Company vs company · Harris County, TX · 2027 plan year

Humana vs HealthSpring Medicare Advantage plans

Medicare.gov compares Medicare Advantage plans with each other. This page also shows Original Medicare, so you can see the full trade-off: premiums, copays, the yearly limit, extra benefits, and the rules about doctors and approvals.

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In most states, including Texas, you cannot count on getting Medigap later

You can buy any Medigap plan with no health questions in the 6 months that start when you are 65 or older and have Part B. After that, a Medigap company in Texas can ask about your health. It can say no, or it can charge you more. So if you join a Medicare Advantage plan now, you may not be able to get Medigap later.

One exception is the trial right. If you joined Medicare Advantage when you first got Medicare at 65, or you left a Medigap plan to try Medicare Advantage for the first time, you can switch back within 12 months. Then you can buy a Medigap plan with no health questions.

Read about Medigap rights on Medicare.gov

Your yearly cost, side by side

Move the controls to match your year. Totals include premiums, the Part B premium, copays, and drug costs.

How much care do you expect?

Ongoing specialist care

Medigap plan with Original Medicare

Plan G pays almost everything after the $292 yearly Part B deductible.

Want to check your exact drugs? Medicare.gov lets you enter each drug and shows what each plan charges for it. Enter your drugs on Medicare.gov

Medicare.gov lists $143 to $680 a month for a 65-year-old woman who does not use tobacco. We start at the lowest price. Health questions can raise the price after your first 6 months with Part B.

Original Medicare

With Medigap Plan G at $143 a month and Wellcare Value Script (PDP)

$6,761 a year

Premiums
$4,294
Medical costs
$292
Drugs
$2,175

Most you can pay in a bad year, before drugs: $4,586.

Humana Essentials Plus Giveback (PPO)

PPO from Humana

$4,704 a year

Premiums
$1,542
Medical costs
$1,867
Drugs
$1,295

Most you can pay in a bad year, before drugs: $9,842.

HealthSpring Preferred Extra Savings (HMO)

HMO from HealthSpring

$3,102 a year

Premiums
$402
Medical costs
$1,455
Drugs
$1,245

Most you can pay in a bad year, before drugs: $7,902.

With these settings, HealthSpring Preferred Extra Savings (HMO) costs about $1,602 less a year than Humana Essentials Plus Giveback (PPO).

Tipping point for Humana Essentials Plus Giveback (PPO): with this drug use, if your medical copays and coinsurance in this plan pass $3,924 in a year, Original Medicare with Plan G costs less. The plan caps those costs at $8,300.

Tipping point for HealthSpring Preferred Extra Savings (HMO): with this drug use, if your medical copays and coinsurance in this plan pass $5,114 in a year, Original Medicare with Plan G costs less. The plan caps those costs at $7,500.

These are estimates, not quotes. Check every number with Medicare (Medicare.gov or 1-800-MEDICARE) and with the plan before you choose. What you pay depends on your doctors and hospitals, your drugs and pharmacy, and the care you use. Drug costs use typical prices for generic and brand-name drugs. Original Medicare amounts are 2027 projections from the 2026 Medicare Trustees Report. CMS sets the final amounts in November.

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What you pay each time you get care

In-network costs for one visit or one stay. The Original Medicare amounts follow your Medigap choice above: Plan G.

Primary doctor visit

  • Original Medicare + Medigap Plan G

    $0

    after the $292 yearly Part B deductible

  • HumanaChoice H5216-043 (PPO)

    $0

  • Humana Essentials Plus Giveback (PPO)

    $0

  • HealthSpring Preferred (HMO)

    $0 copay

  • HealthSpring Preferred Savings (HMO)

    $0 copay

Specialist visit

  • Original Medicare + Medigap Plan G

    $0

    after the $292 yearly Part B deductible

  • HumanaChoice H5216-043 (PPO)

    $35

    Prior authorization
  • Humana Essentials Plus Giveback (PPO)

    $40

    Prior authorization
  • HealthSpring Preferred (HMO)

    $20

    Prior authorization
  • HealthSpring Preferred Savings (HMO)

    $40

    Prior authorization

Lab tests

  • Original Medicare + Medigap Plan G

    $0

    most Medicare-covered tests

  • HumanaChoice H5216-043 (PPO)

    $0

    Prior authorization
  • Humana Essentials Plus Giveback (PPO)

    $0

    Prior authorization
  • HealthSpring Preferred (HMO)

