A non-government entity
HealthSpring Courage (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HealthSpring Courage (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HealthSpring Courage (HMO) in 2026, please refer to our full plan details page.
HealthSpring Courage (HMO) is a HMO plan offered by Health Care Service Corporation available for enrollment in 2025 to people living in North Carolina. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that HealthSpring Courage (HMO) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about HealthSpring Courage (HMO).
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 Courage (HMO), 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. Additionally, this plan comes with a Part B Premium reduction of $115.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $6750.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
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
Prescription drugs are not covered by HealthSpring Courage (HMO).
Additional Benefits
The HealthSpring Courage (HMO) Medicare plan offers comprehensive coverage with predictable out-of-pocket costs for essential medical services. Members enjoy no copay and no coinsurance for primary care visits, while specialist visits require a $50 copay with no coinsurance. Emergency room visits have a $130 copay, which is waived if admitted, and outpatient hospital services range from no copay to a $300 copay. For supplemental care, the plan features no copay and no coinsurance for preventive and comprehensive dental services up to a $1,000 annual limit, as well as no copay for eyewear up to a $100 annual limit. Routine hearing exams carry a $25 copay, while home health services are covered with no copay and no coinsurance. Inpatient acute hospital stays require a $300 daily copay for the first seven days, with no copay required for day eight and beyond.
Inpatient Hospital See details
HealthSpring Courage (HMO) covers inpatient hospital services with no coinsurance, though prior authorization is required. Acute care requires a $300 daily copay for days 1-7 and no copay for days 8 and beyond, while psychiatric care requires a $595 daily copay for days 1-3 and no copay for days 4-90; upgrades and non-Medicare-covered stays are not covered.
Outpatient Services See details
HealthSpring Courage (HMO) covers outpatient services with no coinsurance, including outpatient hospital services with a $0 to $300 copay and observation services with a $300 copay per stay. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions require a $50 copay.
Partial Hospitalization See details
HealthSpring Courage (HMO) covers partial hospitalization services with a $140.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
HealthSpring Courage (HMO) covers ambulance services with prior authorization, requiring a $270 copay and no coinsurance for ground ambulance services, and a 20% coinsurance and no copay for air ambulance services. Transportation services are not covered under this plan.
Emergency Services See details
HealthSpring Courage (HMO) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $50,000 maximum limit with a $130 copay and no coinsurance.
Primary Care See details
HealthSpring Courage (HMO) provides primary care physician services with no copay and no coinsurance, and specialist visits with a $50 copay and no coinsurance. Physical, occupational, and speech therapy require a $45 copay and no coinsurance, whereas chiropractic services are partially covered for a $15 copay and no coinsurance (routine and other chiropractic services are not covered), and podiatry is not covered.
Preventive Services See details
Preventive services under HealthSpring Courage (HMO) are partially covered with no copay and no coinsurance for covered services like annual physicals, kidney disease education, caregiver support, and fitness benefits. However, the plan does not cover health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, chemotherapy wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, smoking cessation counseling, disease management, telemonitoring, remote access, home/bathroom safety modifications, and counseling.
Hearing Services See details
HealthSpring Courage (HMO) covers routine hearing exams and fittings with a $25 copay and no coinsurance, and OTC hearing aids with a $399 copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $399 to $1,800, though inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
HealthSpring Courage (HMO) vision services include partially covered eye exams, offering one routine exam per year with a $0 to $50 copay and no coinsurance, while other eye exam services are not covered. Eyewear is covered with no copay and no coinsurance up to a $100 combined annual limit for contacts, lenses, and frames.
Dental Services See details
HealthSpring Courage (HMO) covers dental services with no copay and no coinsurance for preventive and comprehensive care, including exams, cleanings, and implants, up to a $1,000 annual maximum. Medicare-covered dental services are also available for a $50 copay and no coinsurance, subject to prior authorization.
Home Infusion bundled Services See details
Home infusion bundled services are covered by HealthSpring Courage (HMO) with no copay and require prior authorization. Under this benefit, Medicare Part B drugs—including chemotherapy, radiation, and insulin—have a coinsurance ranging from no coinsurance to 20%, with insulin drugs also requiring a $35 copay.
Dialysis Services See details
Dialysis Services are covered under the HealthSpring Courage (HMO) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical equipment is covered by HealthSpring Courage (HMO) with no copays, but prior authorization is required. Durable medical equipment, prosthetics, and medical supplies are covered with a 15% coinsurance, while diabetic equipment is partially covered, excluding diabetic supplies but covering therapeutic shoes and inserts at a 20% coinsurance.
Diagnostic and Radiological Services See details
HealthSpring Courage (HMO) covers diagnostic and radiological services with prior authorization, offering no copay for lab services and outpatient X-rays, and no coinsurance for diagnostic tests. Diagnostic procedures carry a copay of $0 to $95, while therapeutic radiological services require a copay and a minimum 20% coinsurance.
Home Health Services See details
HealthSpring Courage (HMO) covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
HealthSpring Courage (HMO) covers cardiac rehabilitation services with no coinsurance and a $25 copay, with prior authorization required. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
HealthSpring Courage (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a daily copay of $10 for days 1 to 20, $218 for days 21 to 60, and no copay for days 61 to 100. Prior authorization is required, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by HealthSpring Courage (HMO), which offers a meal benefit with no copay and no coinsurance for eligible medical conditions. Acupuncture and over-the-counter (OTC) items are not covered under this benefit.
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