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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 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 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 $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 $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) prescription drug plan has an annual drug deductible of $615. For Tier 1 preferred generics, Tier 2 generics, and Tier 6 select care drugs, there is no copay for one-month or three-month supplies at standard pharmacies and standard mail order. This coverage provides an affordable option for individuals requiring common generic medications. For brand-name and specialty drugs, the plan transitions to a coinsurance model. Members pay a 25% coinsurance for Tier 3 preferred brand, Tier 4 non-preferred brand, and Tier 5 specialty drugs at standard pharmacies. This 25% coinsurance also applies to three-month supplies of Tier 3 and Tier 4 drugs filled through standard pharmacies or mail order.
Additional Benefits
The Champion Select (HMO-POS C-SNP) plan offers comprehensive medical coverage with no copays and no coinsurance for primary care, specialist visits, preventive care, and home health services. Medicare-covered acute inpatient hospital stays require no copay, while outpatient hospital visits have a $100 copay and emergency services require a $150 copay. Diagnostic services and dialysis are also covered with no coinsurance and low to no copays. Supplemental benefits include dental coverage with no copay for preventive care up to a $3,000 annual limit, alongside routine vision and hearing exams with no copays or coinsurance. Members also benefit from up to 24 one-way transportation trips per year with no copay, as well as medical equipment with no copay and 0% to 20% coinsurance. Note that some services, including cardiac rehabilitation, acupuncture, and over-the-counter items, are not covered.
Inpatient Hospital See details
Champion Select (HMO-POS C-SNP) offers partially covered inpatient hospital services with no coinsurance for both acute and psychiatric stays. Medicare-covered acute stays have no copay, while psychiatric stays require a $100 copay for days 1 through 10 and no copay for days 11 through 90, though additional days, non-Medicare-covered stays, and upgrades are not covered.
Outpatient Services See details
Outpatient services are covered by Champion Select (HMO-POS C-SNP) with no coinsurance, featuring a $100 copay for outpatient hospital services and no copay for observation, ambulatory surgical center, substance abuse, and blood services. Prior authorization and referrals are required for most of these outpatient services.
Partial Hospitalization See details
Partial hospitalization is covered by Champion Select (HMO-POS C-SNP) with no copay and no coinsurance. Prior authorization and a referral are required to receive these services.
Ambulance and Transportation Services See details
Champion Select (HMO-POS C-SNP) covers ground ambulance services with a $0 to $125 copay and coinsurance, and air ambulance services with a 20% coinsurance and a copay. Transportation services are partially covered with no copay and no coinsurance for up to 24 one-way trips per year to plan-approved locations, though transportation to any health-related location is not covered.
Emergency Services See details
Champion Select (HMO-POS C-SNP) covers emergency services with a $150 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours, and urgently needed services with no copay and no coinsurance. Worldwide emergency and urgent services are partially covered up to a $10,000 maximum with no copay and no coinsurance, although worldwide emergency transportation is not covered.
Primary Care See details
Champion Select (HMO-POS C-SNP) covers primary care, specialist, therapy, and mental health services with no copay and no coinsurance. Podiatry services are not covered by this plan, and although some chiropractic services are covered, routine and other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by Champion Select (HMO-POS C-SNP), offering no copays and no coinsurance for covered care such as annual physicals, glaucoma screenings, and kidney disease education. However, multiple supplemental benefits are not covered, including medical nutrition therapy, weight management programs, alternative therapies, therapeutic massage, and in-home safety assessments.
Hearing Services See details
Champion Select (HMO-POS C-SNP) covers hearing exams and evaluations with no deductible, no copay, and no coinsurance. Prescription hearing aids are partially covered with a $149 copay and no coinsurance for up to two devices every three years, but OTC hearing aids and inner ear, outer ear, and over-the-ear prescription aids are not covered.
Vision Services See details
Vision Services are partially covered by Champion Select (HMO-POS C-SNP) with no copay and no coinsurance for covered services, which include one routine eye exam per year and eyeglasses (lenses and frames) up to a $335 annual maximum. Other eye exam services, contact lenses, individual eyeglass lenses, and individual eyeglass frames are not covered.
Dental Services See details
Champion Select (HMO-POS C-SNP) offers partially covered dental services with a $3,000 annual maximum limit, featuring no copay and no coinsurance for preventive and diagnostic care. Covered comprehensive services require no copay and a 20% to 40% coinsurance, while 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 no copay and no coinsurance, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs have a copay of $0.00 to $24.00 and no coinsurance, while Part B chemotherapy, radiation, and other drugs have 0% to 20% coinsurance and no copay.
Dialysis Services See details
Dialysis Services are covered by Champion Select (HMO-POS C-SNP) with no copay and no coinsurance.
Medical Equipment See details
Champion Select (HMO-POS C-SNP) covers medical equipment, offering durable medical equipment, prosthetics, and medical supplies with no copay and 0% to 20% coinsurance, subject to prior authorization. Diabetic equipment, including supplies and therapeutic shoes or inserts, is covered with no copay and no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Champion Select (HMO-POS C-SNP) with no coinsurance and copays starting at $0. Diagnostic services, such as lab tests and outpatient procedures, require prior authorization and a referral.
Home Health Services See details
Home Health Services are covered by Champion Select (HMO-POS C-SNP) with no copay and no coinsurance, although a referral and prior authorization are required.
Cardiac Rehabilitation Services See details
Champion Select (HMO-POS C-SNP) does not cover Cardiac Rehabilitation Services, as none of the individual sub-services—including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation—are covered by the plan in practice.
Skilled Nursing Facility (SNF) See details
Champion Select (HMO-POS C-SNP) covers Skilled Nursing Facility (SNF) care with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization and referrals are required, and additional days beyond the standard 100-day limit are not covered.
Other Services See details
Champion Select (HMO-POS C-SNP) does not cover Other Services, meaning there is no coverage for acupuncture, over-the-counter (OTC) items, or meal benefits. Because these services are not covered, members are responsible for all associated costs.
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