    0%-20%

    Prior authorization
  • HealthSpring Preferred Savings (HMO)

    0%-20%

    Prior authorization

MRI or CT scan

  • Original Medicare + Medigap Plan G

    $0

    after the $292 yearly Part B deductible

  • HumanaChoice H5216-043 (PPO)

    $0-$360

    Prior authorization
  • Humana Essentials Plus Giveback (PPO)

    $0-$360

    Prior authorization
  • HealthSpring Preferred (HMO)

    $0-$160

    Prior authorization
  • HealthSpring Preferred Savings (HMO)

    $0-$300

    Prior authorization

Emergency room

  • Original Medicare + Medigap Plan G

    $0

    after the $292 yearly Part B deductible

  • HumanaChoice H5216-043 (PPO)

    $130

  • Humana Essentials Plus Giveback (PPO)

    $115

  • HealthSpring Preferred (HMO)

    $150

  • HealthSpring Preferred Savings (HMO)

    $115

Urgent care

  • Original Medicare + Medigap Plan G

    $0

    after the $292 yearly Part B deductible

  • HumanaChoice H5216-043 (PPO)

    $50

  • Humana Essentials Plus Giveback (PPO)

    $40

  • HealthSpring Preferred (HMO)

    $65

  • HealthSpring Preferred Savings (HMO)

    $40

Outpatient surgery

  • Original Medicare + Medigap Plan G

    $0

    after the $292 yearly Part B deductible

  • HumanaChoice H5216-043 (PPO)

    $0

    Prior authorization
  • Humana Essentials Plus Giveback (PPO)

    $0-$325

    Prior authorization
  • HealthSpring Preferred (HMO)

    $0-$140

    Prior authorization
  • HealthSpring Preferred Savings (HMO)

    $0-$300

    Prior authorization

Ground ambulance

  • Original Medicare + Medigap Plan G

    $0

    after the $292 yearly Part B deductible

  • HumanaChoice H5216-043 (PPO)

    $325

    Prior authorization
  • Humana Essentials Plus Giveback (PPO)

    $325

    Prior authorization
  • HealthSpring Preferred (HMO)

    $275

    Prior authorization
  • HealthSpring Preferred Savings (HMO)

    $250

    Prior authorization

Hospital stay, 5 days

  • Original Medicare + Medigap Plan G

    $0

    Plan G pays the $1,788 Part A deductible

  • HumanaChoice H5216-043 (PPO)

    $1,725

    for a 5-day stay

    Prior authorization
  • Humana Essentials Plus Giveback (PPO)

    $1,975

    for a 5-day stay

    Prior authorization
  • HealthSpring Preferred (HMO)

    $925

    for a 5-day stay

    Prior authorization
  • HealthSpring Preferred Savings (HMO)

