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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 2026, 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 3 out of 5 stars in 2026.
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 $29.00. 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) offers an Enhanced Alternative drug benefit with no prescription drug deductible, allowing your coverage to begin immediately. During the initial coverage phase, you will enjoy no copay for Tier 1 preferred generic drugs at preferred pharmacies, while standard pharmacies charge a $7.00 copay. Tier 2 standard generic drugs carry a $45.00 copay, and Tier 3 preferred brand drugs require a $100.00 copay at both preferred and standard pharmacies. For Tier 4 non-preferred drugs, you will pay a 33% coinsurance at preferred, standard, and standard mail pharmacies. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and pay nothing for Medicare Part D covered drugs. Additionally, individuals who qualify for the low-income subsidy may benefit from reduced premiums and $0 copays.
Additional Benefits
The CCHP Senior Program (HMO) offers comprehensive medical coverage with predictable costs, featuring no coinsurance and low daily copays for inpatient hospital stays and skilled nursing care. Outpatient services, emergency visits, and urgent care are covered with fixed copayments, while Medicare-covered preventive services require no copay or coinsurance. Additionally, the plan includes no copay for the first 20 days of skilled nursing facility stays and offers up to 36 round trips for plan-approved transportation. Routine dental, vision, and hearing services are partially covered, featuring $20 exam copays and allowances for eyewear and prescription hearing aids. For advanced medical needs, members will pay a 20% coinsurance with no copay for dialysis, durable medical equipment, and therapeutic radiology. Some benefits require prior authorization, and certain services, such as cardiac rehabilitation and diabetic supplies, are excluded from coverage.
Inpatient Hospital See details
Inpatient hospital benefits are partially covered by the CCHP Senior Program (HMO), requiring prior authorization and referrals but no coinsurance. Acute care requires a $100 daily copay for days 1-7 and no copay for days 8-90, whereas psychiatric stays require a $250 daily copay for days 1-7 and no copay for days 8-90. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services under the CCHP Senior Program (HMO) are covered with no coinsurance, featuring copays of $100 to $310 for outpatient hospital and observation services, and $300 for ambulatory surgical center visits. Outpatient substance abuse services require a $15 copay, while outpatient blood services are covered with no copay and no deductible.
Partial Hospitalization See details
Partial hospitalization benefits are covered by the CCHP Senior Program (HMO), but require prior authorization and a doctor referral. Specific copay and coinsurance cost details are not specified in the plan benefits.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the CCHP Senior Program (HMO), with ground and air ambulance services requiring a $180 copay and no coinsurance. Transportation benefits are partially covered, offering up to 36 round trips per year to plan-approved locations, while transportation to any other health-related location is not covered.
Emergency Services See details
CCHP Senior Program (HMO) covers emergency services with a $110 copay and urgent care with a $20 copay, both with no coinsurance. Worldwide emergency and urgent services are partially covered up to a $25,000 limit with a $90 copay and no coinsurance, but worldwide emergency transportation is not covered.
Primary Care See details
Primary Care benefits are partially covered by CCHP Senior Program (HMO), as podiatry services and routine chiropractic care are not covered. Most covered services, including physical therapy, occupational therapy, and mental health specialty sessions, require a $15 copay and no coinsurance.
Preventive Services See details
Preventive services are covered by CCHP Senior Program (HMO) with no copay and no coinsurance for Medicare-covered zero-dollar services. This benefit is partially covered as it excludes in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs for chemotherapy-related hair loss, weight management programs, alternative therapies, therapeutic massage, adult day health services, home-based palliative care, in-home support services, caregiver support, enhanced disease management, telemonitoring, home and bathroom safety devices, and counseling services.
Hearing Services See details
CCHP Senior Program (HMO) partially covers hearing services with no deductible, offering exams for a $20 copay and no coinsurance, and prescription hearing aids (all types) for a $600 to $2,075 copay and no coinsurance. 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 CCHP Senior Program (HMO), which offers annual routine eye exams for a $20 copay and no coinsurance or deductible. Eyewear is covered up to $150 every two years with no copay, coinsurance, or deductible, though individual eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by CCHP Senior Program (HMO), with fluoride treatment, maxillofacial prosthetics, and implant services excluded from coverage. Covered Medicare dental services require a $20 copay and no coinsurance, while other covered dental services range from no copay to a $55 copay and no coinsurance, with several comprehensive benefits offered as optional supplemental coverage.
Home Infusion bundled Services See details
Home infusion bundled services are covered by CCHP Senior Program (HMO) with prior authorization, featuring a $35 copay and no coinsurance for Medicare Part B insulin. Other covered Part B drugs, including chemotherapy and radiation, require no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered by the CCHP Senior Program (HMO) with a 20% coinsurance and no copay. To access this benefit, members are required to obtain prior authorization and a doctor referral.
Medical Equipment See details
Medical equipment is partially covered by CCHP Senior Program (HMO), featuring no copay and a 20% coinsurance for durable medical equipment, prosthetic devices, and medical supplies. However, diabetic supplies and diabetic therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are partially covered by CCHP Senior Program (HMO), as diagnostic procedures, lab services, and outpatient X-ray services are not covered. Diagnostic radiological services require a $100 copay and no coinsurance, while therapeutic radiological services require a 20% coinsurance and a copay.
Home Health Services See details
CCHP Senior Program (HMO) covers Home Health Services, but requires prior authorization and a doctor referral. Specific copay and coinsurance costs are not specified in the plan details.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the CCHP Senior Program (HMO), as none of the sub-services, including Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD services, are covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are partially covered by CCHP Senior Program (HMO) with no copay for days 1 through 20, a $75 daily copay for days 21 through 100, and no coinsurance. Prior authorization and a doctor referral are required, but additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by the CCHP Senior Program (HMO), which includes unlimited acupuncture treatments and a $30 monthly reimbursement for select over-the-counter items. Meal benefits, dual-eligible SNP services, nicotine replacement therapy, and naloxone are not covered.
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