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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 TX. 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 a $250 drug deductible and offers significant savings on generic medications. For Tier 1 preferred generics, you will pay no copay when using a preferred pharmacy or preferred mail-order service, while standard options charge a $10 copay for a one-month supply. Tier 2 generic drugs cost as little as a $5 copay for a one-month supply at preferred locations, with no copay required for a three-month supply filled through preferred mail order. For brand-name and specialty medications, the plan utilizes a mix of flat copays and coinsurance. Tier 3 preferred brands carry a $47 copay for a one-month supply at both preferred and standard pharmacies. Tier 4 non-preferred drugs require a 50% coinsurance, while Tier 5 specialty drugs require a 30% coinsurance for a one-month supply across all pharmacy networks.
Additional Benefits
The HealthSpring True Choice (PPO) plan offers comprehensive medical coverage with no copay for primary care doctor visits and preventive services, while specialist visits require a $40 copay. Inpatient hospital stays require a $230 daily copay for the first six days of acute care with no coinsurance, and emergency room visits carry a $115 copay that is waived if you are admitted. Outpatient services and diagnostic lab tests are highly affordable, with many services requiring no copay or low flat copayments. For extra wellness benefits, this plan provides preventive and comprehensive dental care with no copay up to a $600 annual limit, alongside routine vision exams and a $100 yearly eyewear allowance. Beneficiaries also enjoy routine hearing exams for a $30 copay and coverage for hearing aids starting at a $399 copay. Additionally, skilled nursing facility stays feature no copay for the first 20 days, and home health services are covered with no copay and no coinsurance.
Inpatient Hospital See details
HealthSpring True Choice (PPO) covers inpatient hospital services with no coinsurance, but requires a $230 daily copay for days 1 to 6 of acute stays and a $255 daily copay for days 1 to 6 of psychiatric stays, followed by no copay for days 7 through 90. This benefit is partially covered, as upgrades, additional days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
HealthSpring True Choice (PPO) covers outpatient services with no coinsurance, offering ambulatory surgical center and blood services with no copay. Outpatient hospital services require a copay of $0 to $375, observation services have a $375 copay per stay, and outpatient substance abuse sessions carry a $40 copay.
Partial Hospitalization See details
HealthSpring True Choice (PPO) covers partial hospitalization with a $105.00 copay and no coinsurance. Prior authorization is required to receive this covered benefit.
Ambulance and Transportation Services See details
HealthSpring True Choice (PPO) covers ambulance services with prior authorization, requiring a $275 copay and no coinsurance for ground services, and a 20% coinsurance with no copay for air services. 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, 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 with a $115 copay and no coinsurance.
Primary Care See details
HealthSpring True Choice (PPO) covers primary care physician services with no copay and no coinsurance, while specialist visits, psychiatric, and mental health services require a $40 copay and no coinsurance. Physical, occupational, and speech therapy services carry a $35 copay with no coinsurance, whereas chiropractic and podiatry services are not covered.
Preventive Services See details
HealthSpring True Choice (PPO) offers partial coverage for preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, select screenings, and physical and memory fitness benefits. However, several supplemental benefits such as health education, weight management programs, and in-home safety assessments are not covered under this plan.
Hearing Services See details
HealthSpring True Choice (PPO) provides hearing services with a $30 copay and no coinsurance for annual routine hearing exams and fittings. The plan also covers up to two OTC hearing aids per year for a $399 copay and no coinsurance, as well as up to two prescription hearing aids for a $399 to $1,800 copay and no coinsurance, though prescription inner ear, outer ear, and over-the-ear models are not covered.
Vision Services See details
Vision services are partially covered by HealthSpring True Choice (PPO), which features routine eye exams with a $0 to $40 copay, no coinsurance, and no deductible, while other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and no deductible, up to a combined maximum benefit of $100 per year for contacts, eyeglasses, frames, lenses, and upgrades.
Dental Services See details
HealthSpring True Choice (PPO) covers dental services with a $40 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for other preventive and comprehensive dental benefits. These other dental services 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
Home infusion bundled services are covered by HealthSpring True Choice (PPO) with no copay, although prior authorization and step therapy are required. Covered Medicare Part B chemotherapy and other drugs require no copay and up to 20% coinsurance, while Part B insulin has a $35 copay and up to 20% coinsurance.
Dialysis Services See details
HealthSpring True Choice (PPO) covers Dialysis Services with no copay, but a 20% coinsurance is required. Prior authorization is also required for these services.
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 or inserts. Diabetic supplies are not covered under this plan, and prior authorization is required for covered medical equipment.
Diagnostic and Radiological Services See details
HealthSpring True Choice (PPO) covers diagnostic and radiological services with no coinsurance, though prior authorization is required. Lab services have no copay, outpatient X-rays require a $50 copay, therapeutic radiological services have a minimum copay of $60, and diagnostic tests and radiological services have copays starting at $0.
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 some cardiac rehabilitation services with no copay and no coinsurance, although prior authorization is required. While some services are covered, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are 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 for these services, and any additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
HealthSpring True Choice (PPO) partially covers other services, offering meal benefits and over-the-counter (OTC) items up to $40 every three months with no copay and no coinsurance. Acupuncture is not covered under this benefit.
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