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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: Alameda. 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. During the initial coverage phase, you pay no copay for Tier 1 preferred generic drugs at preferred pharmacies, or a $7 copay at standard pharmacies. Tier 2 standard generic drugs carry a $40 copay, while Tier 3 preferred brand drugs require a $95 copay at both preferred and standard locations. Tier 4 non-preferred drugs require a 33% coinsurance at preferred pharmacies, standard pharmacies, and standard mail. 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. Additionally, members who qualify for the low-income subsidy can reduce their Part D premium to $0.
Additional Benefits
The CCHP Senior Value Program (HMO) offers robust medical coverage with predictable out-of-pocket costs, featuring no copay for Medicare-covered preventive services and low copays of $10 to $20 for specialist visits. Inpatient hospital stays require a $150 daily copay for days 1 to 7, while outpatient services carry a copay of $150 to $310 with no coinsurance. Emergency room visits have a $125 copay, and the plan also covers up to 28 round-trip rides per year to plan-approved locations. For ancillary care, members benefit from a $35 routine eye exam copay, a $100 biennial eyewear allowance, and routine hearing exams for a $20 copay. Dental care is covered with copays ranging from no copay up to $55, and skilled nursing facility stays require no copay for the first 20 days. Durable medical equipment and dialysis services require a 20% coinsurance with no copay, though diabetic supplies and cardiac rehabilitation services are not covered.
Inpatient Hospital See details
CCHP Senior Value Program (HMO) partially covers inpatient hospital services with no coinsurance, requiring a $150 daily copay for days 1-7 of acute stays and a $250 daily copay for days 1-7 of psychiatric stays, followed by no copay for days 8-90. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
CCHP Senior Value Program (HMO) covers outpatient services with no coinsurance, including outpatient hospital and observation services for a $150 to $310 copay. Patients will pay a $300 copay for ambulatory surgical center services, a $20 copay for outpatient substance abuse sessions, and no deductible for outpatient blood services.
Partial Hospitalization See details
Partial hospitalization benefits are covered by the CCHP Senior Value Program (HMO), requiring both prior authorization and a doctor referral. Specific copay and coinsurance costs are not detailed in the plan's benefit summary.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are partially covered by the CCHP Senior Value Program (HMO), as transportation to any health-related location is not covered. Ground and air ambulance services require a $200 copay and no coinsurance, while up to 28 round trips per year to plan-approved locations are covered via rideshare or medical transport.
Emergency Services See details
CCHP Senior Value Program (HMO) covers emergency services with a $125 copay and no coinsurance, and urgently needed services with a $25 copay and no coinsurance. Worldwide emergency services are partially covered up to a $5,000 limit with a $90 copay and no coinsurance for emergency and urgent care, though worldwide emergency transportation is not covered.
Primary Care See details
Primary Care benefits are partially covered by CCHP Senior Value Program (HMO) because podiatry services are not covered. Covered services, such as specialist visits, chiropractic care, and outpatient therapies, require copays ranging from $10 to $20 and no coinsurance.
Preventive Services See details
CCHP Senior Value Program (HMO) provides partially covered preventive services with no copay and no coinsurance for Medicare-covered zero-dollar preventive benefits. Sub-services that are not covered include in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, home-based palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home and bathroom safety modifications, and counseling.
Hearing Services See details
Hearing services are partially covered by the CCHP Senior Value Program (HMO), excluding OTC hearing aids as well as inner ear, outer ear, and over the ear prescription hearing aids. Covered routine hearing exams require a $20 copay and no coinsurance, while eligible prescription hearing aids have a copay ranging from $600 to $2,075 and no coinsurance.
Vision Services See details
Vision services are partially covered by the CCHP Senior Value Program (HMO), which offers one routine eye exam per year for a $35 copay and no coinsurance with no deductible. The plan also provides a $100 combined eyewear allowance every two years with no copay, no coinsurance, and no deductible, though separate eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by the CCHP Senior Value Program (HMO), featuring a $20 copay and no coinsurance for Medicare-covered dental services, and copays ranging from no copay to $55 with no coinsurance for other covered services. Fluoride treatment, maxillofacial prosthetics, and implant services are not covered, while several benefits like restorative and endodontic services are optional and may require additional fees.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the CCHP Senior Value Program (HMO) with prior authorization, featuring a $35 copay and no coinsurance for Medicare Part B insulin. Medicare Part B chemotherapy, radiation, and other Part B drugs require no copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
CCHP Senior Value Program (HMO) covers Dialysis Services with a 20% coinsurance and no copay. Prior authorization and a doctor referral are required to receive these covered services.
Medical Equipment See details
CCHP Senior Value Program (HMO) partially covers medical equipment, requiring no copay and a 20% coinsurance for durable medical equipment, prosthetics, and medical supplies. Diabetic supplies and diabetic therapeutic shoes or inserts are not covered under this plan.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are partially covered by the CCHP Senior Value Program (HMO), but diagnostic procedures/tests, lab services, and outpatient X-ray services are not covered. Covered diagnostic radiological services require a $150 copay with no coinsurance, while therapeutic radiological services require a 20% coinsurance with no copay.
Home Health Services See details
Home Health Services are covered by the CCHP Senior Value Program (HMO), requiring prior authorization and a doctor referral. Specific copay and coinsurance costs are not specified for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the CCHP Senior Value Program (HMO), as all individual sub-services—including Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD services—are excluded from coverage.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by the CCHP Senior Value Program (HMO), requiring prior authorization and a doctor referral. There is no copay or coinsurance for days 1 through 20, and a $100 copay per day with no coinsurance for days 21 through 100, 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 treatments for a $5 copay and no coinsurance, as well as a $30 monthly over-the-counter reimbursement benefit with no copay or coinsurance. Meal benefits and dual eligible SNP services are not covered under this plan.
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