A non-government entity
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 York. 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:
Sign up for HealthSpring True Choice (PPO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The HealthSpring True Choice (PPO) Medicare plan features an annual drug deductible of $250. For Tier 1 preferred generic drugs, there is no copay when using a preferred pharmacy or preferred mail order, while standard pharmacies charge a $10 copay for a one-month supply. Tier 2 generic medications cost as low as a $5 copay for a one-month supply at preferred locations, and there is no copay for a three-month supply filled through preferred mail order. Tier 3 preferred brand drugs require a flat $47 copay for a one-month supply at both preferred and standard pharmacies. For higher-tier medications, cost-sharing transitions to coinsurance, with Tier 4 non-preferred drugs requiring 50% coinsurance and Tier 5 specialty drugs requiring 30% coinsurance.
Additional Benefits
The HealthSpring True Choice (PPO) plan offers affordable coverage for your essential medical needs, featuring no copay or coinsurance for primary care doctor visits and annual physical exams. Specialist visits, urgent care, and physical therapies are accessible with low flat copayments, while inpatient hospital stays require a daily copay of $270 for the first six days before transitioning to no copay. Emergency services are covered with a $115 copay, which is waived if you are admitted to the hospital. In addition to core medical coverage, this plan provides valuable dental, vision, and hearing benefits to help lower your out-of-pocket costs. Preventive and comprehensive dental services are available with no copay up to a $600 annual limit, while routine eye exams and eyewear are covered with minimal to no copays. Members also benefit from no copays on home health services and cardiac rehabilitation, along with a quarterly allowance for over-the-counter items.
Inpatient Hospital See details
Inpatient hospital services are covered by HealthSpring True Choice (PPO) with no coinsurance and a daily copay of $270 for days 1 through 6, followed by no copay for days 7 through 90. This benefit is partially covered, requiring prior authorization and excluding upgrades, additional days, and non-Medicare-covered stays.
Outpatient Services See details
HealthSpring True Choice (PPO) covers outpatient services with no coinsurance, featuring copays ranging from $0 to $375 for hospital services and $375 per stay for observation services. Ambulatory surgical center and blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions have no coinsurance and a $40 copay.
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 to receive these services.
Ambulance and Transportation Services See details
HealthSpring True Choice (PPO) covers ground ambulance services with a $230 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, both requiring prior authorization. While some transportation services are covered, trips to plan-approved health-related locations and any other health-related locations are not covered.
Emergency Services See details
Emergency services under the HealthSpring True Choice (PPO) are covered with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $50,000 maximum limit with a $115 copay and no coinsurance.
Primary Care See details
HealthSpring True Choice (PPO) primary care benefits feature no copay and no coinsurance for primary care physician visits, while specialist services, psychiatric care, and mental health sessions require a $40 copay and no coinsurance. Physical, occupational, and speech therapies are covered with a $35 copay and no coinsurance, whereas chiropractic and podiatry services are not covered.
Preventive Services See details
HealthSpring True Choice (PPO) provides preventive services with no copay and no coinsurance, covering annual physical exams, kidney disease education, and a fitness benefit. However, the plan's additional preventive services are only partially covered, excluding health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, remote access technologies, home safety devices, and counseling.
Hearing Services See details
Hearing services covered by HealthSpring True Choice (PPO) include routine hearing exams for a $25 copay and no coinsurance, alongside OTC hearing aids for a $399 copay and no coinsurance. Prescription hearing aids are partially covered with copayments ranging from $399 to $1,800 and 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) partially covers vision services, offering eye exams with a $0 to $40 copay and no coinsurance, though other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and no deductible, providing up to a $125 combined annual benefit for contacts, eyeglasses, frames, lenses, and upgrades.
Dental Services See details
Dental services under the HealthSpring True Choice (PPO) plan include Medicare-covered dental care for a $40 copay and no coinsurance, as well as preventive and comprehensive dental services with no copay and no coinsurance. These non-Medicare dental benefits are subject to a combined in-network and out-of-network maximum coverage limit of $600 per year.
Home Infusion bundled Services See details
Home infusion bundled services are covered by HealthSpring True Choice (PPO) with no copay, though prior authorization and step therapy apply. Covered Medicare Part B chemotherapy, radiation, and other drugs have no copay and a coinsurance of no coinsurance to 20%, while Part B insulin has a $35 copay and no coinsurance to 20% coinsurance.
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) partially covers medical equipment with no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes, all of which require prior authorization. Diabetic supplies are not covered under this plan.
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, a minimum $60 copay for therapeutic radiological services, and a $0 to $150 copay 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, though prior authorization is required.
Cardiac Rehabilitation Services See details
HealthSpring True Choice (PPO) covers Cardiac Rehabilitation Services with no copay and no coinsurance, though prior authorization is required. While some services are covered, cardiac, intensive cardiac, pulmonary, and Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
HealthSpring True Choice (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, and while a prior three-day inpatient hospital stay is not required, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
HealthSpring True Choice (PPO) partially covers other services, offering over-the-counter (OTC) items up to $45 every three months and qualifying meal benefits with no copay and no coinsurance, while acupuncture is not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved