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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 Colorado. 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 $400.00 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 drug deductible of $250 and offers significant savings on generic medications. For Tier 1 preferred generics, you will pay no copay when using a preferred retail pharmacy or preferred mail-order service. Tier 2 generic drugs are also highly affordable, with a $5 copay for a one-month supply at preferred pharmacies and no copay for a three-month supply when ordered through preferred mail delivery. For brand-name and specialized medications, costs vary depending on the drug tier. Tier 3 preferred brand drugs have a flat $47 copay for a one-month supply at both standard and preferred pharmacies. Tier 4 non-preferred drugs require a 50% coinsurance, while Tier 5 specialty drugs carry a 30% coinsurance for a one-month supply across all pharmacy options.
Additional Benefits
The HealthSpring True Choice (PPO) plan offers comprehensive medical coverage with no copay for primary care doctor visits and a $40 copay for specialists. For hospital stays, members pay a daily copay of $295 for the first six days of inpatient care, followed by no copay for days seven through ninety. Emergency room visits carry a $115 copay, while essential preventive care and home health services are available with no copay and no coinsurance. This plan also includes supplemental dental, vision, and hearing benefits, featuring no copay for preventive dental care up to a $600 annual limit and no copay for routine eyewear up to a $200 limit. Routine hearing exams require a $25 copay, while hearing aids are covered with copays starting at $399. For specialized medical needs, members pay a 20% coinsurance with no copay for dialysis and durable medical equipment.
Inpatient Hospital See details
HealthSpring True Choice (PPO) partially covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $295 copay per day for days 1 through 6 and no copay for days 7 through 90. Additional days, non-Medicare-covered stays, and acute hospital upgrades are not covered under this benefit, and prior authorization is required.
Outpatient Services See details
HealthSpring True Choice (PPO) covers outpatient services with no coinsurance, featuring no copays for outpatient blood services and ambulatory surgical center services. Outpatient hospital services require a copay ranging from $0 to $375, observation services have a $375 copay per stay, and outpatient substance abuse sessions carry a $40 copay, with prior authorization required for most services.
Partial Hospitalization See details
HealthSpring True Choice (PPO) covers partial hospitalization services with a $105.00 copay and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by HealthSpring True Choice (PPO), which features a $255 copay for ground ambulance services and a 20% coinsurance for air ambulance services, both requiring prior authorization. Although transportation is listed as covered, transportation services to plan-approved or health-related locations are not covered by this plan.
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 require a $40 copay with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $115 copay and no coinsurance up to a $50,000 maximum benefit limit.
Primary Care See details
HealthSpring True Choice (PPO) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $40 copay and no coinsurance. Additional benefits like physical, occupational, mental health, and telehealth services feature copays ranging from $0 to $40 and no coinsurance, while chiropractic and podiatry services are not covered.
Preventive Services See details
HealthSpring True Choice (PPO) covers essential preventive services, including annual physical exams, kidney disease education, and screenings, with no copay and no coinsurance. Additional preventive benefits are partially covered, offering a fitness benefit with no copay or coinsurance, while other supplemental services like health education and in-home support are not covered.
Hearing Services See details
HealthSpring True Choice (PPO) covers annual routine hearing exams and fitting evaluations with a $25 copay and no coinsurance. OTC hearing aids are covered with a $399 copay and no coinsurance, while prescription hearing aids are partially covered with a $399 to $1,800 copay and no coinsurance, excluding inner ear, outer ear, and over the ear types.
Vision Services See details
HealthSpring True Choice (PPO) partially covers vision services, with other eye exam services being excluded from coverage. Routine eye exams are covered with a $0 to $40 copay and no coinsurance, while eyewear is covered with no copay, no coinsurance, and a $200 annual combined maximum for contacts, upgrades, and one pair of eyeglasses.
Dental Services See details
HealthSpring True Choice (PPO) covers Medicare-covered dental services with a $40 copay and no coinsurance, alongside other preventive and comprehensive dental services with no copay and no coinsurance. These additional dental services, which include cleanings, x-rays, and implants, are subject to a combined annual maximum benefit of $600 for both in-network and out-of-network care.
Home Infusion bundled Services See details
HealthSpring True Choice (PPO) covers Home Infusion bundled Services with no copay, subject to prior authorization. Under this benefit, Medicare Part B insulin drugs carry a $35 copay, while chemotherapy and other Part B drugs have no copay, with all of these Part B drugs carrying coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered by HealthSpring True Choice (PPO) 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, prosthetics, medical supplies, and diabetic therapeutic shoes, subject to prior authorization. This benefit is partially covered because diabetic supplies are not covered by the plan.
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. Members pay no copay for lab services and diagnostic radiology, a $50 copay for outpatient X-rays, at least a $60 copay for therapeutic radiology, and a $0 to $150 copay for diagnostic procedures and tests.
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 under the HealthSpring True Choice (PPO) plan with no coinsurance, though prior authorization is required. While some services are covered, cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (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, offering no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
HealthSpring True Choice (PPO) partially covers other services, providing over-the-counter (OTC) items with no copay and no coinsurance up to a maximum benefit of $25 every three months. Acupuncture, meal benefits, and other miscellaneous services are not covered under this plan.
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