    $1,625

    for a 5-day stay

    Prior authorization
See every cost in one table
What you pay in networkOriginal Medicare + Medigap Plan GHumanaChoice H5216-043 (PPO)Humana Essentials Plus Giveback (PPO)HealthSpring Preferred (HMO)HealthSpring Preferred Savings (HMO)
Monthly premiumPart B $209.50 + Medigap Plan G $143 + drug plan $5.30$0 + Part B $209.50$0 (pays back $81 a month of your Part B premium) + Part B $209.50$0 + Part B $209.50$0 (pays back $124 a month of your Part B premium) + Part B $209.50
Yearly limit on what you payYou pay the $292 Part B deductible. Plan G pays the rest.$6,800 in network; $10,750 in and out of network$8,300 in network; $13,900 in and out of network$4,000 in network$7,200 in network
Medical deductible$292 Part B. Plan G pays the $1,788 Part A deductible.$175$400$0$0
Primary doctor visit$0, after the $292 yearly Part B deductible$0 copay$0 copay$0 copay$0 copay
Specialist visit$0, after the $292 yearly Part B deductible$35 copayPrior authorization$40 copayPrior authorization$20 copayPrior authorization$40 copayPrior authorization
Lab tests$0, most Medicare-covered tests$0 copayPrior authorization$0 copayPrior authorization0%-20% coinsurancePrior authorization0%-20% coinsurancePrior authorization
MRI or CT scan$0, after the $292 yearly Part B deductible$0-$360 copayPrior authorization$0-$360 copayPrior authorization$0-$160 copayPrior authorization$0-$300 copayPrior authorization
X-rays$0, after the $292 yearly Part B deductible$0-$145 copayPrior authorization$0-$145 copayPrior authorization$0-$5 copayPrior authorization$0-$10 copayPrior authorization
Emergency room$0, after the $292 yearly Part B deductible$130 copay$115 copay$150 copay$115 copay
Urgent care$0, after the $292 yearly Part B deductible$50 copay$40 copay$65 copay$40 copay
Outpatient hospital$0, after the $292 yearly Part B deductible$0-$400 copayPrior authorization$0-$400 copayPrior authorization$0-$160 copayPrior authorization$0-$325 copayPrior authorization
Surgery center$0, after the $292 yearly Part B deductible$0 copayPrior authorization$0-$325 copayPrior authorization$0-$140 copayPrior authorization$0-$300 copayPrior authorization
Ground ambulance$0, after the $292 yearly Part B deductible$325 copayPrior authorization$325 copayPrior authorization$275 copayPrior authorization$250 copayPrior authorization
Hospital stay$0, Plan G pays the $1,788 Part A deductible$345 per day for days 1-6; $0 per day for days 7-90Prior authorization$395 per day for days 1-6; $0 per day for days 7-90Prior authorization$185 per day for days 1-6; $0 per day for days 7-90Prior authorization$325 per day for days 1-6; $0 per day for days 7-90Prior authorization
Skilled nursing facility$0, Plan G pays days 21-100$0 per day for days 1-20; $221 per day for days 21-100Prior authorization$0 per day for days 1-20; $221 per day for days 21-100Prior authorization$20 per day for days 1-20; $221 per day for days 21-100Prior authorization$0 per day for days 1-20; $221 per day for days 21-100Prior authorization
Mental health visit$0, after the $292 yearly Part B deductible$20 copayPrior authorization$20 copayPrior authorization$20 copayPrior authorization$40 copayPrior authorization
Physical therapy$0, after the $292 yearly Part B deductible$30 copayPrior authorization$30 copayPrior authorization$20 copayPrior authorization$35 copayPrior authorization
Home health care$0, Medicare-covered home health$0 copayPrior authorization$0 copayPrior authorization$0 copayPrior authorization$0 copayPrior authorization
Medical equipment$0, after the $292 yearly Part B deductible20% coinsurancePrior authorization20% coinsurancePrior authorization20% coinsurancePrior authorization20% coinsurancePrior authorization
Part B drugs$0 after the $292 Part B deductible0%-20% coinsurancePrior authorization0%-20% coinsurancePrior authorization0%-20% coinsurancePrior authorization0%-20% coinsurancePrior authorization
Drug deductible (Part D)$700 with Wellcare Value Script (PDP)$700$50$500$300
Drug tiers (one month, retail)Generic: $0 copayPreferred Brand: 25% coinsuranceNon-Preferred Drug: 49% coinsuranceInjectable Drugs: 15% coinsuranceSpecialty Tier: 25% coinsuranceSelect Care Drugs: $11 copayPreferred Generic: $0 copayGeneric: $5 copayPreferred Brand: 17% coinsuranceNon-Preferred Drug: 41% coinsuranceSpecialty Tier: 25% coinsurancePreferred Generic: $0 copayGeneric: $0 copayPreferred Brand: 19% coinsuranceNon-Preferred Drug: 37% coinsuranceSpecialty Tier: 32% coinsurancePreferred Generic: $0 copayGeneric: $0 copayPreferred Brand: 20% coinsuranceNon-Preferred Drug: 25% coinsuranceSpecialty Tier: 28% coinsurancePreferred Generic: $0 copayGeneric: $0 copayPreferred Brand: 15% coinsuranceNon-Preferred Drug: 25% coinsuranceSpecialty Tier: 30% coinsurance

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A higher drug plan premium is not, by itself, a reason to switch

With Original Medicare, you buy a separate drug plan. In Texas, 10 drug plans are for sale for 2027, from $5.30 to $199 a month. Half of them cost $104.70 a month or less.

