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Erickson Advantage Champion (HMO-POS C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Erickson Advantage Champion (HMO-POS C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Erickson Advantage Champion (HMO-POS C-SNP) in 2026, please refer to our full plan details page.
Erickson Advantage Champion (HMO-POS C-SNP) is a HMO-POS C-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Erickson Campuses - CO,KS,MA,MD,MI,NJ,PA,TX,VA,NC. This plan received an overall rating of 5 out of 5 stars in 2026.
It's important to know that Erickson Advantage Champion (HMO-POS C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Erickson Advantage Champion (HMO-POS C-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Erickson Advantage Champion (HMO-POS C-SNP).
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 Erickson Advantage Champion (HMO-POS C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $182.00. 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 a $270.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $10000.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $10000.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
This plan has a Maximum Out-Of-Pocket cost of $3400.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $10000.00 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 Erickson Advantage Champion (HMO-POS C-SNP) plan features an annual drug deductible of $270. For Tier 1 preferred generic drugs, you will pay no copay for a 1-month or 3-month supply at standard pharmacies and mail-order services. Tier 2 generic drugs cost $5 for a 1-month supply at standard pharmacies, but you can get a 3-month supply with no copay through preferred mail order. Higher-tier medications are subject to coinsurance under this plan, starting with Tier 3 preferred brand drugs at 24% coinsurance for 1-month and 3-month supplies. Tier 4 non-preferred drugs require a 44% coinsurance, and Tier 5 specialty drugs carry a 30% coinsurance for a 1-month supply.
Additional Benefits
The Erickson Advantage Champion (HMO-POS C-SNP) plan offers robust coverage with no copays and no coinsurance for inpatient hospital stays, primary care visits, home health, and skilled nursing facility care. Specialist visits, outpatient hospital services, and emergency care feature low to moderate copayments, such as a $130 copay for emergency room visits which is waived upon admission. Additionally, there are no deductibles or coinsurance for most of these core medical services, helping to keep out-of-pocket costs predictable. For routine care, members benefit from no copays on preventive dental, annual eye exams, routine hearing tests, and select over-the-counter items. While comprehensive dental services are not covered, the plan provides a $100 eyewear allowance every two years and covers hearing aids with copayments ranging from $199 to $1,249. Durable medical equipment and diabetic supplies are also covered with no copay and no coinsurance, though some specialized services and prosthetic devices require a 20 percent coinsurance.
Inpatient Hospital See details
Erickson Advantage Champion (HMO-POS C-SNP) offers partially covered inpatient hospital services with no copay and no coinsurance for acute and psychiatric stays, subject to prior authorization. However, upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services under the Erickson Advantage Champion (HMO-POS C-SNP) are covered with no coinsurance, featuring no copay for ambulatory surgical center services, outpatient blood services, and group substance abuse sessions. Outpatient hospital services require a copay of $0 to $100, observation services carry a $100 daily copay, and individual substance abuse sessions range from no copay up to $30.
Partial Hospitalization See details
Erickson Advantage Champion (HMO-POS C-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to receive coverage for this benefit.
Ambulance and Transportation Services See details
Erickson Advantage Champion (HMO-POS C-SNP) covers Medicare-covered ground and air ambulance services with a $275 copay and no coinsurance, with prior authorization required. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Emergency services are covered by Erickson Advantage Champion (HMO-POS C-SNP) with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services feature a copay ranging from no copay to $50 with no coinsurance, and worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Erickson Advantage Champion (HMO-POS C-SNP) provides primary care, therapy, telehealth, and podiatry services with no copay and no coinsurance, though chiropractic services are not covered. Specialist visits require a $0 to $25 copay, and mental health or psychiatric individual sessions have a $0 to $30 copay, with no coinsurance required for any covered services.
Preventive Services See details
Preventive services are covered by Erickson Advantage Champion (HMO-POS C-SNP) with no copays and no coinsurance for services like annual physical exams, kidney disease education, and home safety modifications. This benefit is partially covered, as several supplemental services, including fitness benefits, personal emergency response systems, and in-home safety assessments, are not covered.
Hearing Services See details
Hearing services are partially covered by Erickson Advantage Champion (HMO-POS C-SNP) with no deductibles or coinsurance. Routine hearing exams have no copay, while prescription hearing aids (copays of $199 to $1,249) and OTC hearing aids (copays of $199 to $829) are covered up to two per year. However, fitting and evaluation exams, as well as inner ear, outer ear, and over the ear prescription hearing aids, are not covered.
Vision Services See details
Erickson Advantage Champion (HMO-POS C-SNP) offers partially covered vision services with no coinsurance, featuring no copay for annual routine eye exams and a $100 eyewear allowance every two years. Under this plan, contact lenses and eyeglass frames have no copay, and eyeglass lenses have a copay of $0 to $153, but other eye exam services, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by Erickson Advantage Champion (HMO-POS C-SNP), featuring Medicare-covered dental with no copay and 20% coinsurance, and preventive care like exams and cleanings with no copay and no coinsurance. Comprehensive services such as restorative, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by Erickson Advantage Champion (HMO-POS C-SNP) with no copay and no coinsurance, though prior authorization is required. Covered Medicare Part B chemotherapy and other drugs require no copay and up to 15% coinsurance, while covered Part B insulin requires a $35 copay and up to 15% coinsurance.
Dialysis Services See details
Erickson Advantage Champion (HMO-POS C-SNP) covers Dialysis Services with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Erickson Advantage Champion (HMO-POS C-SNP) covers durable medical equipment and diabetic supplies with no copay and no coinsurance. Prosthetic devices and medical supplies are also covered under the plan with no copay and a 20% coinsurance.
Diagnostic and Radiological Services See details
Erickson Advantage Champion (HMO-POS C-SNP) covers diagnostic and radiological services with no coinsurance, though prior authorization is required. Under this plan, there is no copay for lab services and diagnostic radiological services, while outpatient X-rays require a $25 copay, therapeutic radiological services require a $35 copay, and diagnostic procedures and tests require a $40 copay.
Home Health Services See details
Home health services are covered by Erickson Advantage Champion (HMO-POS C-SNP) with no copay and no coinsurance. Prior authorization is required to receive this care.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Erickson Advantage Champion (HMO-POS C-SNP) with no copay and no coinsurance, but prior authorization is required. Although some services are covered, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Erickson Advantage Champion (HMO-POS C-SNP) covers Skilled Nursing Facility (SNF) services for days 1 through 100 with no copay and no coinsurance, although prior authorization is required. A three-day inpatient hospital stay is not required prior to admission, but additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by the Erickson Advantage Champion (HMO-POS C-SNP) plan, which offers over-the-counter (OTC) items with no copay and no coinsurance, while acupuncture and meal benefits are not covered. The OTC benefit covers select items like nicotine replacement therapy and naloxone through claims processing and reimbursement, with no maximum plan benefit limit.
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