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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 2026, 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 3 out of 5 stars in 2026.
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 $3500.00 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) offers an enhanced alternative drug benefit with no prescription drug deductible, meaning your coverage begins immediately. During the initial coverage phase, you will pay no copay for Tier 1 preferred generic drugs at preferred pharmacies, or a $7 copay at standard pharmacies. Tier 2 standard generic drugs require a $47 copay at both preferred and standard pharmacies. Tier 3 preferred brand drugs carry a $100 copay, while Tier 4 non-preferred drugs require a 33% coinsurance. Once your yearly out-of-pocket drug costs reach $2,100, you enter the catastrophic coverage phase and pay nothing for Medicare Part D covered drugs.
Additional Benefits
The CCHP Senior Value Program (HMO) offers comprehensive medical coverage with predictable out-of-pocket costs, featuring no copay or coinsurance for Medicare-covered acute inpatient hospital stays and routine preventive care. Primary care doctor visits range from no copay to a five-dollar copay, while emergency care has a ninety-dollar copay that is waived if you are admitted. The plan also includes valuable transportation benefits, covering up to eighteen round trips per year to approved locations with no copay or coinsurance. For specialty care, members benefit from low-cost dental services and routine vision exams, plus a one-hundred-dollar eyewear allowance every two years with no copay. While many outpatient and specialist services feature no coinsurance, certain services like dialysis, durable medical equipment, and therapeutic radiology require a twenty percent coinsurance. Additional benefits include unlimited acupuncture sessions for a five-dollar copay and a thirty-dollar monthly reimbursement for over-the-counter items.
Inpatient Hospital See details
Inpatient Hospital benefits are partially covered under the CCHP Senior Value Program (HMO), with Medicare-covered acute stays requiring no copay or coinsurance, though upgrades and non-Medicare-covered stays are excluded. Psychiatric stays require a $250 daily copay for days 1 to 7 and no copay or coinsurance for days 8 to 90, but additional psychiatric days and non-Medicare-covered stays are not covered. Both services require prior authorization and a doctor referral.
Outpatient Services See details
Outpatient services are covered by the CCHP Senior Value Program (HMO) with no coinsurance, featuring copays ranging from $20 for substance abuse sessions to $230–$310 for outpatient hospital and observation services. Ambulatory surgical center services require a $300 copay, and there is no copay, coinsurance, or deductible for outpatient blood services.
Partial Hospitalization See details
Partial hospitalization benefits are covered by the CCHP Senior Value Program (HMO), but patients must obtain prior authorization and a doctor referral. Specific copay and coinsurance costs for this benefit are not specified in the plan details.
Ambulance and Transportation Services See details
CCHP Senior Value Program (HMO) covers ground and air ambulance services with a $265 copay and no coinsurance, subject to prior authorization. Transportation services are partially covered, offering up to 18 round trips per year to plan-approved locations with no copay or coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
CCHP Senior Value Program (HMO) covers emergency services with a $90 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours, and urgently needed services with a $45 copay and no coinsurance. Worldwide emergency services are partially covered up to a $5,000 maximum with a $90 copay and no coinsurance for emergency and urgent care, but worldwide emergency transportation is not covered.
Primary Care See details
CCHP Senior Value Program (HMO) offers partially covered primary care benefits with no coinsurance, though podiatry services are not covered. Covered services feature no copay to a $5 copay for primary care physician visits, a $10 to $15 copay for chiropractic care, and a $20 copay for therapy, psychiatric, and mental health services.
Preventive Services See details
Preventive services are partially covered by the CCHP Senior Value Program (HMO), which offers Medicare-covered zero-dollar preventive services with no copay and no coinsurance, though prior authorization and a doctor referral are required. While annual physical exams, health education, and memory fitness are covered, other services such as in-home safety assessments, personal emergency response systems, and weight management programs are not covered.
Hearing Services See details
Hearing services are partially covered by the CCHP Senior Value Program (HMO), which features a $20 copay and no coinsurance for routine hearing exams, and a $600 to $2,075 copay and no coinsurance for prescription hearing aids. Over-the-counter (OTC) hearing aids, as well as inner ear, outer ear, and over-the-ear prescription hearing aids, are not covered.
Vision Services See details
Vision services are partially covered by the CCHP Senior Value Program (HMO), which requires prior authorization and a doctor referral for routine eye exams, costing a $35 copay and no coinsurance. Covered eyewear includes contact lenses and complete eyeglasses with a combined $100 limit every two years and no copay or coinsurance, while individual eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
CCHP Senior Value Program (HMO) partially covers dental services, as fluoride treatment, maxillofacial prosthetics, and implant services are not covered. Covered Medicare dental services require a $20 copay, while other dental and orthodontic services range from no copay to a $55 copay, with no coinsurance for any covered benefits.
Home Infusion bundled Services See details
Home Infusion bundled Services are partially covered by CCHP Senior Value Program (HMO) because Part D home infusion drugs as part of a bundled service are not covered. Covered Medicare Part B insulin requires a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs require no copay and between no coinsurance and 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the CCHP Senior Value Program (HMO) with a 20% coinsurance and no copay. Prior authorization and a doctor referral are required to receive this benefit.
Medical Equipment See details
Medical Equipment is partially covered under the CCHP Senior Value Program (HMO), with a 20% coinsurance and no copay required for durable medical equipment, prosthetic devices, and medical supplies. Diabetic equipment is not covered, specifically excluding diabetic supplies and diabetic therapeutic shoes or inserts.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are partially covered by the CCHP Senior Value Program (HMO), requiring prior authorization and doctor referrals. Some diagnostic services are covered but diagnostic procedures and lab services are not, while covered radiological services include diagnostic radiology for a $200 copay (no coinsurance) and therapeutic radiology for a 20% coinsurance (no copay), with outpatient X-rays not covered.
Home Health Services See details
Home health services are covered under the CCHP Senior Value Program (HMO), though prior authorization and a doctor referral are required to access these benefits.
Cardiac Rehabilitation Services See details
CCHP Senior Value Program (HMO) offers Cardiac Rehabilitation Services, and while some services are covered, the specific sub-services of Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD are not covered. Consequently, there are no copay or coinsurance benefits available for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is partially covered by the CCHP Senior Value Program (HMO), requiring a doctor referral and prior authorization. There is no copay for days 1 through 20, a $115 daily copay for days 21 through 100, and no coinsurance, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
CCHP Senior Value Program (HMO) partially covers other services, offering unlimited acupuncture for a $5 copay and no coinsurance, and a $30 monthly reimbursement for over-the-counter items with no copay or coinsurance. Meal benefits and Dual Eligible SNPs are not covered under this plan.
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