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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: Alameda. 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 $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) has an enhanced alternative drug benefit. This plan has a $0 deductible. In the initial coverage phase, you will pay no copay for preferred generic drugs at preferred pharmacies. Standard generic drugs have a $35 copay, and preferred brand drugs have a $75 copay. Non-preferred drugs have a 30% coinsurance.
Additional Benefits
The CCHP Senior Value Program (HMO) offers a wide range of benefits with varying costs. This plan includes coverage for inpatient and outpatient hospital services, with copays ranging from $20 to $310, as well as emergency and ambulance services with copays from $25 to $200. Additionally, the plan covers primary care, hearing, vision, and dental services, along with home health and skilled nursing, but some services require prior authorization and referrals.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, but Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered. For Inpatient Hospital-Acute, you will pay a $150 copay for days 1-7, and no copay for days 8-90, while for Inpatient Hospital Psychiatric, you will pay a $250 copay for days 1-7, and no copay for days 8-90. Additional Days for Inpatient Hospital-Acute are covered with no copay.
Outpatient Services See details
Outpatient Services, offered by the CCHP Senior Value Program (HMO), cover outpatient hospital services with a copay of $150-$310, observation services with a copay of $230-$310, ambulatory surgical center services with a $300 copay, and outpatient substance abuse services, including individual and group sessions, with a $20 copay. Outpatient blood services are also covered.
Partial Hospitalization See details
Partial Hospitalization benefits are covered, but require prior authorization and a doctor referral. There is no information about the cost of services.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with a $200 copay for both ground and air ambulance services. Transportation services to a plan-approved health-related location are covered for 6 round trips per year, while transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Coverage are covered under the CCHP Senior Value Program (HMO). Emergency Services have a $125 copay, and Urgently Needed Services have a $25 copay, while Worldwide Emergency Coverage has a $90 copay. Worldwide Emergency Transportation is not covered.
Primary Care See details
The CCHP Senior Value Program (HMO) covers primary care physician services, chiropractic services with a $15 copay, occupational therapy services with a $20 copay, physician specialist services with a $15 copay, mental health specialty services with a $20 copay for individual and group sessions, physical therapy and speech-language pathology services with a $20 copay, additional telehealth benefits, and opioid treatment program services. Podiatry services are not covered.
Preventive Services See details
Preventive services, including annual physical exams, are covered, along with health education, nutritional/dietary benefits, additional sessions of smoking and tobacco cessation counseling, fitness benefits, remote access technologies, kidney disease education, and other preventive services like glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs. In-home safety assessment, 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 are not covered.
Hearing Services See details
Hearing Services include routine hearing exams with a $20 copay, fitting/evaluation for hearing aids, and prescription hearing aids with a $3,000 maximum benefit every year. Prescription Hearing Aids (inner ear, outer ear, and over the ear) and OTC hearing aids are not covered.
Vision Services See details
The CCHP Senior Value Program (HMO) covers vision services including eye exams with a $35 copay. This plan also covers eyewear, with a combined maximum benefit of $100 every two years, as well as contact lenses and eyeglasses (lenses and frames) once every two years. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
The CCHP Senior Value 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, prophylaxis (cleaning), and periodontics with a copay ranging from $0 to $55. Fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B insulin drugs, there is a $35 copay. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, coinsurance ranges from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization and a doctor's referral. You will pay 20% coinsurance.
Medical Equipment See details
Medical equipment, including durable medical equipment and prosthetic devices, is covered by the CCHP Senior Value Program (HMO) with a 20% coinsurance, but durable medical equipment for use outside the home and diabetic supplies and therapeutic shoes/inserts are not covered. There is no copay for medical equipment.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are partially covered under the CCHP Senior Value Program (HMO), with no copay for all diagnostic services, and no copay for Medicare-covered X-Ray Services. Diagnostic Procedures/Tests, Lab Services, and Outpatient X-Ray Services are not covered, while Diagnostic Radiological Services have a copay of at most $150, and Therapeutic Radiological Services have a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the CCHP Senior Value Program (HMO) with no copay and no 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 Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization and a doctor's referral are required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, requiring prior authorization and a doctor's referral. For days 1-20, there is no copay, and for days 21-100, the copay is $100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include acupuncture and over-the-counter (OTC) items. Acupuncture has a $10 copay per visit, with a limit of 15 treatments per year. The plan offers OTC items as a supplemental benefit, with a maximum coverage amount of $65.00 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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