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CCHP Senior Value Program (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for CCHP Senior Value Program (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on CCHP Senior Value Program (HMO) in 2025, please refer to our full plan details page.
CCHP Senior Value Program (HMO) is a HMO plan offered by Chinese Hospital Association available for enrollment in 2025 to people living in Counties: SF, SM. This plan received an overall rating of 2.5 out of 5 stars in 2025.
It's important to know that CCHP Senior Value Program (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about CCHP Senior Value Program (HMO).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For CCHP Senior Value Program (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $7550.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The CCHP Senior Value Program (HMO) has an enhanced alternative drug benefit. This plan has no deductible for prescription drugs. In the initial coverage phase, you will pay either a copay or coinsurance for your prescriptions. For preferred generic drugs, you will have no copay at preferred pharmacies, and a $3 copay at standard pharmacies. For standard generic drugs, the copay is $35, and for preferred brand drugs, the copay is $75. Non-preferred drugs have a 30% coinsurance. After your total drug costs reach $2000, you enter the catastrophic coverage phase and pay nothing for covered drugs.
Additional Benefits
The CCHP Senior Value Program (HMO) offers comprehensive coverage with a variety of benefits. Inpatient hospital stays have copays, with different amounts for acute and psychiatric care. Outpatient services, including surgery and substance abuse treatment, require referrals and have varying copays. Emergency and urgent care services have set copays, and ambulance services require prior authorization with a copay. Primary care visits have low copays, and specialist visits are $20. Preventive services, hearing exams, vision exams, and dental services are covered with varying copays. Other benefits include home infusion, dialysis, medical equipment, home health services, and skilled nursing facilities, each with specific cost-sharing structures or prior authorization requirements.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. Inpatient Hospital-Acute has a copay of $150 for days 1-7, and no copay for days 8-90; Inpatient Hospital Psychiatric has a copay of $250 for days 1-7, and no copay for days 8-90. Additional days for Inpatient Hospital-Acute are covered with no copay. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered, and additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are also not covered.
Outpatient Services See details
Outpatient Services, including outpatient hospital services and observation services, require prior authorization and a doctor's referral, with a copay of $230 to $310. Ambulatory Surgical Center (ASC) Services are covered with a $300 copay, while Outpatient Substance Abuse Services have a $20 copay for individual or group sessions. Outpatient Blood Services are also covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the CCHP Senior Value Program (HMO) and requires prior authorization and a doctor referral. There is no information about the cost of this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered, with prior authorization required for all ambulance services. Both ground and air ambulance services have a copay of $265. Transportation services to a plan-approved health-related location are covered for up to 6 round trips per year, and services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the CCHP Senior Value Program (HMO). Emergency Services have a $90 copay, and Urgently Needed Services have a $45 copay, both with no coinsurance, while Worldwide Emergency Services has a $90 copay for Worldwide Emergency Coverage and Worldwide Urgent Coverage, and is not covered for Worldwide Emergency Transportation.
Primary Care See details
The CCHP Senior Value Program (HMO) covers primary care physician services with a copay between $0 and $5, and chiropractic services with a $15 copay. Occupational therapy services, physician specialist services, mental health specialty services, other health care professional, psychiatric services, physical therapy, and speech-language pathology services are covered with a copay of $20. Additional telehealth benefits and opioid treatment program services are also covered. Podiatry services are not covered.
Preventive Services See details
Preventive Services include coverage for Medicare-covered preventive services, annual physical exams, health education, nutritional/dietary benefits, additional sessions of smoking and tobacco cessation counseling, fitness benefits, remote access technologies, kidney disease education services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit. Some services are not covered, including in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, home-based palliative care, in-home support services, support for caregivers of enrollees, enhanced disease management, home and bathroom safety devices and modifications, and counseling services.
Hearing Services See details
Hearing Services include routine hearing exams with a $20 copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are partially covered, while OTC hearing aids are not covered.
Vision Services See details
Vision services include eye exams with a $35 copay, and eyewear including contact lenses or eyeglasses (lenses and frames). Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services include Medicare dental services with a $20 copay, and other dental services. Other dental services include oral exams, dental x-rays, other diagnostic dental services and prophylaxis (cleaning) with no copay, and fluoride treatment is not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, requiring prior authorization. Medicare Part B Insulin Drugs have a $35 copay, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the CCHP Senior Value Program (HMO) with prior authorization and a doctor referral required. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment, including durable medical equipment and prosthetics/medical supplies, is covered under the CCHP Senior Value Program (HMO). Durable medical equipment has a 20% coinsurance and requires authorization, while durable medical equipment for use outside the home is not covered. Prosthetic devices and medical supplies have a 20% coinsurance, and diabetic equipment is covered, but diabetic supplies and diabetic therapeutic shoes/inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the CCHP Senior Value Program (HMO), but Diagnostic Procedures/Tests, Lab Services, and Outpatient X-Ray Services are not covered. Diagnostic Radiological Services have a copay of $200.00, and Therapeutic Radiological Services have a coinsurance of 20%.
Home Health Services See details
Home Health Services are covered by the CCHP Senior Value Program (HMO), with no copay or coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the specific services of Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, and Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services are not covered. A doctor referral and prior authorization are required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the CCHP Senior Value Program (HMO) plan. For days 1-20, there is no copay, and for days 21-100, the copay is $115. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include acupuncture, which has a $10 copay and covers up to 15 treatments per year, while over-the-counter items are covered up to $40 per month. Meal benefits, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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