Heart and Diabetes Care
C-SNP HMO
Champion Care
Medicare Only
Enroll NowCalifornia
Chronic Special Needs Plans for Diabetes and Heart Disease
Champion Health Plan offers Champion Care and Champion Choice, which both bring together specialized clinical support, medication coverage, and care coordination, designed around the unique needs of members managing heart disease or diabetes.
Our care teams work directly with your cardiologist, endocrinologist, and primary care doctor to coordinate blood sugar management, heart health monitoring, medications, and the full range of preventive services Champion members count on.
If you’re living with chronic heart failure, chronic systolic heart failure, chronic diastolic heart failure, chronic combined systolic and diastolic heart failure, other documented chronic heart failure (acute heart failure without an underlying chronic diagnosis may not qualify), or Cardiovascular disorders (CMS limits this category to Cardiac arrhythmias, Coronary artery disease, peripheral vascular disease, chronic venous thromboembolic disorder), these plans are designed around your care needs.
Heart and Diabetes Care plus Medi-Cal Support
C-SNP HMO
Champion Choice
Medicare + Medi-Cal
Enroll NowCalifornia Counties Available
- Imperial County
- Fresno County
- Kern County
- Los Angeles County
- Madera County
- Orange County
- Riverside County
- San Bernardino County
- San Diego County
| Doctor & Care Cost | Champion Care | Champion Choice |
|---|---|---|
| Monthly Premium | $0 | $12 |
| Deductible | None | None |
| MOOP | $199 | $9,250 |
| Primary Care Physician | $0 | $0 |
| Specialists | $0 | 20% |
| Diagnostic Radiology, Lab | $0 | $0 |
| Annual Wellness Visit | $0, up to one (1) annual exam | $0, up to one (1) annual exam |
| Dialysis | 20% | 20% |
| Urgent Care | $0 | $0 |
| Emergency Room | $70 | $115 |
| Inpatient Hospital | $0 | $1,676 |
| Outpatient Hospital | $100 | 20% |
| Plan Benefits | Champion Care | Champion Choice |
|---|---|---|
| OTC / Healthy Food / Utilities | $300 Allowance every (3) three months | $500 Allowance every (3) three months |
| Transportation | $0, 24 one-way plan-approved locations | $0, 36 one-way plan-approved locations |
| Dental | $3000 Allowance | $3000 Allowance |
| Routine Eye Exam | $0 Exam | $0 Exam |
| Vision Eyewear (frames/lenses/contacts) | $335 Eyewear Allowance | $500 Eyewear Allowance |
| Routine Hearing Exam | $0 Exam | $0 Exam |
| Hearing Aid | $149 Aids | $149 Aids |
| Respite | $0, up to 12 sessions a year | $0, up to 12 sessions a year |
| PERS | $0 | $0 |
| Prescription Drug Costs | Champion Care | Champion Choice |
|---|---|---|
| Tier 1 - Preferred Generics | $0 | $0 |
| Tier 2 - Non-Preferred Generics | Participating Retail Pharmacy: $3 Mail Order: $6 | $0 |
| Tier 3 - Preferred Brand | Participating Retail Pharmacy: $47 Mail Order: $94 | 25% |
| Tier 4 - Non-Preferred Brands | Participating Retail Pharmacy: $100 Mail Order: $200 | 25% |
| Tier 5 - Specialty Drugs | 33% (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 |
| Insulin | $20, one-month supply $60, three-month supply | $20, one-month supply $60, three-month supply |
| Plan Resources | Champion Care | Champion Choice |
|---|---|---|
| Plan Summary | Download | |
| Summary of Benefits | Download | Download |
| Over-the-Counter Catalog | Download | Download |
| Healthy Foods Catalog | Download | Download |
| Dental Fee Schedule | Download | Download |
| Clinical Criteria | Download | Download |
| Verification of Chronic Condition Form | Download | Download |
| Health Risk Assessment Form | Download | Download |
| Enrollment Form | Download | Download |
| Authorization for Disclosure of Protected Health Information | Download | Download |
| Evidence of Coverage (EOC) | Download | Download |
| Enrollment Kit | Download | Download |