  • Every 2027 drug plan limits what you pay for covered drugs to $2,400 a year. The drug coverage in Medicare Advantage plans has the same limit.
  • The premium is one part of your yearly cost. The calculator above adds premiums, medical costs, and drug costs, so you can see the whole year.
  • A Medicare Advantage plan can cost less in a light year. But you also take on its network and prior authorization rules, and you may not be able to get Medigap later.
  • If your income is limited, Extra Help can pay most of your drug plan premium and drug costs. Check Extra Help at SSA.gov

The two companies in Harris County

Humana

  • 14 plans for 2027 (not counting special needs plans)
  • 11 with a $0 premium; 4 pay back part of your Part B premium
  • Yearly limits from $3,950 to $8,300
  • Star ratings 3.5 to 4.5

HealthSpring

  • 6 plans for 2027 (not counting special needs plans)
  • 6 with a $0 premium; 3 pay back part of your Part B premium
  • Yearly limits from $3,600 to $7,500
  • Star ratings 3 to 3.5

Doctors, referrals, and prior authorization

Cost is one side. The other side is how you get care. These rules come from the CMS plan files. Prior authorization means the plan must approve a service before you get it.

Original Medicare

  • Any doctor or hospital in the U.S. that takes Medicare
  • No referrals
  • Prior authorization only for a short list of services

HumanaChoice H5216-043 (PPO)

PPO

  • The plan has a network. You can go outside it, but you pay more.
  • No referral needed to see a specialist.

Prior authorization for 24 services

Specialist visits, Diagnostic tests, MRI or CT, Radiation therapy, Outpatient hospital, Observation stay, Surgery center, Ambulance, Mental health visits, Psychiatrist visits, Physical therapy, Occupational therapy, Home health, Partial hospitalization, Cardiac rehab, Pulmonary rehab, Medical equipment, Prosthetics, Diabetic supplies, Dialysis, Substance use care, Hospital stay, Skilled nursing, Part B drugs

Humana Essentials Plus Giveback (PPO)

PPO

  • The plan has a network. You can go outside it, but you pay more.
  • No referral needed to see a specialist.

Prior authorization for 24 services

Specialist visits, Diagnostic tests, MRI or CT, Radiation therapy, Outpatient hospital, Observation stay, Surgery center, Ambulance, Mental health visits, Psychiatrist visits, Physical therapy, Occupational therapy, Home health, Partial hospitalization, Cardiac rehab, Pulmonary rehab, Medical equipment, Prosthetics, Diabetic supplies, Dialysis, Substance use care, Hospital stay, Skilled nursing, Part B drugs

HealthSpring Preferred (HMO)

HMO

  • You use doctors and hospitals in the plan network. Outside the network, the plan pays for emergencies and urgent care.
  • You need a referral to see a specialist.

Prior authorization for 24 services

Specialist visits, Diagnostic tests, MRI or CT, Radiation therapy, Outpatient hospital, Observation stay, Surgery center, Ambulance, Mental health visits, Psychiatrist visits, Physical therapy, Occupational therapy, Home health, Partial hospitalization, Cardiac rehab, Pulmonary rehab, Medical equipment, Prosthetics, Diabetic supplies, Dialysis, Substance use care, Hospital stay, Skilled nursing, Part B drugs

HealthSpring Preferred Savings (HMO)

HMO

  • You use doctors and hospitals in the plan network. Outside the network, the plan pays for emergencies and urgent care.
  • You need a referral to see a specialist.

Prior authorization for 24 services

Specialist visits, Diagnostic tests, MRI or CT, Radiation therapy, Outpatient hospital, Observation stay, Surgery center, Ambulance, Mental health visits, Psychiatrist visits, Physical therapy, Occupational therapy, Home health, Partial hospitalization, Cardiac rehab, Pulmonary rehab, Medical equipment, Prosthetics, Diabetic supplies, Dialysis, Substance use care, Hospital stay, Skilled nursing, Part B drugs

Extra benefits

Extra benefitOriginal MedicareHumanaChoice H5216-043 (PPO)Humana Essentials Plus Giveback (PPO)HealthSpring Preferred (HMO)HealthSpring Preferred Savings (HMO)
DentalNoComprehensive, up to $2,000 a yearComprehensive, up to $2,000 a yearComprehensive, up to $2,750 a yearComprehensive, up to $5,000 a year
Eye examNoYesYesYesYes
Glasses or contactsNoYes, $150 allowanceYes, $150 allowanceYes, $300 allowanceYes, $200 allowance
Hearing aidsNoYes, copays from $575Yes, copays from $575Yes, copays from $399Yes, copays from $399
Over-the-counter allowanceNo$200 a yearNo$260 a year$120 a year
Fitness benefitNoYesYesYesYes
Rides to careNoNoNoYesNo
Meals after a hospital stayNoYesYesYesYes
Emergency care abroadPlan G and Plan N pay 80% after a $250 deductibleYesYesYesYes
Part B premium givebackNoNo$81 a monthNo$124 a month

