Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026

HealthSpring TotalCare, 2027

H4513Contract060Plan

HMO D-SNP · special needs plan, dual-eligible · 39 counties in Texas

Run by HealthSpring Life & Health Insurance Company, Inc. (contract H4513), sold as HealthSpring, owned by Health Care Service Corporation

Renews, split 3 ways

2026 star rating, contract H4513: 4.5 of 5

HealthSpring TotalCare (H4513-060) costs $0 a month in 2027, the same as in 2026, with an in-network out-of-pocket limit of $9,850 ($3,400 to $3,450 in 2026). Some of its 2026 members move to H4513-104, H4513-105 instead (CMS crosswalk).

What changes from 2026 to 2027?

The changed lines are marked and come first. In-network amounts; members keep paying the Part B premium unless the plan reduces it. The plan files its benefits in parts for different counties, so lines marked ◆ show the most generous part of its area and some counties get less: the plan's Evidence of Coverage gives your county's amounts.
What you pay or get	2026	2027	Change
In-network out-of-pocket limit, by county	$3,400 to $3,450	$9,850	up $6,400 at the top
Drug deductible	$615	$300	down $315
Emergency room (best in its area)	$150 copay	$115 copay	down $35
Hospital stay, in network (best in its area)	$0 a stay	$280 a day for days 1–6, then $0 a day for days 7–90	up $1,400for a 5-day stay
Skilled nursing facility, in network (best in its area)	$20 a day for days 1–20, then $218 a day for days 21–100	$0 a day for days 1–20, then $221 a day for days 21–100	down $370for a 30-day stay
Ground ambulance, in network (best in its area)	$100 copay	20% of the cost	changed
Eyewear, yearly limit (best in its area)	$400 a year	$300 a year	down $100
Over-the-counter items, yearly (best in its area)	$1,000 a year	$200 a year	down $800
Drug tier 1, preferred generic	$5	$4	down $1
Drug tier 2, generic	$10	$5	down $5
Drug tier 3, preferred brand	24% of the cost	16% of the cost	down 8 points
Drug tier 5, specialty tier	25% of the cost	30% of the cost	up 5 points
9 lines do not change
Monthly premium	$0	$0	no change
Part B premium reduction, monthly (best in its area)	none	none	no change
Primary care visit (best in its area)	$0 copay	$0 copay	no change
Specialist visit (best in its area)	$0 copay	$0 copay	no change
Medical deductible, in network (best in its area)	none	none	no change
Comprehensive dental, yearly limit (best in its area)	not offered	not offered	no change
Hearing aids, yearly limit for both ears (best in its area)	not offered	not offered	no change
Counties served	39	39	no change
Drug tier 4, non-preferred drug	25% of the cost	25% of the cost	no change

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS plan benefit package files, 2027 and 2026; CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026). Plan details can change during the year; confirm on Medicare Plan Finder.

What will prescriptions cost?

Your share for a 30-day supply at a retail pharmacy, as filed with CMS; tiers whose share changes are marked. The plan charges less at its preferred pharmacies
Tier	What the tier holds	2026, standard pharmacy	2027, standard pharmacy	2027, preferred pharmacy
Tier 1	Preferred Generic	$5	$4	$0
Tier 2	Generic	$10	$5	$0
Tier 3	Preferred Brand	24% of the cost	16% of the cost	16% of the cost
Tier 4	Non-Preferred Drug	25% of the cost	25% of the cost	25% of the cost
Tier 5	Specialty Tier	25% of the cost	30% of the cost	30% of the cost

Source: CMS plan benefit package files, 2027 and 2026. Insulin is capped at $35 a month by law. A drug's tier is set by the plan's formulary.

How does it compare with plans sold where it is?

In the counties it serves, 83 dual-eligible special needs plans are sold for 2027, this one included. Against the others, 8 plans have a lower out-of-pocket limit, 74 the same. On the premium, 76 the same, 6 a higher one.

Out-of-pocket limits of the 83 dual-eligible special needs plans

$0 to under $2,0000 plans

$2,000 to under $4,0003 plans

$4,000 to under $6,0003 plans

$6,000 to under $8,0000 plans

$8,000 to $10,000 (this plan)77 plans

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).

Where is it sold, and what does it cost there?

The premium and the out-of-pocket limit are the same in all 39 counties: $0 a month and $9,850.

Texas

Angelina Atascosa Bandera Bexar Brazoria Cameron Chambers Collin Comal Dallas Denton El Paso Fort Bend Galveston Guadalupe Hardin Harris Hidalgo Hood Jasper Jefferson Johnson Kendall Liberty Medina Montgomery Nacogdoches Orange Parker Polk San Jacinto Tarrant Tyler Walker Waller Webb Willacy Wilson Wise

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).

Where do its 2026 members go?

The CMS crosswalk moves the members of the 2026 plan into 3 plans for 2027. It names the plans but not which member goes to which; the counties show where each 2027 plan is sold, and the plan's Annual Notice of Change says which one is yours.

2027 plan	Sold in	Members in those counties, Sept. 2026	Premium 2027	Limit 2027
Stays in this plan	39 of its 39 2026 counties, in Texas	27,327	$0	$9,850
HealthSpring TotalCare PlusH4513-104	9 of its 39 2026 counties, in Texas	4,939	$0	$9,850
HealthSpring TotalCare PlusH4513-105	30 of its 39 2026 counties, in Texas	22,388	$0	$9,850

Where the plans are sold in the same counties, the member counts overlap, so they add up to more than the plan's members.

Source: CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026); CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11).

Who runs this plan?

Plan ID: H4513-060
Legal name of the contract: HealthSpring Life & Health Insurance Company, Inc.
Sold as: HealthSpring
Parent company: Health Care Service Corporation
Plan type: HMO D-SNP
2026 star rating of the contract: 4.5 of 5 overall; health plan 4.5 of 5, drug plan 3.5 of 5
Members, September 2026: 27,395
Plan website, as filed with CMS: HealthSpringMedicare.com

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS 2026 Star Ratings (October 2025); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11). CMS publishes the 2027 Star Ratings in October 2026.

What else should you check?

Other 2027 plans in Hidalgo, TXWhere most of its members live; premiums and limits side by side
Every HealthSpring plan for 2027Its contracts, counties and plans that end
The other 49 plans of contract H4513Same company, same contract
Is your prescription covered?Coverage share and tier for 2,259 drugs

Data, not advice. These are the plan's filed amounts, not a quote for you; confirm on Medicare Plan Finder or call the plan before you enroll.