Specialized Kidney (CKD) Care
C-SNP HMO-POS
Champion Advantage
Medicare Only
Enroll NowCalifornia
Chronic Special Needs Plans for Kidney Diseases
Champion Health Plan offers Champion Advantage, Champion Connect and Champion Select, which all bring together specialized clinical support, medication coverage, and care coordination, designed around the unique needs of members managing kidney disease.
Our care teams work directly with your nephrologist and primary care doctor to coordinate dialysis, transplant evaluations, medications, and the full range of preventive services Champion members count on.
If you have chronic kidney disease (stage 4 or stage 5), severe loss of kidney function (generally an eGFR of 15–29), kidney failure (generally an eGFR below 15, whether or not dialysis has started), end-stage renal disease requiring dialysis, hemodialysis, peritoneal dialysis, home dialysis, in-center dialysis, kidney transplant recipient (within 36 months following the kidney transplant, when included in Champion Health Plan’s CMS-approved eligibility criteria), Champion Health Plan has a plan built to help you manage your healthcare needs.
Kidney Care plus Medi-Cal Support
C-SNP HMO-POS
Champion Connect
Medicare + Medi-Cal
Enroll NowSpecialized Kidney (CKD) Care without Medi-Cal
C-SNP HMO-POS
Champion Select
Medicare + Extra Help (No Medi-Cal)
Enroll NowCalifornia Counties Available
- Los Angeles County
- Orange County
- San Bernardino County
- Imperial County
- Riverside County
- San Diego County
- Fresno County
- Kern County
- Madera County
| Doctor & Care Cost | Champion Advantage | Champion Connect | Champion Select |
|---|---|---|---|
| Monthly Premium | $0 | $0 | $8.40 |
| Deductible | None | None $257 Part B deductible. | None |
| MOOP | $499 | $9,250 | $499 |
| Primary Care Physician | $0 | In-Network: $0 Copay Out-of-Network: $0 Copay Your cost with Medicare and Medi-Cal: $0 Copay | $0 |
| Specialists | $0 | 20% | $0 |
| Diagnostic Radiology, Lab | $0 | $0 | $0 |
| Annual Wellness Visit | $0, up to one (1) annual exam | $0, up to one (1) annual exam | $0, up to one (1) annual exam |
| Dialysis | $0 | $0 | $0 |
| Urgent Care | $0 | $0 | $0 |
| Emergency Room | $150 | $115 | $150 |
| Inpatient Hospital | $0 | In-Network: $1,676 Deductible per Medicare-covered benefit period $0 for days 1-60 | $0 |
| Outpatient Hospital | $100 | In-Network: 20% Out-of-Network: 20% Your Cost with Medicare & Medi-Cal: $0 Copay | $100 |
| Plan Benefits | Champion Advantage | Champion Connect | Champion Select |
|---|---|---|---|
| OTC / Healthy Food / Utilities | $330 Allowance every (3) three months | $505 Allowance every (3) three months | $400 Allowance every (3) three months |
| Transportation | $0, 24 one-way plan-approved locations | $0, 36 one-way plan-approved locations | $0, 24 one-way plan-approved locations |
| Dental | $3000 Allowance | $3000 Allowance | $3000 Allowance |
| Routine Eye Exam | $0 Exam | $0 Exam | $0 Exam |
| Vision Eyewear (frames/lenses/contacts) | $335 Eyewear Allowance | $500 Eyewear Allowance | $335 Eyewear Allowance |
| Routine Hearing Exam | $0 Exam | $0 Exam | $0 Exam |
| Hearing Aid | $149 Aids | $149 Aids | $149 Aids |
| Respite | $0, Up to 12 sessions a year | $0, up to 12 sessions a year | $0, up to 12 sessions a year |
| PERS | $0 | $0 | $0 |
| Prescription Drug Costs | Champion Advantage | Champion Connect | Champion Select |
|---|---|---|---|
| Tier 1 - Preferred Generics | $0 | $0 | $0 |
| Tier 2 - Non-Preferred Generics | Participating Retail Pharmacy: $3 Mail Order: $6 | $0 | $0 |
| Tier 3 - Preferred Brand | Participating Retail Pharmacy: $47 Mail Order: $94 | 25% | 25% |
| Tier 4 - Non-Preferred Brands | Participating Retail Pharmacy: $100 Mail Order: $200 | 25% | 25% |
| Tier 5 - Specialty Drugs | Participating Retail Pharmacy: 33% Mail Order: A 100-day supply is not available in Tier 5 | 25% (A 100-day supply is not available in Tier 5) | 25% (A 100-day supply is not available in Tier 5) |
| Tier 6 - Select Care | $0 | $0 | $0 |
| Insulin | $20, one-month supply $60, three-month supply | $20, one-month supply $60, three-month supply | $20, one-month supply $60, three-month supply |
| Plan Resources | Champion Advantage | Champion Connect | Champion Select |
|---|---|---|---|
| Summary of Benefits | Download | Download | Download |
| Annual Notice of Change (ANOC) | Download | Download | Download |
| Over-the-Counter Catalog | Download | Download | Download |
| Healthy Foods Catalog | Download | Download | Download |
| Dental Fee Schedule | Download | Download | Download |
| Clinical Criteria | Download | Download | Download |
| Verification of Chronic Condition Form | Download | Download | Download |
| Health Risk Assessment Form | Download | Download | Download |
| Enrollment Form | Download | Download | Download |
| Authorization for Disclosure of Protected Health Information | Download | Download | Download |
| Evidence of Coverage (EOC) | Download | Download | Download |
| Enrollment Kit | Download | Download | Download |
*As a Point-of-Service (POS) plan, you can use providers outside of the plan’s network but you may have an additional cost. If you use an out-of-network provider that is not participating in Medicare, neither Medicare nor Champion Advantage, Champion Connect, or Champion Select (HMO-POS C-SNP) will pay for those services. Make sure your provider participates in Medicare.
