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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 2025, 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 4.5 out of 5 stars in 2025.
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 $167.00. 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 $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 has a $0 deductible for prescription drugs. During the initial coverage phase, you will pay a copay for your prescriptions depending on the drug tier and the pharmacy. For example, a standard pharmacy has a $5 copay for preferred generic drugs, and a $47 copay for standard generic drugs. For preferred brand drugs, you will pay a $100 copay at either a standard or preferred pharmacy. For non-preferred drugs, you will pay 33% coinsurance. After your yearly out-of-pocket drug costs reach $2000, you will enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The Erickson Advantage Champion (HMO-POS C-SNP) plan offers a variety of benefits, including no copays for inpatient hospital stays, outpatient hospital services, primary care, preventive services, and many other services. The plan also covers emergency services, hearing and vision services, and dental services with varying copays or coinsurance. This plan provides coverage for ambulance services, outpatient services, and home health services, all with either no copay or a fixed copay. Additionally, it includes benefits like home infusion services, medical equipment, and diagnostic services, with specific cost-sharing arrangements like coinsurance for certain services.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For Inpatient Hospital-Acute, there is no copay for a Medicare-covered stay, and for additional days (91-999), there is no copay. However, Non-Medicare-covered Stay and Upgrades are not covered. For Inpatient Hospital Psychiatric, there is no copay for a Medicare-covered stay. Additional Days and Non-Medicare-covered Stay are not covered.
Outpatient Services See details
Outpatient Services includes coverage for all outpatient hospital services with a copay between $0 and $75, observation services with a $75 copay, ambulatory surgical center services with no copay, outpatient substance abuse services with a copay between $0 and $30 for individual sessions, no copay for group sessions, and outpatient blood services with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Erickson Advantage Champion (HMO-POS C-SNP) plan, requiring prior authorization. You will pay a $30 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including both ground and air ambulance services. Ground and air ambulance services have a copay of $175, and there is no coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Erickson Advantage Champion (HMO-POS C-SNP) plan. Emergency Services have a $100 copay, and Urgently Needed Services have a copay between $0 and $50. Worldwide Emergency Services, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay.
Primary Care See details
The Erickson Advantage Champion (HMO-POS C-SNP) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, and occupational therapy services with no copay. The plan also covers physician specialist services with a copay between $0 and $25, and mental health specialty services with varying copays based on the session type. Podiatry services and routine foot care are covered with no copay, while other health care professional services have a copay up to $25. The plan also covers psychiatric services, physical therapy, speech-language pathology services, additional telehealth benefits, and opioid treatment program services with no copay.
Preventive Services See details
The Erickson Advantage Champion (HMO-POS C-SNP) plan covers preventive services, including an annual physical exam with no copay. Other preventive services have no copay for glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams are covered once per year with no copay. Prescription hearing aids are covered with a copay between $199 and $1249, and OTC hearing aids are covered with a copay between $99 and $829. Fitting/evaluation for hearing aids, and prescription hearing aids for inner ear, outer ear, and over the ear are not covered.
Vision Services See details
The Erickson Advantage Champion (HMO-POS C-SNP) plan covers vision services, including eye exams with no copay. This plan also covers eyewear, including contact lenses with no copay and eyeglass lenses with a copay between $0 and $153. Eyeglass frames are covered with no copay, and there is a combined maximum of $100 for all eyewear every two years.
Dental Services See details
The Erickson Advantage Champion (HMO-POS C-SNP) plan covers Medicare Dental Services with 20% coinsurance and requires prior authorization, while Oral Exams, Dental X-Rays, Prophylaxis (Cleaning), Fluoride Treatment, and Other Preventive Dental Services have no copay. Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable), Maxillofacial Prosthetics, Implant Services, Prosthodontics (fixed), Oral and Maxillofacial Surgery, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and 0-10% coinsurance, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-10% coinsurance. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered under the Erickson Advantage Champion (HMO-POS C-SNP) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment, including durable medical equipment, is covered under this plan. Prosthetic devices and medical supplies have a 20% coinsurance, and diabetic supplies and therapeutic shoes/inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services with a $40 copay, and lab services with no copay. Diagnostic Radiological Services have a maximum copay of $100, Therapeutic Radiological Services have a minimum copay of $35, and Outpatient X-Ray Services have a $25 copay.
Home Health Services See details
Home Health Services are covered by the Erickson Advantage Champion (HMO-POS C-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Erickson Advantage Champion (HMO-POS C-SNP) plan, including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, there is a $203 copay; additional days beyond Medicare-covered SNF stays and non-Medicare-covered SNF stays are not covered.
Other Services See details
Other Services include over-the-counter items, which have no copay, while acupuncture, meal benefits, Dual Eligible SNPs with Highly Integrated Services, and several other services are not covered.
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