Plan Results
Your questions and comments are important to us. Our licensed insurance agents can explain plan benefits, how it works and how to get started.
1-800-885-8000 | TTY 711
Member Services Hours of Operation
April 1 – September 30: Monday – Friday, 8 am – 8 pm
October 1 – March 31: Monday – Sunday, 8 am – 8 pm
Champion Advantage
Plan ID H6170-001 | ESRD Chronic Special Needs Plan
A Medicare Advantage Prescription Drug (MAPD) HMO Chronic Special Needs (C-SNP) best suited for individuals with end stage renal disease who qualify for Medicare but who do not qualify for Medicaid.
Medical Deductible
$0
Medical Premium
$0
Maximum Out of Pocket
$5,495
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
- Hearing
- Personal Alert
Champion Connect
Plan ID H6170-002 | ESRD Chronic Special Needs Plan
Medical Deductible
$0
Medical Premium
$41
with Extra Help
$0
Maximum Out of Pocket
$8,300
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
- Hearing
- Personal Alert
Champion Select
Medical Deductible
$0
Medical Premium
$0
Maximum Out of Pocket
$5,495
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
- Hearing
- Personal Alert
View Other Plans
View Other Plans
Champion Advantage
A Medicare Advantage Prescription Drug (MAPD) HMO Chronic Special Needs (C-SNP) best suited for individuals with end stage renal disease who qualify for Medicare but who do not qualify for Medicaid.
Medical Deductible
$0
Medical Premium
$0
Maximum Out of Pocket
$5,495
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
- Hearing
- Personal Alert
Champion Connect
Medical Deductible
$0
Medical Premium
$41
with Extra Help
$0
Maximum Out of Pocket
$8,300
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
- Hearing
- Personal Alert
Champion Select
Medical Deductible
$0
Medical Premium
$0
Maximum Out of Pocket
$5,495
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
- Hearing
- Personal Alert
