HealthSpring Preferred (HMO)

BRAVO HEALTH PENNSYLVANIA, INC. · 2027 plan year

Plan ID H0354-028-000

HMO★ 3.5 CMS Stars
MOOP (in-network)
$3,200
MOOP (combined)
—
Monthly premium
$0/mo
Part C $0 + Part D $0
Prescription drugs
Included

This plan in 2026

Plan information

Contract / Plan / Segment
H0354-028-000
Medical deductible
$0 — no deductible
Part D premium
$0/mo (part of the monthly premium above)
Part D deductible
$500/yr
Also owed
Your Medicare Part B premium, paid separately

More BRAVO HEALTH PENNSYLVANIA, INC. plans in AZ

Benefits & cost sharing

Primary Care

BenefitIn-network
Chiropractic — Routine Care$20

Hospital

BenefitIn-network
Inpatient Hospital — Acute$250/day for days 1–7, $0 after
Inpatient Hospital — Additional Days (Acute)No charge
Inpatient Hospital — Psychiatric$250/day for days 1–7, $0 after
Worldwide Urgent Care Coverage$150

Pharmacy

BenefitIn-network
Part B DrugsSee plan details
Chemotherapy & Radiation Drugs (Part B)0%-20% coinsurance
Other Part B Drugs0%-20% coinsurance

Mental Health

BenefitIn-network
Mental Health — Individual Sessions$10
Mental Health — Group Sessions$10
Supplemental Health BenefitsSee plan details
Mental Health Specialty ServicesSee plan details

Other

BenefitIn-network
Skilled Nursing Facility (SNF)$20/day for days 1–20, $221/day for days 21–100
Cardiac Rehabilitation — Additional Sessions$10
Intensive Cardiac Rehabilitation — Additional Sessions$10
Pulmonary Rehabilitation — Additional Sessions$10
Supervised Exercise Therapy (SET)$10
Emergency Services$150
Urgently Needed Services$65
Worldwide Emergency & Urgent CoverageSee plan details
Worldwide Emergency Coverage$150
Worldwide Emergency Transportation20% coinsurance
Partial Hospitalization Program$190
Intensive Outpatient Program (IOP)$190
Home Health ServicesNo charge
Primary Care Physician ServicesNo charge
Chiropractic Services$20
Chiropractic ServicesSee plan details
Occupational Therapy Services$15
Physician Specialist Services$10
Podiatry Services$10
Podiatry Services$10
Other Health Care Professional Services$0-$10
Psychiatric ServicesSee plan details
Psychiatric Services — Individual Sessions$10
Psychiatric Services — Group Sessions$10
Physical Therapy & Speech-Language Pathology$15
Additional Telehealth Services (Part B)$0-$15
Opioid Treatment Program Services$10
Diagnostic Tests & Lab ServicesSee plan details
Diagnostic Procedures & TestsNo charge
Laboratory Services0%-20% coinsurance
Radiological ServicesSee plan details
Diagnostic Radiology$0-$150
X-Ray Services$10
Outpatient Hospital Services$0-$225
Hospital Observation Services$225 per stay
Ambulatory Surgical Center (ASC)$0-$175
Outpatient Substance Abuse ServicesSee plan details
Substance Abuse — Individual Sessions$10
Substance Abuse — Group Sessions$10
Outpatient Blood ServicesNo charge
Ambulance ServicesSee plan details
Ground Ambulance$250
Air Ambulance20% coinsurance
Durable Medical Equipment (DME)20% coinsurance
Prosthetics & OrthoticsSee plan details
Prosthetic Devices20% coinsurance
Medical Supplies20% coinsurance
Diabetic Supplies & ServicesSee plan details
Diabetic Therapeutic Shoes & Inserts20% coinsurance
Diabetic Monitors0%-20% coinsurance
Dialysis Services20% coinsurance
Meal BenefitNo charge
Annual Physical ExamNo charge
Fitness BenefitNo charge
Kidney Disease Education ServicesNo charge
Glaucoma ScreeningNo charge
Diabetes Self-Management TrainingNo charge
Digital Rectal ExamsNo charge
Welcome to Medicare EKGNo charge
Insulin (Part B)0%-20% coinsurance (max $35)
Dental — Medicare-Covered Services$10
Dental — PreventiveSee plan details
Dental — Oral ExamsNo charge
Dental — X-RaysNo charge
Dental — Diagnostic ServicesNo charge
Dental — Prophylaxis (Cleaning)No charge
Dental — Fluoride TreatmentNo charge
Dental — Other Preventive ServicesNo charge
Dental — ComprehensiveSee plan details
Dental — Restorative ServicesNo charge
Dental — Endodontics (Root Canal)No charge
Dental — Periodontics (Gum Care)No charge
Dental — Removable Prosthodontics (Dentures)No charge
Dental — Maxillofacial ProstheticsNo charge
Dental — Implant ServicesNo charge
Dental — Fixed Prosthodontics (Bridges)No charge
Dental — Oral & Maxillofacial SurgeryNo charge
Dental — OrthodonticsNo charge
Dental — Adjunctive General ServicesNo charge
Vision — Eye Exams$0-$10
Vision — Routine Eye ExamsNo charge
Vision — EyewearNo charge
Vision — EyewearSee plan details
Vision — Contact LensesNo charge
Vision — Eyeglasses (Lenses & Frames)No charge
Vision — Eyeglass LensesNo charge
Vision — Eyeglass FramesNo charge
Vision — Eyewear UpgradesNo charge
Hearing — Exams$10
Hearing — ExamsSee plan details
Hearing — Routine ExamsNo charge
Hearing — Fitting & Evaluation for Hearing AidNo charge
Hearing — Prescription Hearing AidsSee plan details
Hearing — Hearing Aids (All Types)$399-$1,800
Hearing — OTC Hearing Aids$399
Cardiac & Pulmonary RehabilitationSee plan details
Therapeutic Radiology20% coinsurance
Diabetic Supplies0%-20% coinsurance
Medicare-Covered Preventive ServicesSee plan details
Vision — Eye ExamsSee plan details

Service area

  • AZ: 3 counties

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