and urgent care visits require a $40 copay. For extra health benefits, the plan provides dental coverage up to a $700 annual maximum and a $100 yearly allowance for eyewear with no copay. Routine hearing exams carry a $25 copay, with hearing aid options starting at a $399 copay and no coinsurance. Additionally, the plan features no copay for the first 20 days of skilled nursing facility stays and a $25 quarterly allowance for over-the-counter products.
Inpatient Hospital See details
HealthSpring True Choice (PPO) partially covers inpatient hospital services with no coinsurance, excluding additional days, non-Medicare-covered stays, and upgrades. For acute stays, there is a $375 daily copay for days 1 to 6, while psychiatric stays require a $340 daily copay for days 1 to 6, with no copay required for days 7 through 90 for either service.
Outpatient Services See details
HealthSpring True Choice (PPO) covers outpatient services with no coinsurance, featuring copays ranging from no copay for ambulatory surgical center services up to $375 for outpatient hospital and observation stays. Outpatient substance abuse sessions require a $40 copay, and prior authorization is required for most of these services.
Partial Hospitalization See details
HealthSpring True Choice (PPO) covers partial hospitalization benefits with a $105.00 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
HealthSpring True Choice (PPO) partially covers ambulance and transportation services, though transportation services to plan-approved or any health-related locations are not covered. Covered ground ambulance services require a $300 copay and no coinsurance, while air ambulance services require a 20% coinsurance and no copay.
Emergency Services See details
HealthSpring True Choice (PPO) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a $40 copay and no coinsurance, while worldwide emergency services are covered up to a $50,000 maximum with a $115 copay and no coinsurance.
Primary Care See details
HealthSpring True Choice (PPO) partially covers primary care benefits with copays ranging from no copay up to $40 and no coinsurance, though podiatry services and routine chiropractic care are not covered. Covered services include primary care, specialist visits, mental health, and physical therapy, many of which require prior authorization.
Preventive Services See details
HealthSpring True Choice (PPO) covers preventive services, including annual physical exams, kidney disease education, and glaucoma screenings, with no copay or coinsurance. Additional preventive services are partially covered, offering physical and memory fitness benefits, but excluding health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, remote access, bathroom safety, and counseling.
Hearing Services See details
HealthSpring True Choice (PPO) covers annual routine hearing exams and fitting evaluations with a $25 copay and no coinsurance. Prescription hearing aids are partially covered—excluding inner ear, outer ear, and over the ear models—with copays ranging from $399 to $1,800 and no coinsurance, while over-the-counter hearing aids are covered with a $399 copay and no coinsurance.
Vision Services See details
HealthSpring True Choice (PPO) covers one routine eye exam every year with no copay to a $40 copay and no coinsurance. Eyewear, including contacts and eyeglasses, is also covered up to a combined maximum of $100 annually with no deductible, copay, or coinsurance.
Dental Services See details
HealthSpring True Choice (PPO) covers Medicare-covered dental services with a $40 copay, and prior authorization is required. Other dental services, including preventive and comprehensive care, are covered up to a combined yearly maximum of $700 for both in-network and out-of-network services.
Home Infusion bundled Services See details
Home infusion bundled services are covered by HealthSpring True Choice (PPO) subject to prior authorization. Covered Medicare Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by HealthSpring True Choice (PPO) with no copay and a 20% coinsurance. Prior authorization is required to receive these services.
Medical Equipment See details
HealthSpring True Choice (PPO) partially covers medical equipment with no copay and a 20% coinsurance, though prior authorization is required. While durable medical equipment, prosthetic devices, and diabetic therapeutic shoes are covered, diabetic supplies are not covered.
Diagnostic and Radiological Services See details
HealthSpring True Choice (PPO) covers diagnostic and radiological services with no coinsurance, though prior authorization is required. Lab services have no copay, outpatient X-rays require a $50 copay, therapeutic radiology has a $60 copay, and other diagnostic procedures and radiological services have copays ranging from $0 to $225.
Home Health Services See details
Home Health Services are covered under the HealthSpring True Choice (PPO) plan, though prior authorization is required before receiving these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the HealthSpring True Choice (PPO) plan. This includes intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD), none of which are covered by the plan.
Skilled Nursing Facility (SNF) See details
HealthSpring True Choice (PPO) partially covers Skilled Nursing Facility (SNF) services with prior authorization, offering no coinsurance, no copay for days 1 through 20, and a $218 copay for days 21 through 100. Additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by HealthSpring True Choice (PPO), featuring a meal benefit for chronic or homebound conditions and a $25 quarterly over-the-counter (OTC) allowance with no copay or coinsurance. Acupuncture and Dual Eligible SNPs with Highly Integrated Services are not covered.
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