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CCHP Senior Program (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for CCHP Senior 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 Program (HMO) in 2025, please refer to our full plan details page.
CCHP Senior Program (HMO) is a HMO plan offered by Chinese Hospital Association available for enrollment in 2025 to people living in Counties: Alameda. This plan received an overall rating of 2.5 out of 5 stars in 2025.
It's important to know that CCHP Senior 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 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 Program (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $31.00. 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 $3000.00 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 Program (HMO) has an enhanced alternative drug benefit with no deductible. During the initial coverage phase, you will pay a copay for your prescriptions based on the drug tier. For example, preferred generic drugs have a $7 copay, while standard generic drugs have a $30 copay. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase where you pay nothing for Medicare Part D covered drugs. If you qualify for the low-income subsidy, you will pay $31.00. Please note that this summary does not include all the details of the plan, so be sure to review the plan's formulary for specific drug coverage.
Additional Benefits
The CCHP Senior Program (HMO) offers a range of health benefits, including inpatient hospital stays with copays, outpatient services with varying copays, and coverage for emergency services. This plan also covers primary care, preventive services, hearing exams, and vision exams with associated copays. Dental services, home infusion, dialysis, and medical equipment are included, often with coinsurance or copays. Additional benefits extend to ambulance services, transportation, and skilled nursing facilities, each with specific cost-sharing arrangements. The plan covers services such as acupuncture and over-the-counter items, while also offering specialized services like cardiac rehabilitation. However, certain services like private duty nursing, and some dental and vision services are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services, but Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered. For Inpatient Hospital-Acute, you will pay a $100 copay for days 1-7, and no copay for days 8-90; for Inpatient Hospital Psychiatric, you will pay a $250 copay for days 1-7, and no copay for days 8-90.
Outpatient Services See details
Outpatient Services, including outpatient hospital services and observation services, require prior authorization and a doctor's referral and have a copay of $100-$310. Ambulatory Surgical Center (ASC) Services have a $300 copay, while Outpatient Substance Abuse Services have a copay of $15 for both individual and group sessions. Outpatient Blood Services are covered.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization and a doctor referral.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including both ground and air ambulance services, with a $180 copay per service. Transportation to a plan-approved health-related location is covered for 12 round trips per year via rideshare or medical transport.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the CCHP Senior Program (HMO). Emergency Services have a $110 copay with no coinsurance, Urgently Needed Services have a $20 copay with no coinsurance, and Worldwide Emergency Coverage has a $90 copay with no coinsurance. Worldwide Emergency Transportation is not covered.
Primary Care See details
The CCHP Senior Program (HMO) covers primary care physician services, chiropractic services, occupational therapy, specialist services, mental health specialty services, other health care professional services, psychiatric services, physical therapy, speech-language pathology, telehealth, and opioid treatment program services. Chiropractic services, occupational therapy, individual and group mental health sessions, other health care professional services, psychiatric services, and physical therapy/speech therapy have a $15 copay. Specialist services have no copay. Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
The CCHP Senior Program (HMO) plan covers Medicare-covered preventive services, annual physical exams, and additional preventive services, along with health education, nutritional/dietary benefits, additional sessions of smoking and tobacco cessation counseling, fitness benefits, remote access technologies, kidney disease education services, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following welcome visits. 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, telemonitoring services, home and bathroom safety devices and modifications, and counseling services are not covered.
Hearing Services See details
Hearing Services include coverage for hearing exams with a $20 copay, as well as routine hearing exams and fitting/evaluation for hearing aids. Prescription Hearing Aids (all types) are covered, but Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered. OTC Hearing Aids are not covered.
Vision Services See details
Vision services include coverage for eye exams with a $20 copay, and coverage for eyewear with a combined maximum of $150 every two years, as well as contact lenses and eyeglasses (lenses and frames). Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
The CCHP Senior Program (HMO) plan covers Medicare Dental Services with a $20 copay, and other dental services including oral exams, dental x-rays, other diagnostic dental services, and prophylaxis (cleaning), each limited to 2 visits per year. Fluoride treatment, maxillofacial prosthetics, implant services, prosthodontics, fixed, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the CCHP Senior Program (HMO), and prior authorization is required. Medicare Part B Insulin Drugs have a $35 copay, while the coinsurance for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs ranges from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered under the CCHP Senior Program (HMO) plan, but require prior authorization and a doctor's referral. You will pay a 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and no copay, but Durable Medical Equipment for use outside the home is not covered. Prosthetics/Medical Supplies - Non-Medicare benefit includes 20% coinsurance with no copay, 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 under the CCHP Senior Program (HMO). Diagnostic services, including diagnostic procedures/tests and lab services, are not covered. Diagnostic Radiological Services have a copay of at most $100, and Therapeutic Radiological Services have a coinsurance of at most 20%. Outpatient X-Ray Services are not covered.
Home Health Services See details
Home Health Services are covered by the CCHP Senior Program (HMO) with no copay or coinsurance, but authorization and a referral are required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover the sub-services Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. A doctor referral and prior authorization are required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered by the CCHP Senior Program (HMO), with a doctor's referral and prior authorization required. For days 1-20, there is no copay, but for days 21-100, the copay is $75. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The CCHP Senior Program (HMO) covers acupuncture with a $5 copay and over-the-counter items with a maximum benefit of $52 per month. Meal Benefit, 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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