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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 2026, 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 CAR, CHU, CLA and WAS counties. 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.
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 $9.50. 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 $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 $9250.00 (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 $9250.00 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 features an annual prescription drug deductible of $615. Under this plan, you will pay no copay for Tier 1 preferred generic, Tier 2 generic, and Tier 6 select care drugs at standard pharmacies and through standard mail order. This ensures that essential medications remain highly accessible with no out-of-pocket copayments. For brand-name and specialty medications, a 25% coinsurance applies to Tier 3 preferred brand, Tier 4 non-preferred brand, and Tier 5 specialty drugs. This 25% coinsurance is required for one-month and three-month fills at standard pharmacies and standard mail order, though Tier 5 specialty drugs are limited to a one-month supply. Understanding these tier-based costs helps you plan your healthcare expenses effectively.
Additional Benefits
The Champion Connect (HMO-POS C-SNP) plan offers robust coverage with no copay for primary care, preventive services, urgent care, dialysis, and home health services. Members also benefit from no copay on inpatient hospital stays, though a deductible applies, while specialist visits and outpatient hospital services generally require no copay but incur a 20% coinsurance. Supplemental benefits include dental care up to a $3,000 annual limit with no copay for preventive services, and vision coverage featuring a $500 annual allowance for eyewear with no copay or deductible. Additionally, the plan provides up to 36 one-way transportation trips per year with no copay and covers prescription hearing aids with a $149 copay.
Inpatient Hospital See details
Champion Connect (HMO-POS C-SNP) partially covers inpatient hospital services for acute and psychiatric stays with no copay and no coinsurance, though a deductible applies and prior authorization and referrals are required. Additional days, upgrades, and non-Medicare-covered stays are not covered under this benefit.
Outpatient Services See details
Champion Connect (HMO-POS C-SNP) covers outpatient services with no copay, though a 20% coinsurance applies to outpatient hospital and observation services. Ambulatory surgical center services, outpatient substance abuse sessions, and outpatient blood services are covered with no copay and no coinsurance, though prior authorization and referrals are required for most services.
Partial Hospitalization See details
Champion Connect (HMO-POS C-SNP) covers partial hospitalization services with no copay and no coinsurance. Members will need to obtain a referral and prior authorization to receive these covered services.
Ambulance and Transportation Services See details
Champion Connect (HMO-POS C-SNP) covers ground ambulance services with a copay ranging from $0 to $125 and coinsurance, and air ambulance services with a 20% coinsurance and a copay. Transportation services are partially covered, offering up to 36 one-way trips per year to plan-approved locations with no copay and no coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
Champion Connect (HMO-POS C-SNP) covers emergency services with a $115 copay and no coinsurance, and urgently needed services with no copay and no coinsurance. Worldwide emergency and urgent benefits are partially covered up to a $10,000 limit with no copay and no coinsurance, but worldwide emergency transportation is not covered.
Primary Care See details
Champion Connect (HMO-POS C-SNP) offers primary care, occupational therapy, telehealth, mental health, and psychiatric services with no copay and no coinsurance. Specialist visits, physical therapy, speech-language pathology, opioid treatment, and other professional services are covered with no copay and 20% coinsurance. Podiatry is not covered, and while some chiropractic services are covered, routine and other chiropractic services are not.
Preventive Services See details
Preventive Services are partially covered by Champion Connect (HMO-POS C-SNP) with no copay and no coinsurance for covered options like annual physicals, kidney disease education, and diabetes self-management training. Sub-services not covered under this plan include in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, smoking cessation counseling, enhanced disease management, telemonitoring, and counseling.
Hearing Services See details
Champion Connect (HMO-POS C-SNP) hearing services include routine hearing exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially 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 Connect (HMO-POS C-SNP) offers partially covered vision services with no copay, no coinsurance, and no deductible. Covered benefits include one routine eye exam per year and eyeglasses (lenses and frames) up to a $500 annual maximum, while contact lenses, other eye exams, and individual eyeglass lenses or frames are not covered.
Dental Services See details
Champion Connect (HMO-POS C-SNP) offers partially covered dental services up to a $3,000 annual maximum, with preventive care, exams, and cleanings available for no copay and no coinsurance. Covered comprehensive services, such as restorative care, endodontics, periodontics, prosthodontics, and oral surgery, feature no copay and 20% to 40% coinsurance. Adjunctive general services, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Champion Connect (HMO-POS C-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs have a 0% to 20% coinsurance, while Part B insulin is covered with a $0.00 to $24.00 copay and no coinsurance.
Dialysis Services See details
Dialysis Services are fully covered under Champion Connect (HMO-POS C-SNP) with no copay and no coinsurance.
Medical Equipment See details
Champion Connect (HMO-POS C-SNP) covers medical equipment with no copays for all items, including durable medical equipment (DME), prosthetics, and diabetic supplies. Diabetic equipment and supplies feature no coinsurance, while DME and prosthetics require prior authorization and have a coinsurance ranging from 0% to 20%.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Champion Connect (HMO-POS C-SNP), with prior authorization and referrals required for diagnostic care. Lab services, outpatient x-rays, and therapeutic radiology feature no copay but require coinsurance, while diagnostic procedures and diagnostic radiological services require a copay and a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered by Champion Connect (HMO-POS C-SNP) with no copay and no coinsurance, although prior authorization and a referral are required.
Cardiac Rehabilitation Services See details
Champion Connect (HMO-POS C-SNP) covers some cardiac rehabilitation services with no copay, though prior authorization and referrals are required. However, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Champion Connect (HMO-POS C-SNP) with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. This benefit requires prior authorization and a referral, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services are not covered under the Champion Connect (HMO-POS C-SNP) plan, as acupuncture, over-the-counter (OTC) items, and meal benefits are all excluded from coverage.
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