Clear Spring Health Choice Plan (PPO)

Georgia Medicare Advantage Plan (2025 Plan)

Monthly Premium

Your Cost

by Clear Spring Health

Additional Coverage

HearingVisionDental

Overall Government Star Rating

(coming soon)

Ready to Enroll Online?

Plan Name

Clear Spring Health Choice Plan (PPO)

Insurance Carrier

Clear Spring Health

Plan Type

Medicare Advantage Plan With Part D Prescription Drug Coverage

Network Type

PPO

Clear Spring Health Choice Plan (PPO) is a Medicare Advantage Plan With Part D Prescription Drug Coverage, which is available in Georgia and offered by the health insurance company Clear Spring Health. This plan’s network type is PPO which determines in-network doctors who accept the health plan and whether a referral is needed.

Monthly Premium

Annual Deductible

Max Out-of-Pocket

$6,751

Primary doctor visit

$0 copay

Specialist visit

$0-35 copay per visit

ER visit

$90 copay per visit (always covered)

Ambulance

$275 copay

Clear Spring Health Choice Plan (PPO) has a monthly premium cost of $0 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $9,250 In and Out-of-network $6,751 In-network. The most common benefit costs which people evaluate when choosing a plan are costs for a primary doctor visit, specialist doctor visit, emergency room visit, and ambulance. These costs are listed in this summary section and a full list of benefit costs for Clear Spring Health Choice Plan (PPO) are defined below.

Yes

Part D Prescription Drug Coverage

Yes

Dental

Yes

Vision

Yes

Hearing

Clear Spring Health Choice Plan (PPO) is a Medicare Advantage plan which does include Medicare Part D Prescription Drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. Clear Spring Health Choice Plan (PPO) includes coverage for hearing, vision, dental.

Medicare Advantage health plans can offer even more additional benefits. Clear Spring Health Choice Plan (PPO) includes coverage for the following additional benefits:

Other benefits

Fitness benefit

Limited coverage

Over the counter drug benefits

Limited coverage

In-home support services

Not covered

Home and bathroom safety devices

Not covered

Meals for short duration

Not covered

Annual physical exams

Not covered

Telehealth

Limited coverage

Monthly Premium

Health Portion of Premium

Drug Portion of Premium

Health Plan Deductible

Health Plan Max Out-of-Pocket

$9,250 In and Out-of-network
$6,751 In-network

Nationwide Coverage included

Hearing Coverage included

Yes

Vision Coverage included

Yes

Dental Coverage included

Yes

Doctor Lookup Link

http://www.clearspringhealthcare.com

Plan Link

http://www.clearspringhealthcare.com

Doctor Services

Primary doctor visit

In-network: $0 copay
Out-of-network: 45% coinsurance per visit

Specialist visit

In-network: $0-35 copay per visit
Out-of-network: $50 copay per visit

Tests, labs, & imaging

Diagnostic tests & procedures

In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Lab services

In-network: $0 copay
Out-of-network: 45% coinsurance

Diagnostic radiology services (like MRI)

In-network: $0-100 copay
Out-of-network: 20% coinsurance

Outpatient x-rays

In-network: $0-100 copay
Out-of-network: 40% coinsurance

Emergency care

$90 copay per visit (always covered)

Urgent care

$35 copay per visit (always covered)

Hospital Services

Inpatient hospital coverage

In-network: $295 per day for days 1 through 7
$0 per day for days 8 through 90
Out-of-network: $395 per day for days 1 through 7
$0 per day for days 8 through 90

Outpatient hospital coverage

In-network: $250 copay per visit
Out-of-network: 20% coinsurance per visit

Skilled nursing facility

In-network: $0 per day for days 1 through 20
$160 per day for days 21 through 100
Out-of-network: $195 per day for days 1 through 35
$0 per day for days 36 through 100

Preventive services

In-network: $0 copay
Out-of-network: 45% coinsurance

Ambulance

Ground ambulance

In-network: $275 copay
Out-of-network: 20% coinsurance

Therapy services

Occupational therapy visit

In-network: $35 copay
Out-of-network: 45% coinsurance

Physical therapy & speech & language therapy visit

In-network: $40 copay
Out-of-network: 45% coinsurance

Mental health services

Outpatient group therapy with a psychiatrist

In-network: $40 copay
Out-of-network: 20% coinsurance

Outpatient individual therapy with a psychiatrist

In-network: $40 copay
Out-of-network: 20% coinsurance

Outpatient group therapy visit

In-network: $40 copay
Out-of-network: 20% coinsurance

Outpatient individual therapy visit

In-network: $40 copay
Out-of-network: 20% coinsurance

Opioid treatment services

Covered

Other services

Durable medical equipment (like wheelchairs & oxygen)

