Plan Results
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April 1 – September 30: Monday – Friday, 8 am – 8 pm
October 1 – March 31: Monday – Sunday, 8 am – 8 pm
2 Plans to compare
Champion Advantage
Medical Deductible
$0
Medical Premium
$0
with Extra Help
Not Covered
Maximum Out of Pocket
$0
Inpatient Hospital Copay
$0
Nephrologist Copay
$0
PCP Copay
$0
Specialist Copay
$0
Preferred Generic Rx
$0
Plan Benefits
- Vision
- Dental
- Transportation
- Over-the-Counter
- Healthy Foods
- Utilities
- Hearing
- Personal Alert
- Fitness
- Acupuncture and Chiropractic
- Telehealth
- Respite
Champion Connect
Plan ID H6170-002 | CKD/ESRD Point of Service Chronic Special Needs Plan
Medical Deductible
No Plan Deductible
$257 Part B deductible. (This is the 2025 amount. The Plan will update this once the 2026 amount is released.)
Medical Premium
$0
with Extra Help
$0
Maximum Out of Pocket
$0
Inpatient Hospital Copay
$0
Nephrologist Copay
20% of the Cost
PCP Copay
$0
Specialist Copay
20% of the Cost
Preferred Generic Rx
$0
Plan Benefits
- Vision
- Dental
- Transportation
- Over-the-Counter
- Healthy Foods
- Utilities
- Hearing
- Personal Alert
- Fitness
- Acupuncture and Chiropractic
- Telehealth
- Respite
Champion Select
Plan ID H6170-003 | CKD/ESRD Point of Service Chronic Special Needs Plan
Medical Deductible
$0
Medical Premium
$0
with Extra Help
Maximum Out of Pocket
$0
Inpatient Hospital Copay
$0
Nephrologist Copay
$0
PCP Copay
$0
Specialist Copay
$0
Preferred Generic Rx
$0
Plan Benefits
- Vision
- Dental
- Transportation
- Over-the-Counter
- Healthy Foods
- Utilities
- Hearing
- Personal Alert
- Fitness
- Acupuncture and Chiropractic
- Telehealth
- Respite
Champion Plus
Plan ID H6170-010 | Mental Health Conditions Chronic Special Needs Plan
Medical Deductible
No Plan Deductible
$257 Part B deductible. (This is the 2025 amount. The Plan will update this once the 2026 amount is released.)
Medical Premium
$0
with Extra Help
$0
Maximum Out of Pocket
$0
Inpatient Hospital Copay
$0
Nephrologist Copay
$0
PCP Copay
$0
Specialist Copay
20% of the Cost
Preferred Generic Rx
$0
Plan Benefits
- Vision
- Dental
- Transportation
- Over-the-Counter
- Healthy Foods
- Utilities
- Hearing
- Personal Alert
- Fitness
- Acupuncture and Chiropractic
- Telehealth
Champion Care
Plan ID H6170-008 | Diabetes/Congestive Heart Failure/Cardiovascular Disease Chronic Special Needs Plan
Medical Deductible
$0
Medical Premium
$0
with Extra Help
Maximum Out of Pocket
$0
Inpatient Hospital Copay
$0
PCP Copay
$0
Specialist Copay
$0
Preferred Generic Rx
$0
Plan Benefits
- Vision
- Dental
- Transportation
- Over-the-Counter
- Healthy Foods
- Utilities
- Hearing
- Personal Alert
- Fitness
- Acupuncture and Chiropractic
- Telehealth
- Respite
Champion Choice
Plan ID H6170-009 | Diabetes/Congestive Heart Failure/Cardiovascular Disease Chronic Special Needs Plan
The Champion Choice plan is a great choice for individuals with a diagnosis of Cardiovascular Disease, Congestive Heart Failure, or Diabetes who qualify for Medicaid and do not receive institutional-level type of care (long-term care).
Medical Deductible
No Plan Deductible
$257 Part B deductible. (This is the 2025 amount. The Plan will update this once the 2026 amount is released.)
Medical Premium
$0
with Extra Help
$0
Maximum Out of Pocket
$0
Inpatient Hospital Copay
$0
PCP Copay
$0
Specialist Copay
20% of the Cost
Preferred Generic Rx
$0
Plan Benefits
- Vision
- Dental
- Transportation
- Over-the-Counter
- Healthy Foods
- Utilities
- Hearing
- Personal Alert
- Fitness
- Acupuncture and Chiropractic
- Telehealth
- Respite
Champion Ally
Plan ID H6170-007 | Medicare Advantage Prescription Drug Plan
The Champion Ally plan is a great choice for anyone who doesn’t qualify for a Special Needs plan (SNP). This plan reduces the cost of prescription drugs while adding additional services and benefits. This plan is a great choice for anyone who doesn’t qualify for a Special Needs plan. This plan reduces the cost of prescription drugs while adding additional services and benefits.
