Champion Connect (HMO-POS C-SNP)

Champion Connect (HMO-POS C-SNP) is a HMO-POS C-SNP plan offered by Champion Health Plans-USA, LLC. available for enrollment in 2025 to people living in Central & Southern California. The overall rating for this plan is not yet available for 2026.

It's important to know that Champion Connect (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.

Key Plan Facts

Below are a few key facts and commonly-asked questions about Champion Connect (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.

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:

Drug Coverage

The Champion Connect (HMO-POS C-SNP) Medicare plan offers an Enhanced Alternative drug benefit with an annual prescription drug deductible of $615.00. Under the initial coverage phase at standard pharmacies, there is no copay for Tier 1 preferred generic and Tier 5 specialty tier drugs, while Tier 2 standard generic, Tier 3 preferred brand, and Tier 4 non-preferred drugs require a 25% coinsurance. These cost-sharing rates apply until your total drug costs reach the next coverage phase limit. Once your yearly out-of-pocket drug costs reach $2100.00, you will enter the catastrophic coverage phase and pay nothing for covered Part D prescription drugs. Furthermore, beneficiaries who qualify for the low-income subsidy, or Extra Help, will pay a $0.00 Part D premium. This straightforward drug plan structure helps you easily anticipate your prescription medication costs.

Additional Benefits

The Champion Connect (HMO-POS C-SNP) plan offers comprehensive coverage for everyday healthcare needs, featuring no copay for primary care visits, preventive screenings, and home health services. For more specialized medical care, members can expect a 20% coinsurance for specialist visits and outpatient hospital services, while emergency room visits carry a $115 copay. Additionally, the plan provides convenient transit benefits, including no copay for up to 36 one-way trips to approved health locations and a maximum $125 copay for ground ambulance services. This plan also includes valuable supplemental benefits, such as preventive dental care with no copay and comprehensive dental services up to a $3,000 annual limit. Routine vision exams and eyeglasses are covered with no copay or deductible up to a $500 annual limit, while prescription hearing aids are available for a $149 copay. Furthermore, diabetic equipment and supplies require no copay, making it easier for members to manage chronic conditions affordably.