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Champion Connect (HMO-POS C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Champion Connect (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 Champion Connect (HMO-POS C-SNP) in 2025, please refer to our full plan details page.
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 2025.
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.
Important:
Champion Connect (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 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.
For Champion Connect (HMO-POS C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $20.50. 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 $590.00 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 combined Maximum Out-Of-Pocket cost of $9350.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $9350.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 Champion Connect (HMO-POS C-SNP) plan has a $590 deductible for prescription drugs. After you meet your deductible, you will pay for your prescriptions based on the drug tier and pharmacy you use. In the initial coverage phase, you may pay either a coinsurance or a copay depending on the drug tier and the pharmacy. For example, you will pay a $0 copay for preferred generic drugs, and 25% coinsurance for standard generic, preferred brand, and non-preferred drugs.
Additional Benefits
The Champion Connect (HMO-POS C-SNP) plan offers a variety of benefits with varying costs. Inpatient hospital stays have no copay for the first 90 days, but require a deductible. Outpatient services include no copays for many services, but some have copays or coinsurance, and there are no copays for mental health services. This plan also includes coverage for ambulance and transportation services, emergency services, and preventive services, many with no copay. Dental, hearing, and vision benefits are included, with some services having no copay. Home health, skilled nursing, and medical equipment are covered, with some services requiring a copay or coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits with Champion Connect (HMO-POS C-SNP) include coverage for Inpatient Hospital-Acute with no copay for days 1-90, and no copay for days 1-60, after a $1712 deductible, and Inpatient Hospital Psychiatric with a $1712 deductible, but additional days, non-Medicare covered stays, and upgrades are not covered. Prior authorization and a doctor referral are required.
Outpatient Services See details
Outpatient Services include coverage for outpatient hospital services with a $125 copay, observation services with 20% coinsurance, and ambulatory surgical center services with no copay. Outpatient substance abuse services cover individual and group sessions with no copay. Outpatient blood services are not covered.
Partial Hospitalization See details
Champion Connect (HMO-POS C-SNP) covers partial hospitalization, but requires prior authorization and a doctor referral. There is no copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including both ground and air ambulance services. Ground ambulance services have a 20% coinsurance and no copay, while air ambulance services have a 20% coinsurance and a copay. Transportation services to a plan-approved health-related location are covered for up to 168 one-way trips per year, but transportation services to any other health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Champion Connect (HMO-POS C-SNP) plan. Emergency Services have a $110 copay with no coinsurance, while Urgently Needed Services have no copay and no coinsurance. Worldwide Emergency Services has a maximum plan benefit coverage of $10,000.
Primary Care See details
Primary Care benefits include primary care physician services, chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Primary care physician services, chiropractic services, individual and group mental health specialty sessions, individual and group psychiatric sessions, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services have no copay. Occupational therapy services, physician specialist services, and other health care professional services have a coinsurance of 0% to 20%. Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
Preventive services include coverage for Medicare-covered services with no copay, annual physical exams with no copay, additional preventive services with varying copays, and other services like health education and personal emergency response systems with no copay. Kidney disease education services and other preventive services are also covered, but with varying copays.
Hearing Services See details
The Champion Connect (HMO-POS C-SNP) plan covers hearing exams and fitting/evaluation for hearing aids with no copay. Prescription hearing aids (all types) are covered with a $149 copay, but prescription hearing aids - inner ear, outer ear, and over the ear are not covered. OTC hearing aids are not covered.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams and eyewear have no copay. Eyewear includes eyeglasses (lenses and frames) and upgrades, but contact lenses, eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
The Champion Connect (HMO-POS C-SNP) plan offers dental services with a $3,000 annual maximum. Oral exams, dental x-rays, cleaning, fluoride treatments, and other preventative dental services are covered, and some restorative services, endodontics, periodontics, prosthodontics (removable and maxillofacial), and oral and maxillofacial surgery are covered with 20-40% coinsurance, but implant services, prosthodontics (fixed), 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 copay between $0 and $24, Medicare Part B Chemotherapy/Radiation Drugs with a coinsurance between 0% and 20%, and Other Medicare Part B Drugs with a coinsurance between 0% and 20%. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered by the Champion Connect (HMO-POS C-SNP) plan. There is a 20% coinsurance for this benefit.
Medical Equipment See details
Medical Equipment is covered by the Champion Connect (HMO-POS C-SNP) plan, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Champion Connect (HMO-POS C-SNP) plan, with all diagnostic services and radiological services covered. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of at most 20%, while Lab Services and Outpatient X-Ray Services have no copay. Therapeutic Radiological Services also have a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the Champion Connect (HMO-POS C-SNP) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Champion Connect (HMO-POS C-SNP) plan, including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization and a doctor referral are required if these services were covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization and a doctor's referral. For days 1-20, there is no copay, while days 21-100 have a copay of $214.
Other Services See details
Other Services include coverage for over-the-counter (OTC) items, with a maximum plan benefit coverage amount of $500.00 every three months; however, acupuncture, meal benefits, 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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