HealthSpring Preferred (HMO) Medicare Advantage Plan H7020-011-3 • 2026
This Medicare Advantage HMO plan, identified by CMS Plan ID H7020-011-3, is offered by HealthSpring for the 2026 plan year. The plan uses a Health Maintenance Organization (HMO) provider network and comes with Part D prescription drug coverage.
HealthSpring Preferred Overview
Plan Overview for
H7020-011-3
|
|
|---|---|
| CMS Plan ID: |
H7020-011-3
|
| Plan Type: | HMO |
| Plan Year: | 2026 |
| Monthly Premium: |
$0.00
Plus your Medicare Part B premium. |
| Medical Deductible: | $0.00 |
| Maximum Out-of-Pocket: | $4250.00 (In-Network) |
| Part B Give Back: | Not offered |
| Prescription Drug Coverage: | Enhanced, $395.00 deductible |
| Additional Benefits: | Dental, Vision, Hearing |
| Service Area: | See List |
| Enrollment (Nationwide): | 6,509 beneficiaries |
| Provided By: | HealthSpring |
Plan Availability
HealthSpring Preferred (H7020-011-3) is available in the following locations (click to open):
Plan Details for HealthSpring Preferred
With a monthly premium of $0.00, HealthSpring Preferred is a Medicare Advantage HMO plan that includes hospital, medical, and prescription drug coverage under Medicare Parts A and B. Services are generally covered when received from in-network providers, except in emergency situations. The annual Part D deductible is $395.00.
Primary care visits have a $0 copay, specialist visits come with a $25 copay, urgent care services carry a $50 copay, and ambulance transportation is $270 copay. These costs apply toward the maximum out-of-pocket (MOOP) limit of $4250.00. Once this limit is reached, in-network services are fully covered for the remainder of the year.
This plan is listed by CMS under Plan ID H7020-011-3. Cost-sharing details are provided below.
Cost Sharing Expenses
HealthSpring Preferred has cost-sharing, meaning there are out-of-pocket costs when receiving covered healthcare services. The table below details the most common in-network out-of-pocket expenses for plan H7020-011-3.
Certain preventive services are covered 100% by HealthSpring Preferred as a Part B benefit.
Prescription Drug Coverage
HealthSpring Preferred includes a Medicare Part D prescription drug plan (PDP). Plan type and coverage level are defined by CMS and may vary between basic and enhanced benefit designs.
This plan includes an enhanced benefit Medicare Part D plan (PDP), providing coverage beyond the standard CMS-defined minimum.
Prescription Drug Plan Premium
The Part D prescription drug plan premium is included in the overall Medicare Advantage plan cost. Additional adjustments may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help, administered by Social Security. LIS benefits are separate from Medicare Advantage coverage.
| Basic Part D Premium: | $0.00 |
|---|---|
| Supplemental Part D Premium: | $0.00 |
| Total Part D Premium: | $0.00 |
| Low-Income Premium Subsidy: | $35.66 |
| Low-Income Premium Subsidy Paid by CMS: | $0.00 |
| Low-Income Subsidy Premium: | $0.00 |
For more details, visit the Social Security Extra Help program.
Prescription Drug Plan Deductible
This plan has a $395.00 annual Part D deductible. You'll pay this deductible at the pharmacy before HealthSpring starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, HealthSpring Preferred may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Preferred Generic | $0.00 copay | Coming soon |
| Generic | $4.00 copay | Coming soon |
| Preferred Brand | $47.00 copay | Coming soon |
| Non-Preferred Drug | 50% coinsurance | Coming soon |
| Specialty Tier | 28% coinsurance | Coming soon |
| *Deductible does not apply. | ||
CMS Star Ratings
The Centers for Medicare & Medicaid Services (CMS) rates Medicare Advantage (Part C) and Part D prescription drug plans each year using a 5-star system. These ratings measure plan performance in areas such as preventive care, management of chronic conditions, and member experience.
| CMS Measure | Star Rating |
|---|---|
| 2026 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
Is there a monthly premium for this plan in 2026?
For 2026, the monthly premium is $0.00. Medicare Part B premiums apply in addition to this amount.
What is the MOOP for HealthSpring Preferred in 2026?
The annual in-network MOOP is $4250.00 for 2026. After this limit is reached, covered in-network services are fully paid.
What is the star rating for plan H7020-011-3 in 2026?
CMS rates this plan at ★4.0 out of 5 stars for 2026.
What is the current enrollment for HealthSpring Preferred?
CMS reports 6,509 beneficiaries enrolled in this plan.
Is there a Part D deductible for this plan?
The Part D deductible is $395.00.
Contact Information for HealthSpring
| Contact Type | Details |
|---|---|
| Website: | HealthSpring Plan Page |
| New Members: | 1-866-617-8713 |
| Existing Members: | 1-800-668-3813 |
| Plan Address: | Attn: Member Services | P.O. Box 2888 | Houston, TX 77252 |
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at medicare.gov.
| Data Source | Publisher | Last Accessed |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | September 8, 2026 |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | September 8, 2026 |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | September 8, 2026 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | September 8, 2026 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| HealthSpring (official source) | http://www.healthspring.com/ | October 13, 2025 |
| Medicare.gov | Compare types of Medicare Advantage Plans | 25 May, 2025 |
| NCOA.org | 5 Steps to Choosing the Right Medicare Plan for You | 25 May, 2025 |
| Medicare.gov | Compare Original Medicare & Medicare Advantage | 25 May, 2025 |
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