What changed for 2027

HumanaChoice H5216-043 (PPO)

Renewal Plan · 2026 plan H5216-043-6

  • Medical deductible up from $0 to $175
  • Drug deductible up from $420 to $700
  • Part B giveback down from $2 to $0
  • Specialist visit: $30 copay to $35 copay
  • Emergency care: $115 copay to $130 copay
  • Urgent care: $40 copay to $50 copay
  • Outpatient hospital: $0-$300 copay to $0-$400 copay
  • Ground ambulance: $335 copay to $325 copay
  • Inpatient hospital: $340 per day for days 1-6; $0 per day for days 7-90 to $345 per day for days 1-6; $0 per day for days 7-90
  • Skilled nursing facility: $0 per day for days 1-20; $218 per day for days 21-100 to $0 per day for days 1-20; $221 per day for days 21-100
  • Yearly OTC allowance up from $160 to $200
  • Overall star rating up from 3.5 to 4

Humana Essentials Plus Giveback (PPO)

Renewal Plan with SAR · 2026 plan H7617-035-0

  • Medical deductible down from $425 to $400
  • Drug deductible down from $350 to $50
  • Part B giveback down from $90 to $81
  • Outpatient hospital: $0-$350 copay to $0-$400 copay
  • Ground ambulance: $335 copay to $325 copay
  • Inpatient hospital: $310 per day for days 1-7; $0 per day for days 8-90 to $395 per day for days 1-6; $0 per day for days 7-90
  • Skilled nursing facility: $0 per day for days 1-20; $218 per day for days 21-100 to $0 per day for days 1-20; $221 per day for days 21-100
  • Dental maximum up from $1,500 to $2,000

HealthSpring Preferred (HMO)

Consolidated Renewal Plan · 2026 plan H4513-061-1

  • In-network out-of-pocket maximum up from $3,500 to $4,000
  • Drug deductible up from $200 to $500
  • Urgent care: $25 copay to $65 copay
  • Diagnostic radiology (MRI, CT): $0-$150 copay to $0-$160 copay
  • Outpatient hospital: $0-$150 copay to $0-$160 copay
  • Ground ambulance: $250 copay to $275 copay
  • Inpatient hospital: $230 per stay to $185 per day for days 1-6; $0 per day for days 7-90
  • Skilled nursing facility: $20 per day for days 1-20; $218 per day for days 21-100 to $20 per day for days 1-20; $221 per day for days 21-100
  • Dental maximum up from $2,550 to $2,750
  • Yearly OTC allowance down from $540 to $260
  • Overall star rating down from 4.5 to 3.5

HealthSpring Preferred Savings (HMO)

Renewal Plan with SAR · 2026 plan H4513-083-1

  • In-network out-of-pocket maximum up from $6,900 to $7,200
  • Part B giveback down from $130 to $124
  • Specialist visit: $45 copay to $40 copay
  • Urgent care: $35 copay to $40 copay
  • Outpatient hospital: $0-$350 copay to $0-$325 copay
  • Skilled nursing facility: $0 per day for days 1-20; $218 per day for days 21-100 to $0 per day for days 1-20; $221 per day for days 21-100
  • Dental maximum down from $20,000 to $5,000
  • Yearly OTC allowance down from $560 to $120
  • Eyewear allowance down from $275 to $200
  • Overall star rating down from 4.5 to 3.5

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Sources and method

Plan data comes from the CMS 2027 Plan Benefit Package and landscape files. The data is from 2026-10-10. We checked a sample of plans field by field against Medicare.gov. Original Medicare amounts are the 2027 projections in the 2026 Medicare Trustees Report (Tables V.E1 and V.E2). CMS sets the final amounts in November. Medigap prices are the range Medicare.gov showed for ZIP 77002 on 2026-10-09. Totals use typical Medicare-allowed amounts for each service and typical drug prices.

These are estimates, not quotes, and they are for education only. Check every number with Medicare and with the plan before you choose. What you pay depends on your doctors and hospitals, your drugs and pharmacy, and the care you use. Plans can change their benefits, premiums, drug lists, and networks each year.

Pinnie is not an insurance agent or broker and does not sell Medicare plans. Pinnie is not connected with or endorsed by the U.S. government or the federal Medicare program. For all your options, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.

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