HealthSpring TotalCare Plus (HMO D-SNP) in Clay County, Tennessee — 2026 plan details

Last updated Jul 18, 2026

Reviewed by Jason Burns, Editorial Steward

Published by Senior Direct Answers · Licensed under Citation License 1.0

HealthSpring TotalCare Plus (HMO D-SNP) (H4513-034) is a $0-premium Medicare Advantage HMO D-SNP from Health Care Service Corporation available in Clay County, Tennessee in 2026, with a 4.0-star overall rating, a $9,250 in-network out-of-pocket maximum, and a $615 annual Part D drug deductible.

Plan facts (CMS CY2026 Landscape file)

OrganizationHealth Care Service Corporation
Plan nameHealthSpring TotalCare Plus (HMO D-SNP)
Contract IDH4513
Plan ID034
Segment ID0
Contract year2026
Contract categorySNP
Plan typeHMO D-SNP
SNPYes — Dual-Eligible
Monthly consolidated premium$0.00
Part C premium$0.00
Part D basic premium$0.50
Part D total premium$0.00
Annual Part D deductible$615.00
Maximum out-of-pocket (in-network)$9250.00
Overall star rating4.0

How this plan is structured

  • $0 consolidated premium. A $0 or near-$0 consolidated premium does not remove the Part B premium — the standard 2026 Part B premium is $202.90 per month and still applies. See the 2026 Medicare Part B premium.
  • HMO D-SNP plan type. In an HMO-style Medicare Advantage plan, in-network care and primary-care referral rules generally apply. See how Medicare Advantage HMO and PPO plans differ.
  • $9,250 in-network out-of-pocket maximum. The MOOP is the annual cap on what a member pays in-network for covered Part A and Part B services. See how the Medicare Advantage MOOP works.
  • Service area = Clay County. Medicare Advantage plans are sold by service area; moving out of the plan's service area triggers a Special Enrollment Period to switch plans. See how moving changes your Medicare options.

How it compares in Clay County

The CMS CY2026 Landscape file lists 61 Medicare Advantage plans in Clay County, Tennessee, of which 0 carry a 5.0-star overall rating and 30 have a $0 consolidated monthly premium. Consolidated premiums range from $0.00 to $147.00 per month, and in-network out-of-pocket maximums range from $2975.00 to $9250.00.

For the full county plan directory, see all Medicare plans in Clay County, Tennessee.

How to verify your doctors take this plan

Network participation changes throughout the year; we hold no provider-network data, so verify directly with these three sources before you decide:

  1. Open the plan's official Medicare.gov page and use its provider-directory link: Medicare.gov Plan Finder — H4513-034.
  2. Call the plan (Health Care Service Corporation) using the member-services number listed on that plan page and ask whether each doctor, hospital, and pharmacy is in-network for 2026.
  3. Get free, unbiased help from your State Health Insurance Assistance Program (SHIP) — see free unbiased Medicare help from SHIP.

What H4513-034 means

CMS assigns every Medicare Advantage and Part D offering a plan identifier made of three parts. In H4513-034, the leading H marks the contract type (H = Medicare Advantage / Part C contract), the four digits 4513 are the contract number issued to the organization, and the three-digit 034 is the plan benefit package under that contract. The segment ID 0 identifies the service-area segment within the plan (0 = the default single segment).

Frequently asked questions

Is HealthSpring TotalCare Plus (HMO D-SNP) an HMO or PPO?

HealthSpring TotalCare Plus (HMO D-SNP) is an HMO D-SNP — a Health Maintenance Organization-style Medicare Advantage plan, meaning in-network care and referral rules generally apply.

Does HealthSpring TotalCare Plus (HMO D-SNP) include prescription drug coverage?

Yes — HealthSpring TotalCare Plus (HMO D-SNP) is a Medicare Advantage plan with prescription drug coverage (MA-PD) and a $615.00 annual Part D drug deductible for 2026.

What is the maximum out-of-pocket cost for HealthSpring TotalCare Plus (HMO D-SNP)?

The 2026 in-network maximum out-of-pocket limit for HealthSpring TotalCare Plus (HMO D-SNP) is $9250.00, per the CMS CY2026 Landscape file.

What counties offer HealthSpring TotalCare Plus (HMO D-SNP) (H4513-034)?

HealthSpring TotalCare Plus (HMO D-SNP) (H4513-034) is offered in 62 Tennessee counties: Bedford County, Benton County, Bledsoe County, Bradley County, Cannon County, Carroll County, Cheatham County, Chester County, Clay County, Coffee County, Crockett County, Cumberland County, Davidson County, Decatur County, DeKalb County, Dickson County, Fayette County, Fentress County, Gibson County, Giles County, Grundy County, Hamilton County, Hardeman County, Hardin County, Haywood County, Henderson County, Hickman County, Houston County, Humphreys County, Jackson County, Lauderdale County, Lawrence County, Lewis County, Lincoln County, Macon County, Madison County, Marion County, Marshall County, Maury County, McNairy County, Montgomery County, Moore County, Overton County, Perry County, Pickett County, Polk County, Putnam County, Robertson County, Rutherford County, Sequatchie County, Shelby County, Smith County, Stewart County, Sumner County, Tipton County, Trousdale County, Van Buren County, Warren County, Wayne County, White County, Williamson County, and Wilson County.

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