Medical Deductible
$0
Medical Premium
$0
with Extra Help
Maximum Out of Pocket
$0
Inpatient Hospital Copay
$0
PCP Copay
$0
Specialist Copay
$0
Preferred Generic Rx
$0
Plan Benefits
- Vision
- Dental
- Transportation
- Over-the-Counter
- Healthy Foods
- Utilities
- Hearing
- Personal Alert
- Fitness
- Acupuncture and Chiropractic
- Telehealth
View Other Plans
View Other Plans
Champion Advantage
Plan ID H6170-001 | CKD/ESRD Point of Service Chronic Special Needs Plan
Medical Deductible
$0
Medical Premium
$0
with Extra Help
Maximum Out of Pocket
$0
Inpatient Hospital Copay
$0
Nephrologist Copay
$0
PCP Copay
$0
Specialist Copay
$0
Preferred Generic Rx
$0
Plan Benefits
- Vision
- Dental
- Transportation
- Over-the-Counter
- Healthy Foods
- Utilities
- Hearing
- Personal Alert
- Fitness
- Acupuncture and Chiropractic
- Telehealth
- Respite
Champion Connect
Plan ID H6170-002 | CKD/ESRD Point of Service Chronic Special Needs Plan
Medical Deductible
No Plan Deductible
$257 Part B deductible. (This is the 2025 amount. The Plan will update this once the 2026 amount is released.)
Medical Premium
$0
with Extra Help
$0
Maximum Out of Pocket
$0
Inpatient Hospital Copay
$0
Nephrologist Copay
20% of the Cost
PCP Copay
$0
Specialist Copay
20% of the Cost
Preferred Generic Rx
$0
Plan Benefits
- Vision
- Dental
- Transportation
- Over-the-Counter
- Healthy Foods
- Utilities
- Hearing
- Personal Alert
- Fitness
- Acupuncture and Chiropractic
- Telehealth
- Respite
Champion Select
Plan ID H6170-003 | CKD/ESRD Point of Service Chronic Special Needs Plan
Medical Deductible
$0
Medical Premium
$0
with Extra Help
Maximum Out of Pocket
$0
Inpatient Hospital Copay
$0
Nephrologist Copay
$0
PCP Copay
$0
Specialist Copay
$0
Preferred Generic Rx
$0
Plan Benefits
- Vision
- Dental
- Transportation
- Over-the-Counter
- Healthy Foods
- Utilities
- Hearing
- Personal Alert
- Fitness
- Acupuncture and Chiropractic
- Telehealth
- Respite
Champion Plus
Plan ID H6170-010 | Mental Health Conditions Chronic Special Needs Plan
Medical Deductible
No Plan Deductible
$257 Part B deductible. (This is the 2025 amount. The Plan will update this once the 2026 amount is released.)
Medical Premium
$0
with Extra Help
$0
Maximum Out of Pocket
$0
Inpatient Hospital Copay
$0
Nephrologist Copay
$0
PCP Copay
$0
Specialist Copay
20% of the Cost
Preferred Generic Rx
$0
Plan Benefits
- Vision
- Dental
- Transportation
- Over-the-Counter
- Healthy Foods
- Utilities
- Hearing
- Personal Alert
- Fitness
- Acupuncture and Chiropractic
- Telehealth
Champion Care
Plan ID H6170-008 | Diabetes/Congestive Heart Failure/Cardiovascular Disease Chronic Special Needs Plan
Medical Deductible
$0
Medical Premium
$0
with Extra Help
Maximum Out of Pocket
$0
Inpatient Hospital Copay
$0
PCP Copay
$0
Specialist Copay
$0
Preferred Generic Rx
$0
Plan Benefits
- Vision
- Dental
- Transportation
- Over-the-Counter
- Healthy Foods
- Utilities
- Hearing
- Personal Alert
- Fitness
- Acupuncture and Chiropractic
- Telehealth
- Respite
Champion Choice
Plan ID H6170-009 | Diabetes/Congestive Heart Failure/Cardiovascular Disease Chronic Special Needs Plan
Medical Deductible
No Plan Deductible
$257 Part B deductible. (This is the 2025 amount. The Plan will update this once the 2026 amount is released.)
Medical Premium
$0
with Extra Help
$0
Maximum Out of Pocket
$0
Inpatient Hospital Copay
$0
PCP Copay
$0
Specialist Copay
$0
Preferred Generic Rx
$0
Plan Benefits
- Vision
- Dental
- Transportation
- Over-the-Counter
- Healthy Foods
- Utilities
- Hearing
- Personal Alert
- Fitness
- Acupuncture and Chiropractic
- Telehealth
- Respite
Champion Ally
Plan ID H6170-007 | Medicare Advantage Prescription Drug Plan
The Champion Ally plan is a great choice for anyone who doesn’t qualify for a Special Needs plan (SNP). This plan reduces the cost of prescription drugs while adding additional services and benefits. This plan is a great choice for anyone who doesn’t qualify for a Special Needs plan. This plan reduces the cost of prescription drugs while adding additional services and benefits.
Medical Deductible
$0
Medical Premium
$0
with Extra Help
Not Covered
Maximum Out of Pocket
$0
Inpatient Hospital Copay
$0
PCP Copay
$0
Specialist Copay
$0
Preferred Generic Rx
$0
Plan Benefits
- Vision
- Dental
- Transportation
- Over-the-Counter
- Healthy Foods
- Utilities
- Hearing
- Personal Alert
- Fitness
- Acupuncture and Chiropractic
- Telehealth