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HealthSpring Preferred Select (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HealthSpring Preferred Select (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HealthSpring Preferred Select (HMO) in 2026, please refer to our full plan details page.
HealthSpring Preferred Select (HMO) is a HMO plan offered by Health Care Service Corporation available for enrollment in 2025 to people living in Charlotte/Triad/Triangle. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that HealthSpring Preferred Select (HMO) 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 Preferred Select (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 Preferred Select (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 $5.00. 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.
This plan has a $295.00 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 Maximum Out-Of-Pocket cost of $3200.00 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
The HealthSpring Preferred Select (HMO) plan features an annual prescription drug deductible of $295. For Tier 1 preferred generic drugs, you will pay no copay when using a preferred pharmacy or preferred mail-order service, while standard options require a $10 copay for a one-month supply. Tier 2 generic medications cost as little as a $4 copay for a one-month supply at preferred locations, or no copay for a three-month supply filled through preferred mail order. Tier 3 preferred brand drugs require a flat copay of $47 for a one-month supply across all pharmacy and mail-order options. For higher-tier medications, Tier 4 non-preferred drugs carry a 50% coinsurance, and Tier 5 specialty drugs require a 29% coinsurance for a one-month supply.
Additional Benefits
The HealthSpring Preferred Select (HMO) plan offers robust medical coverage, featuring no copay and no coinsurance for primary care visits, annual physical exams, and home health services. For inpatient hospital stays, members pay a $275 daily copay for days one through five, followed by no copay for additional days. Outpatient and emergency services are also highly affordable, with emergency visits requiring a $150 copay that is waived if admitted, and many diagnostic lab services requiring no copay. In addition to medical care, the plan provides valuable supplemental benefits including preventive dental care and eyewear up to a $250 annual maximum with no copay or coinsurance. Routine hearing exams are available for a $15 copay, and qualifying members can access a quarterly $135 over-the-counter item allowance with no copay. While most covered services feature no coinsurance, select benefits like dialysis and medical equipment require a 20% coinsurance.
Inpatient Hospital See details
HealthSpring Preferred Select (HMO) covers inpatient acute hospital stays with no coinsurance, featuring a $275 copay for days 1 through 5 and no copay for days 6 and beyond, though upgrades and non-Medicare-covered stays are not covered. Inpatient psychiatric hospital stays are also covered with no coinsurance, requiring a $595 copay for days 1 through 3 and no copay for days 4 through 90, while additional psychiatric days are not covered.
Outpatient Services See details
HealthSpring Preferred Select (HMO) covers outpatient services with no coinsurance, featuring a $0 to $275 copay for outpatient hospital services and a $275 copay per stay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions require a $15 copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization services are covered by HealthSpring Preferred Select (HMO) with a $175 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by HealthSpring Preferred Select (HMO), with ground ambulance services requiring a $270 copay and no coinsurance, and air ambulance services requiring a 20% coinsurance and no copay. Prior authorization is required for ambulance services, and though some transportation services are covered, transportation to plan-approved health-related locations and any health-related locations is not covered.
Emergency Services See details
HealthSpring Preferred Select (HMO) covers emergency services with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $65 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $50,000 maximum with a $150 copay and no coinsurance.
Primary Care See details
HealthSpring Preferred Select (HMO) provides primary care physician services with no copay and no coinsurance, while specialist, therapy, and mental health services generally feature a $15 copay and no coinsurance. Chiropractic services are partially covered with a $20 copay and no coinsurance, though routine chiropractic care and podiatry services are not covered.
Preventive Services See details
HealthSpring Preferred Select (HMO) covers preventive services, including annual physical exams and kidney disease education, with no copay and no coinsurance. Additional preventive benefits are only partially covered, excluding services like health education, weight management, in-home support, nutritional therapy, and counseling. Covered supplemental benefits include physical and memory fitness programs as well as caregiver respite care.
Hearing Services See details
HealthSpring Preferred Select (HMO) covers routine hearing exams and fitting evaluations with a $15 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 prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered by HealthSpring Preferred Select (HMO) with no deductibles, offering annual routine eye exams with a $0 to $20 copay and no coinsurance, though other eye exam services are not covered. Eyewear is also covered with no deductible, no copay, and no coinsurance up to a $250 annual maximum for contacts, glasses, and upgrades.
Dental Services See details
Dental Services are partially covered by HealthSpring Preferred Select (HMO), with maxillofacial prosthetics, implant services, and orthodontics excluded from coverage. Preventive services feature no copay and no coinsurance, while other covered dental services require copays ranging up to $675 and no coinsurance, up to a $20,000 annual maximum.
Home Infusion bundled Services See details
HealthSpring Preferred Select (HMO) covers home infusion bundled services with no copay, although prior authorization and step therapy are required. Associated Medicare Part B chemotherapy, radiation, and other drugs carry no coinsurance to 20% coinsurance, while Part B insulin has a $35 copay and up to 20% coinsurance.
Dialysis Services See details
HealthSpring Preferred Select (HMO) covers dialysis services with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Medical equipment covered by HealthSpring Preferred Select (HMO) features no copay and a 20% coinsurance, with prior authorization required. This benefit is partially covered, as durable medical equipment, prosthetics, and diabetic therapeutic shoes are covered, but diabetic supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by HealthSpring Preferred Select (HMO) with prior authorization required, featuring no coinsurance and a $0 to $20 copay for diagnostic tests, and no copay for lab services. Outpatient X-rays have no copay but require coinsurance, while diagnostic radiological services have a $0 minimum copay and therapeutic radiological services carry a copay and a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by HealthSpring Preferred Select (HMO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the HealthSpring Preferred Select (HMO) plan, including intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD). Because these services are not covered, members do not have benefits or cost-sharing options for them under this plan.
Skilled Nursing Facility (SNF) See details
HealthSpring Preferred Select (HMO) partially covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a $20 daily copay for days 1 to 20, a $218 daily copay for days 21 to 60, and no copay for days 61 to 100. Prior authorization is required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
HealthSpring Preferred Select (HMO) partially covers other services, offering a meal benefit and over-the-counter (OTC) items with no copay and no coinsurance, while acupuncture is not covered. The OTC benefit provides up to $135 every three months for select items, and the meal benefit is available at no cost for members with qualifying chronic or medical conditions.
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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.
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