In-network: 20% coinsurance per item
Out-of-network: 40% coinsurance per item

Prosthetics (like braces, artificial limbs)

In-network: 20% coinsurance per item
Out-of-network: 45% coinsurance per item

Diabetes supplies

In-network: $0 copay
Out-of-network: 45% coinsurance per item

Tier drug costs for: Standard retail pharmacy drug cost for 1-month

Tiers	Initial coverage phase	Catastrophic coverage phase
Preferred Generic	$5.00 copay	$0 copay
Generic	$17.00 copay	$0 copay
Preferred Brand	$47.00 copay	$0 copay
Non-Preferred Drug	$100.00 copay	$0 copay
Specialty Tier	29% coinsurance	$0 copay

Part B Drugs

Chemotherapy drugs

In-network: 0-20% coinsurance
Out-of-network: 0-20% coinsurance

Other Part B drugs

In-network: 0-20% coinsurance
Out-of-network: 0-20% coinsurance

Hearing

Hearing exam

In-network: $50 copay
Out-of-network: 20% coinsurance

Fitting/evaluation

In-network: $0 copay
Out-of-network: 45% coinsurance

Hearing aids - All types

In-network: $0 copay
Out-of-network: 45% coinsurance

Preventive Dental

Oral exam

In-network: $0 copay
Out-of-network: 45% coinsurance

Cleaning

In-network: $0 copay
Out-of-network: 45% coinsurance

Fluoride treatment

In-network: $0 copay
Out-of-network: 45% coinsurance

Dental x-rays

In-network: $0 copay
Out-of-network: 45% coinsurance

Comprehensive dental

Restorative services

In-network: $0 copay
Out-of-network: 45% coinsurance

Endodontics

In-network: $0 copay
Out-of-network: 45% coinsurance

Periodontics

In-network: $0 copay
Out-of-network: 45% coinsurance

Prosthodontics, removable

In-network: $0 copay
Out-of-network: 45% coinsurance

Prosthodontics, fixed

In-network: $0 copay
Out-of-network: 45% coinsurance

Maxillofacial prosthetics

In-network: $0 copay
Out-of-network: 45% coinsurance

Implant services

In-network: $0 copay
Out-of-network: 45% coinsurance

Oral and maxillofacial surgery

In-network: $0 copay
Out-of-network: 45% coinsurance

Orthodontics

In-network: $0 copay
Out-of-network: 45% coinsurance

Adjunctive general services

In-network: $0 copay
Out-of-network: 45% coinsurance

Vision

Routine eye exam

In-network: $0 copay
Out-of-network: 45% coinsurance

Contact lenses

Not covered

Eyeglasses (frames & lenses)

In-network: $0 copay
Out-of-network: 45% coinsurance

Eyeglass frames (only)

Not covered

Eyeglass lenses (only)

Not covered

Upgrades

Not covered

When Can I Sign Up for Medicare?

Enter your birthday month and year to learn when you can sign up for different Medicare plan options.

Speak with a Licensed Insurance Agent

Mon-Fri: 8am - 9pm ET
Sat: 8am - 8pm ET

Medicare Advantage Plans
Medicare Prescription Drug Plans
Medicare Supplement Insurance Plans

No obligation to enroll. Find your plan online or speak with a licensed insurance agent to get help signing up for the right plan for you! See www.medicare65quote.com for our Third-Party Marketing Organization disclaimer.
Insurance Ad -No Government Affiliation

Health Plan Radar

In this article we rank Georgia Medicare Advantage plans based on our evaluation of government 5-star quality scores. Each year the government rates the quality of Medicare Advantage health insurance plans with a 5-star quality score. An overall quality score is assigned to each plan which is based on the scores of various quality metrics.

Health Plan Radar

The Medicare landscape in Georgia is constantly changing. In this article we show a summary of new and returning health insurance companies offering Medicare Advantage Plans (Part C) and Medicare Prescription Drug Plans (Part D) in Georgia.

Clear Spring Health Choice Plan (PPO)

Monthly Premium

Additional Coverage

Overall Government Star Rating

Ready to Enroll Online?

Plan Overview

Cost Summary

Additional Benefits and Coverage

Other benefits

Plan Benefits and Coverage Details

Medical Benefits

Doctor Services

Tests, labs, & imaging

Hospital Services

Skilled nursing facility

Preventive services

Ambulance

Therapy services

Mental health services

Opioid treatment services

Other services

Prescription Drug Benefits

Tier drug costs for: Standard retail pharmacy drug cost for 1-month

Part B Drugs

Extra Benefits

Hearing

Preventive Dental

Comprehensive dental

Vision

When Can I Sign Up for Medicare?

Ready to Enroll Online?

Medicare Health Plans

Best Georgia Medicare Advantage Health Insurance Companies for 2025

New Georgia Medicare Advantage Health Insurance Companies for 2025