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Champion Select (HMO-POS C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Champion Select (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 Select (HMO-POS C-SNP) in 2026, please refer to our full plan details page.
Champion Select (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 Select (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 Select (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 Select (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 Select (HMO-POS C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $8.40. 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 $615.00 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 $499.00 (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 $499.00 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 Select (HMO-POS C-SNP) Medicare plan offers an Enhanced Alternative drug benefit with a $615.00 annual prescription drug deductible. During the initial coverage phase at standard pharmacies, there is no copay for Tier 1 preferred generic and Tier 5 specialty tier drugs. For Tier 2 standard generic, Tier 3 preferred brand, and Tier 4 non-preferred drugs, you will pay a 25% coinsurance. After your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and pay nothing for Medicare Part D covered drugs. Additionally, individuals who qualify for the low-income subsidy, or Extra Help, will pay a reduced Part D premium of $8.40. This plan provides structured cost-sharing to help you manage your medication expenses.
Additional Benefits
The Champion Select (HMO-POS C-SNP) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care doctor visits, specialist care, and preventive services. Acute inpatient hospital stays, home health services, and diagnostic tests also feature no copay and no coinsurance, while outpatient hospital services require a $100 copay. Emergency room visits have a $150 copay, and urgent care services are available with no copay. For additional health needs, the plan provides dental, vision, and hearing benefits, featuring no copay for routine exams and cleanings. Dental treatments are covered up to a $3,000 annual limit with coinsurance ranging from 20% to 40%, while prescription hearing aids require a $149 copay and eyeglasses are covered up to a $335 yearly limit. Skilled nursing facility care is also covered with no copay for the first 20 days, followed by a $218 daily copay for days 21 through 100.
Inpatient Hospital See details
Champion Select (HMO-POS C-SNP) offers partially covered inpatient hospital benefits with no coinsurance, requiring prior authorization and a doctor referral. Inpatient acute stays have no copay, while psychiatric stays require a $100 daily copay for days 1 to 10 and no copay for days 11 to 90; however, additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Champion Select (HMO-POS C-SNP) covers outpatient services, featuring a $100 copay and no coinsurance for outpatient hospital services. Other covered services—including outpatient observation, ambulatory surgical center visits, substance abuse sessions, and blood services—require no copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization benefits are covered by Champion Select (HMO-POS C-SNP) with no copay and no coinsurance. Prior authorization and a doctor referral are required to receive these covered services.
Ambulance and Transportation Services See details
Champion Select (HMO-POS C-SNP) partially covers ambulance and transportation services, as transportation to any health-related location is not covered. Ground ambulance services require no copay to a $125 copay, air ambulance services require a 20% coinsurance, and plan-approved transportation is limited to 24 one-way trips per year.
Emergency Services See details
Champion Select (HMO-POS C-SNP) covers emergency services with a $150 copay and no coinsurance, and urgently needed services with no copay and no coinsurance. Worldwide emergency and urgent services are partially covered up to a $10,000 maximum, though worldwide emergency transportation is not covered.
Primary Care See details
Primary care benefits are partially covered by Champion Select (HMO-POS C-SNP) with no copay and no coinsurance for most services, including doctor visits, specialist care, and therapies. However, routine chiropractic care and podiatry services are not covered under this plan.
Preventive Services See details
Champion Select (HMO-POS C-SNP) partially covers preventive services with no copay and no coinsurance for covered options like annual physical exams, health education, and glaucoma screenings. Sub-services not covered include In-Home Safety Assessments, Medical Nutrition Therapy, Post-discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefits, Home-Based Palliative Care, In-Home Support Services, additional smoking cessation counseling, Enhanced Disease Management, Telemonitoring Services, and Counseling Services.
Hearing Services See details
Champion Select (HMO-POS C-SNP) provides partially covered hearing services, featuring routine hearing exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids (all types) are covered with a $149 copay and no coinsurance for up to two aids every three years, while OTC hearing aids and inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Champion Select (HMO-POS C-SNP) features partially covered vision services with no copay or coinsurance, including one routine eye exam per year and eyeglasses (lenses and frames) up to a $335 annual limit. However, contact lenses, eyeglass lenses, and eyeglass frames are not covered.
Dental Services See details
Champion Select (HMO-POS C-SNP) offers partially covered dental services up to a $3,000 annual maximum, featuring no copay and no coinsurance for preventive care, and no copays with a 20% to 40% coinsurance for comprehensive treatments. Adjunctive general services, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Champion Select (HMO-POS C-SNP) covers home infusion bundled services with prior authorization, including Medicare Part B insulin drugs with no coinsurance and a copay ranging from no copay to $24. Other Part B drugs, including chemotherapy and radiation services, feature no copay and require no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Champion Select (HMO-POS C-SNP) plan. While specific copay and coinsurance costs are not listed in the plan details, these essential kidney care services are a covered benefit.
Medical Equipment See details
Champion Select (HMO-POS C-SNP) covers medical equipment, including durable medical equipment and prosthetics, with no copay and coinsurance ranging from no coinsurance to 20%. Diabetic supplies and therapeutic shoes or inserts are also covered with no copay and no coinsurance.
Diagnostic and Radiological Services See details
Champion Select (HMO-POS C-SNP) covers diagnostic and radiological services with no copay and no coinsurance for all diagnostic tests, lab services, therapeutic radiology, and outpatient X-rays. Prior authorization and a doctor referral are required for diagnostic services.
Home Health Services See details
Champion Select (HMO-POS C-SNP) covers Home Health Services with no copay and no coinsurance. Prior authorization and a doctor referral are required to access these covered services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under Champion Select (HMO-POS C-SNP), as none of the sub-services, including intensive cardiac, pulmonary, and SET for PAD services, are covered in practice.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by Champion Select (HMO-POS C-SNP), requiring no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and no coinsurance. Prior authorization and a referral are required, and additional days beyond Medicare-covered SNF are not covered.
Other Services See details
Champion Select (HMO-POS C-SNP) states that some services are covered under its Other Services benefit, but acupuncture, over-the-counter (OTC) items, meal benefits, and dual eligible SNPs with highly integrated services are not covered.
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