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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 Tennessee. 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 $12000.00 (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 $12000.00 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. Tier 2 generic drugs are also highly affordable, starting at a $5 copay for a one-month supply at preferred pharmacies, while standard pharmacies charge higher copays for both tiers. Tier 3 preferred brand drugs carry a flat $47 copay for a one-month supply across all pharmacy and mail-order options. Higher-tier medications require coinsurance instead of copays, with Tier 4 non-preferred drugs requiring 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 a focus on predictable copayments and no coinsurance for many key services. Members benefit from no copay for primary care visits, preventive services, and home health care, while specialist visits and outpatient therapies require a moderate copayment. Inpatient hospital stays, emergency care, and skilled nursing facility services are also covered, though daily copays apply for the initial days of care. For supplemental care, the plan provides dental and vision benefits with no copay up to specified annual limits, alongside routine hearing coverage. Diagnostic lab tests and home infusion services are also available with no copay, while dialysis, durable medical equipment, and Part B drugs generally carry a 20% coinsurance. This plan balances robust routine coverage with structured cost-sharing for major medical needs to help manage your healthcare expenses.
Inpatient Hospital See details
HealthSpring True Choice (PPO) partially covers inpatient hospital services with no coinsurance, though upgrades, additional days, and non-Medicare-covered stays are not covered. For Medicare-covered acute stays, there is a $375 copay per day for days 1 through 6 and no copay for days 7 through 90, while psychiatric stays require a $340 copay per day for days 1 through 6 and no copay for days 7 through 90.
Outpatient Services See details
HealthSpring True Choice (PPO) covers outpatient services with no coinsurance, featuring a $0 to $375 copay for outpatient hospital services and a $375 copay per stay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay, while 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. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
HealthSpring True Choice (PPO) covers ground ambulance services with a $270 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required for both. Transportation services to health-related locations are not covered under 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 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) features primary care physician services with no copay and no coinsurance, while specialist, psychiatric, mental health, and opioid treatment services require a $40 copay and no coinsurance. Physical, occupational, and speech therapies cost a $35 copay with no coinsurance, telehealth ranges from no copay to a $40 copay with no coinsurance, and chiropractic and podiatry services are not covered.
Preventive Services See details
HealthSpring True Choice (PPO) preventive services are partially covered with no copay and no coinsurance for covered benefits like annual physical exams, kidney disease education, and fitness benefits. Uncovered services under this plan include health education, personal emergency response systems, nutritional therapy, and in-home safety assessments.
Hearing Services See details
HealthSpring True Choice (PPO) covers annual routine hearing exams and fitting evaluations for a $20 copay and no coinsurance, and OTC hearing aids for a $399 copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $399 to $1,800, but inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
HealthSpring True Choice (PPO) partially covers vision services, as other eye exam services are not covered. Routine eye exams are covered with a $0 to $40 copay and no coinsurance, while eyewear is available with no copay and no coinsurance up to a $175 yearly limit for contacts, frames, lenses, and upgrades.
Dental Services See details
HealthSpring True Choice (PPO) covers Medicare-covered dental services with a $40 copay and no coinsurance, while other preventive and comprehensive dental services have no copay and no coinsurance. These dental benefits, which include cleanings, exams, x-rays, implants, and orthodontic services, are subject to a combined annual maximum of $650 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, though prior authorization is required. Medicare Part B chemotherapy and other drugs require between no coinsurance and 20% coinsurance, while Part B insulin drugs carry a $35 copay and between no coinsurance and 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under HealthSpring True Choice (PPO) with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
HealthSpring True Choice (PPO) partially covers medical equipment, offering covered items like durable medical equipment, prosthetics, and diabetic therapeutic shoes with no copay and a 20% coinsurance. Prior authorization is required for these benefits, and 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. There is no copay for lab services, while outpatient X-rays require a $50 copay, therapeutic radiological services start at a $60 copay, and diagnostic procedures range from no copay to a $150 copay.
Home Health Services See details
Home health services are covered under the HealthSpring True Choice (PPO) plan with no copay and no coinsurance. Prior authorization is required to receive these benefits.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are not covered under the HealthSpring True Choice (PPO) plan, as cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services are all excluded from coverage.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is partially covered by HealthSpring True Choice (PPO), with additional days beyond the Medicare-covered limit not covered. This benefit requires prior authorization and features no coinsurance, with no copay for days 1 through 20 and a $218 daily copay for days 21 through 100.
Other Services See details
HealthSpring True Choice (PPO) partially covers other services, offering over-the-counter (OTC) items and a meal benefit with no copay and no coinsurance, while acupuncture is not covered. Eligible members receive up to $35 every three months for OTC items and access to a limited-duration meal benefit for chronic illness or homebound recovery.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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