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Champion Choice (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Champion Choice (HMO C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Champion Choice (HMO C-SNP) in 2026, please refer to our full plan details page.
Champion Choice (HMO C-SNP) is a HMO C-SNP plan offered by Champion Health Plans-USA, LLC. available for enrollment in 2026 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 Choice (HMO 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 Choice (HMO 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 Choice (HMO 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 Choice (HMO 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 Maximum Out-Of-Pocket cost of $9250.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
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 Choice (HMO C-SNP) Medicare plan features an annual drug deductible of $615. For Tier 1 preferred generics, Tier 2 generics, and Tier 6 select care drugs, members enjoy no copay for 1-month or 3-month supplies at standard pharmacies and standard mail order. This ensures affordable access to many essential and everyday medications. Higher-tier medications, including Tier 3 preferred brands, Tier 4 non-preferred brands, and Tier 5 specialty drugs, require a 25% coinsurance. This 25% coinsurance rate applies to both 1-month and 3-month supplies at standard pharmacies, as well as standard mail order for Tier 3 and Tier 4. Understanding these costs helps you plan your healthcare budget effectively under this Champion Choice plan.
Additional Benefits
The Champion Choice (HMO C-SNP) plan offers robust coverage with no copay and no coinsurance for inpatient hospital stays, primary care visits, and home health services. For outpatient care, specialist visits, and diagnostic services, members will generally pay no copay alongside a twenty percent coinsurance. Emergency services are available with a one hundred fifteen dollar copay, which is waived if admitted, while urgently needed care requires no copay. Supplemental benefits include no copay for preventive dental care up to a three thousand dollar yearly limit and a five hundred dollar annual allowance for eyewear with no copay. Additionally, routine hearing exams and transportation services for up to thirty-six one-way trips per year are provided with no copay. Prescription hearing aids are available with a flat one hundred forty-nine dollar copay, while select durable medical equipment carries no copay with coinsurance up to twenty percent.
Inpatient Hospital See details
Champion Choice (HMO C-SNP) covers inpatient acute and psychiatric hospital services with no copay and no coinsurance, subject to Medicare-defined deductibles, prior authorization, and referral requirements. Additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Champion Choice (HMO C-SNP) covers outpatient hospital, observation, and ambulatory surgical center services with no copay and a 20% coinsurance. Outpatient substance abuse individual sessions require no copay and a 20% coinsurance, while group sessions and outpatient blood services are provided with no copay and no coinsurance.
Partial Hospitalization See details
Champion Choice (HMO C-SNP) covers partial hospitalization services with no copay and no coinsurance. Prior authorization and a referral are required for these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Champion Choice (HMO C-SNP), with ground ambulance costing between no copay to a $125 copay and no coinsurance to 20% coinsurance, and air ambulance requiring 20% coinsurance. Transportation services are partially covered with no copay and no coinsurance for up to 36 one-way trips per year to plan-approved locations, while transportation to any health-related location is not covered.
Emergency Services See details
Champion Choice (HMO C-SNP) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services have no copay and no coinsurance, and worldwide emergency and urgent services are partially covered up to a $10,000 maximum with no copay or coinsurance, though worldwide emergency transportation is not covered.
Primary Care See details
Champion Choice (HMO C-SNP) covers primary care, occupational therapy, and telehealth services with no copay and no coinsurance, while chiropractic services are partially covered with no copay or coinsurance for routine care as other chiropractic services are not covered. Specialist visits, physical and speech therapy, psychiatric, mental health, and opioid treatment services feature no copay and a 20% coinsurance, whereas podiatry services are not covered.
Preventive Services See details
Champion Choice (HMO C-SNP) offers partially covered preventive services with no copay and no coinsurance for covered benefits like annual physical exams and kidney disease education. However, several sub-services are not covered, including in-home safety assessments, medical nutrition therapy, alternative therapies, therapeutic massage, adult day health, and home-based palliative care.
Hearing Services See details
Champion Choice (HMO C-SNP) covers routine and diagnostic hearing exams with 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, though inner ear, outer ear, over the ear, and over-the-counter (OTC) hearing aids are not covered.
Vision Services See details
Champion Choice (HMO C-SNP) offers partially covered vision services with no copay, no coinsurance, and no deductible, including one routine eye exam annually and eyeglasses (lenses and frames) with a $500 yearly maximum. Other eye exam services, contact lenses, individual eyeglass lenses, and individual eyeglass frames are not covered.
Dental Services See details
Dental services are partially covered by Champion Choice (HMO C-SNP), offering preventive and diagnostic care with no copay and no coinsurance up to a $3,000 yearly maximum. Comprehensive dental services are covered with no copay and 20% to 40% coinsurance, though adjunctive general services, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Champion Choice (HMO C-SNP) with no copay and no coinsurance, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs have a $0 to $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs require no copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by Champion Choice (HMO C-SNP) with no copay and a 20% coinsurance.
Medical Equipment See details
Champion Choice (HMO 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, supplies, and therapeutic shoes or inserts are also covered with no copay and no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are partially covered by Champion Choice (HMO C-SNP), featuring no copays and a 20% coinsurance for covered diagnostic procedures, diagnostic radiological services, and therapeutic radiological services. Outpatient x-ray services and lab services are not covered, and covered diagnostic services require prior authorization and referrals.
Home Health Services See details
Home Health Services are covered under the Champion Choice (HMO C-SNP) plan with no copay and no coinsurance. Both a referral and prior authorization are required to receive these services.
Cardiac Rehabilitation Services See details
Champion Choice (HMO C-SNP) covers some cardiac rehabilitation services with no copay, requiring prior authorization and referrals. 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
Champion Choice (HMO 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 Medicare-covered limit are not covered.
Other Services See details
Champion Choice (HMO C-SNP) partially covers other services, offering acupuncture with no copay and no coinsurance for up to 30 treatments per year. Over-the-counter (OTC) items, meal benefits, and other supplemental services are not covered.
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