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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 New Jersey. 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) prescription drug plan features an annual drug deductible of $250. You can save on prescriptions by using preferred pharmacies or preferred mail order, which offer no copay for Tier 1 preferred generic drugs. Tier 2 generic drugs are also cost-effective, with a copay as low as $5 for a one-month supply at preferred pharmacies and preferred mail order. For Tier 3 preferred brand drugs, you will pay a flat $47 copay for a one-month supply regardless of whether you use preferred or standard pharmacies. More expensive medications fall into Tier 4 and Tier 5, which carry a 50% coinsurance for non-preferred drugs and a 30% coinsurance for specialty tier drugs.
Additional Benefits
The HealthSpring True Choice (PPO) plan offers comprehensive medical coverage with affordable cost-sharing, including no copay for primary care visits and a $40 copay for specialist visits. For inpatient hospital stays, members pay a $290 daily copay for days 1 through 6 and no copay for days 7 through 90, with no coinsurance required. Emergency care is accessible with a $115 copay, while many preventive services, home health care, and lab tests are fully covered with no copay or coinsurance. This plan also features valuable dental, vision, and hearing benefits to lower your out-of-pocket costs. Dental services are covered with no copay or coinsurance up to a $650 annual maximum, and routine vision eyewear is covered with no copay up to a $150 annual limit. Additionally, members can take advantage of a fitness benefit, home-delivered meals, and a $30 quarterly allowance for over-the-counter items with no copay.
Inpatient Hospital See details
HealthSpring True Choice (PPO) covers inpatient acute and psychiatric hospital stays with no coinsurance and a $290 daily copay for days 1 through 6, followed by no copay for days 7 through 90. Prior authorization is required, and certain services such as additional days, non-Medicare-covered stays, and upgrades are not covered.
Outpatient Services See details
Outpatient services are covered by HealthSpring True Choice (PPO) with no coinsurance for all services, including no copay for ambulatory surgical center and blood services. Outpatient hospital and observation services carry a copay ranging from $0 to $375, while outpatient substance abuse sessions require a $40 copay.
Partial Hospitalization See details
Partial hospitalization is covered by HealthSpring True Choice (PPO) with a $105.00 copay and no coinsurance, although prior authorization is required.
Ambulance and Transportation Services See details
HealthSpring True Choice (PPO) covers ambulance services with prior authorization, featuring a $255 copay and no coinsurance for ground transport, and a 20% coinsurance with no copay for air transport. Transportation services to plan-approved or other health-related locations 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, both featuring no coinsurance and waived copays if admitted to the hospital within 24 hours. Worldwide emergency, urgent, and transportation services are also covered up to a $50,000 maximum with a $115 copay and no coinsurance.
Primary Care See details
HealthSpring True Choice (PPO) covers primary care visits with no copay and no coinsurance, and specialist visits with a $40 copay and no coinsurance. Physical, occupational, and speech therapies require a $35 copay and no coinsurance, while podiatry is not covered, and for chiropractic care, some services are covered but routine and other chiropractic services are not covered.
Preventive Services See details
Preventive services are covered by HealthSpring True Choice (PPO) with no copay and no coinsurance for annual physical exams, kidney disease education, and diabetes training. Additional preventive benefits are partially covered, providing a fitness benefit but excluding health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, and weight management.
Hearing Services See details
HealthSpring True Choice (PPO) provides partially covered hearing services, which include one annual routine exam and fitting for a $30 copay and no coinsurance. The plan also covers up to two OTC hearing aids per year for a $399 copay and up to two prescription hearing aids per year with a copay of $399 to $1,800 (both with no coinsurance), though inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
HealthSpring True Choice (PPO) offers vision services, including one annual routine eye exam with a $0 to $40 copay and no coinsurance, although other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and no deductible, featuring a $150 combined annual maximum benefit for contacts, eyeglasses, lenses, frames, and upgrades.
Dental Services See details
HealthSpring True Choice (PPO) dental services are covered with no copay and no coinsurance for preventive and comprehensive care, up to a maximum annual benefit of $650 for both in-network and out-of-network services. Medicare-covered dental services are also available for a $40 copay and no coinsurance, subject to prior authorization.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by HealthSpring True Choice (PPO) with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs require no coinsurance to 20% coinsurance, while Part B insulin is covered with a $35 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, although prior authorization is required.
Medical Equipment See details
HealthSpring True Choice (PPO) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance, subject to prior authorization. Diabetic equipment is partially covered under this plan, as diabetic therapeutic shoes and inserts are covered with no copay and a 20% coinsurance, while diabetic supplies are not covered.
Diagnostic and Radiological Services See details
HealthSpring True Choice (PPO) covers diagnostic and radiological services with no coinsurance, although prior authorization is required. Diagnostic procedures and tests have a copay ranging from $0 to $150, outpatient X-rays have a $50 copay, therapeutic radiological services require a minimum copay of $60, and lab services and diagnostic radiological services have no copay.
Home Health Services See details
Home health services are covered under the HealthSpring True Choice (PPO) plan with no copay and no coinsurance, although 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 only some services are covered in practice and prior authorization is required. Standard cardiac, intensive cardiac, and pulmonary rehabilitation services require a $25 copay but are not covered, while SET for PAD services require a $20 copay and are also not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by HealthSpring True Choice (PPO) with no coinsurance, featuring 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, offering a meal benefit and over-the-counter (OTC) items up to $30 every three months with no copay and no coinsurance, while acupuncture is not covered.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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