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HealthSpring Preferred Savings (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HealthSpring Preferred Savings (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HealthSpring Preferred Savings (HMO) in 2026, please refer to our full plan details page.
HealthSpring Preferred Savings (HMO) is a HMO plan offered by Health Care Service Corporation available for enrollment in 2025 to people living in Richmond. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that HealthSpring Preferred Savings (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 Savings (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 Savings (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 $135.00. 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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $6250.00 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:
Sign up for HealthSpring Preferred Savings (HMO)
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Drug Coverage
The HealthSpring Preferred Savings (HMO) plan features no drug deductible, allowing your prescription coverage to begin immediately. For Tier 1 preferred generic drugs, you pay no copay for any supply length when using preferred pharmacies or preferred mail order. Tier 2 generic drugs cost as little as a $4 copay for a 1-month supply at preferred pharmacies, and there is no copay for a 3-month supply filled through preferred mail order. Tier 3 preferred brand drugs require a flat $47 copay for a 1-month supply across all pharmacy and mail order options. For higher-tier prescriptions, Tier 4 non-preferred drugs carry a 50% coinsurance regardless of where they are filled. Tier 5 specialty drugs require a 33% coinsurance for a 1-month supply at both preferred and standard networks.
Additional Benefits
The HealthSpring Preferred Savings (HMO) plan provides strong core medical coverage with no copay and no coinsurance for primary care doctor visits and annual preventive exams. If you require hospital care, inpatient stays require a $320 daily copay for days one through five and no copay for additional days, while outpatient services range from no copay to a $320 copay. Specialist visits require a $40 copay, and emergency room services are covered with a $130 copay that is waived upon admission. In addition to medical care, the plan features routine dental benefits with no copay up to a $1,150 annual maximum, alongside a $200 yearly allowance for eyeglasses and contacts with no copay. Routine hearing exams carry a $35 copay, while hearing aids are covered with copayments ranging from $399 to $1,800. Finally, durable medical equipment and dialysis services are covered with 20% coinsurance and no copay.
Inpatient Hospital See details
HealthSpring Preferred Savings (HMO) covers inpatient hospital services with no coinsurance, requiring a $320 daily copay for days 1 through 5 and no copay for days 6 through 90 for acute and psychiatric stays. While unlimited additional days are covered for acute care, additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
HealthSpring Preferred Savings (HMO) covers outpatient services with no coinsurance, including no copays for ambulatory surgical center and outpatient blood services. Outpatient hospital and observation services require copays ranging from $0 to $320, while outpatient substance abuse individual and group sessions carry a $40 copay.
Partial Hospitalization See details
Partial hospitalization is covered by HealthSpring Preferred Savings (HMO) with a $140.00 copay and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
HealthSpring Preferred Savings (HMO) covers ambulance services with a $245 copay and no coinsurance for ground transport, and a 20% coinsurance and no copay for air transport, with prior authorization required. For transportation benefits, some services are covered but transportation to plan-approved health-related locations and any health-related locations is not covered.
Emergency Services See details
HealthSpring Preferred Savings (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 carry a $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $130 copay and no coinsurance up to a $50,000 maximum benefit.
Primary Care See details
HealthSpring Preferred Savings (HMO) offers primary care physician services with no copay and no coinsurance, while specialist, therapy, mental health, psychiatric, and opioid treatment services require a $40 copay and no coinsurance. Additional telehealth and other healthcare professional services range from a $0 to $40 copay with no coinsurance, whereas chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive services are covered by HealthSpring Preferred Savings (HMO) with no copay and no coinsurance, including annual physical exams, kidney disease education, and fitness benefits. However, 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, smoking cessation, enhanced disease management, telemonitoring, remote access technologies, home and bathroom safety, and counseling.
Hearing Services See details
Hearing Services are partially covered by HealthSpring Preferred Savings (HMO), offering routine hearing exams and evaluations for a $35 copay and no coinsurance, alongside OTC hearing aids for a $399 copay and no coinsurance. Prescription hearing aids are covered with a copay ranging from $399 to $1,800 and no coinsurance for up to two aids per year, though inner ear, outer ear, and over the ear types are not covered.
Vision Services See details
HealthSpring Preferred Savings (HMO) offers partially covered vision services, featuring one annual routine eye exam with a $0 to $35 copay and no coinsurance, though other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and no deductible up to a $200 yearly limit for contact lenses, upgrades, and one annual pair of eyeglasses, frames, or lenses.
Dental Services See details
HealthSpring Preferred Savings (HMO) covers Medicare-covered dental services with a $40 copay and no coinsurance, subject to prior authorization. Other preventive and comprehensive dental services are covered with no copay and no coinsurance, up to a maximum annual plan benefit of $1,150.
Home Infusion bundled Services See details
HealthSpring Preferred Savings (HMO) covers home infusion bundled services with no copay and no coinsurance, although prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs feature no copay and a coinsurance ranging from no coinsurance to 20%, while Part B insulin requires a $35 copay and a coinsurance of no coinsurance to 20%.
Dialysis Services See details
Dialysis services are covered under the HealthSpring Preferred Savings (HMO) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
HealthSpring Preferred Savings (HMO) covers durable medical equipment, prosthetics, and medical supplies with no copay, 20% coinsurance, and prior authorization. Diabetic equipment is partially covered with no copay and 20% coinsurance for therapeutic shoes and inserts, but diabetic supplies are not covered.
Diagnostic and Radiological Services See details
HealthSpring Preferred Savings (HMO) covers diagnostic and radiological services, with prior authorization required for all services. Diagnostic lab services and diagnostic radiological services feature no copay and no coinsurance, while diagnostic procedures range from no copay up to a $50 copay, outpatient X-rays require a $35 copay, and therapeutic radiological services have a minimum 20% coinsurance.
Home Health Services See details
HealthSpring Preferred Savings (HMO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by HealthSpring Preferred Savings (HMO) with no coinsurance and required prior authorization, though some services are covered while standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered and require a $25 copay.
Skilled Nursing Facility (SNF) See details
HealthSpring Preferred Savings (HMO) partially covers Skilled Nursing Facility (SNF) services, as additional days beyond the Medicare-covered limit are not covered. Covered stays require no coinsurance and feature a daily copay of $10 for days 1 to 20 and $218 for days 21 to 100, with prior authorization required.
Other Services See details
HealthSpring Preferred Savings (HMO) partially covers other services, offering a meal benefit with no copay and no coinsurance for qualifying chronic illnesses or medical conditions. Acupuncture and over-the-counter (OTC) items are not covered under this plan.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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