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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 Connecticut. 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) plan features an annual drug deductible of $250. 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 medications cost as little as a $5 copay for a one-month supply at preferred locations, with no copay for a three-month supply when using preferred mail order. For Tier 3 preferred brand drugs, the plan charges a flat $47 copay for a one-month supply across all pharmacy and mail-order options. Higher-tier medications require coinsurance rather than copays, with Tier 4 non-preferred drugs carrying a 50% coinsurance and Tier 5 specialty drugs requiring 30% coinsurance for a one-month supply.
Additional Benefits
The HealthSpring True Choice (PPO) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care visits, home health services, and preventive care. For specialist visits, emergency care, and urgent care, members will pay copays ranging from $40 to $115 with no coinsurance. Inpatient hospital stays require a $300 copay for days 1 through 6 and no copay for days 7 through 90, while outpatient hospital services range from no copay to a $375 copay. This plan also features dental, vision, and hearing benefits, including no copay for preventive dental care and routine eyewear up to set annual limits. Diagnostic lab work and home infusion services are available with no copay, while dialysis and durable medical equipment require a 20% coinsurance. Additionally, members can access routine hearing exams for a $25 copay and a quarterly over-the-counter allowance with no copay.
Inpatient Hospital See details
HealthSpring True Choice (PPO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $300 copay for days 1 through 6 and no copay for days 7 through 90. Prior authorization is required for these services, and additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
HealthSpring True Choice (PPO) covers outpatient services with no coinsurance, though prior authorization is required for most services. There is no copay for ambulatory surgical center and blood services, while outpatient hospital services range from $0 to $375, observation services cost $375 per stay, and outpatient substance abuse sessions require a $40 copay.
Partial Hospitalization See details
HealthSpring True Choice (PPO) covers partial hospitalization services with a $105.00 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by HealthSpring True Choice (PPO), which features ground ambulance services with a $300 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay. Prior authorization is required for all ambulance transfers, and routine transportation services to health-related locations are not covered.
Emergency Services See details
HealthSpring True Choice (PPO) covers emergency services with a $115 copay and no coinsurance, and urgently needed services with a $40 copay and no coinsurance, with 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, subject to a $50,000 maximum plan benefit.
Primary Care See details
HealthSpring True Choice (PPO) covers primary care physician services with no copay and no coinsurance, and specialist, mental health, and psychiatric services with a $40 copay and no coinsurance. Physical, occupational, and speech therapy services require a $35 copay and no coinsurance, but podiatry and chiropractic services are not covered.
Preventive Services See details
HealthSpring True Choice (PPO) covers preventive services, including annual physical exams, kidney disease education, and glaucoma screenings, with no copay and no coinsurance. Additional preventive benefits are partially covered, offering physical and memory fitness benefits with no copay or coinsurance, while services such as health education, weight management, and in-home safety assessments are not covered.
Hearing Services See details
HealthSpring True Choice (PPO) offers partially covered hearing services, excluding inner ear, outer ear, and over the ear prescription hearing aids. Covered services include annual routine exams and fitting evaluations for a $25 copay and no coinsurance, plus up to two OTC or prescription hearing aids per year with no coinsurance and copays ranging from $399 to $1,800.
Vision Services See details
HealthSpring True Choice (PPO) partially covers vision services, offering one routine eye exam per year with a $0 to $40 copay and no coinsurance, though other eye exam services are not covered. Covered eyewear—including contacts, eyeglasses, and upgrades—features no copay, no coinsurance, and no deductible, up to a combined annual maximum benefit of $175.
Dental Services See details
Dental services under HealthSpring True Choice (PPO) are covered with a $40 copay and no coinsurance for Medicare-covered dental care, while other preventive and comprehensive dental services have no copay and no coinsurance. There is a combined yearly maximum benefit of $650 that applies to both in-network and out-of-network dental services.
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 Part B drugs have no copay and a coinsurance ranging from no coinsurance to 20%, while Part B insulin is covered with a $35 copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
HealthSpring True Choice (PPO) covers dialysis services with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
HealthSpring True Choice (PPO) covers medical equipment with no copay and a 20% coinsurance, subject to prior authorization. This benefit is partially covered because diabetic supplies are not covered, although durable medical equipment, prosthetics, and diabetic therapeutic shoes are covered.
Diagnostic and Radiological Services See details
HealthSpring True Choice (PPO) covers diagnostic and radiological services with no coinsurance, though prior authorization is required. There is no copay for lab services, a $50 copay for outpatient X-rays, copays starting at $60 for therapeutic radiology, and copays ranging from $0 to $150 for diagnostic procedures and tests.
Home Health Services See details
Home Health Services are covered by HealthSpring True Choice (PPO) 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 and required prior authorization, though some services are covered while standard cardiac, intensive cardiac, and pulmonary rehabilitation services (which carry a $25 copay) and SET for PAD services (which carry 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, requiring no copay for days 1 through 20 and a $218 copay for days 21 through 100. Prior authorization is required, and while a prior three-day hospital stay is not required, additional days beyond the Medicare-covered limit are not covered.
Other Services See details
HealthSpring True Choice (PPO) provides partial coverage for other services, featuring a meal benefit and an over-the-counter (OTC) benefit of up to $25 every three months with no copay and no coinsurance. Acupuncture and other extra services are not covered under this benefit.
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