couple listening to music - different aspect ratio

Senior Program (HMO)

$38/month*

Senior Program (HMO) is available for people with Medicare Parts A & B
who live in San Francisco or San Mateo county.

Monthly Plan Premium
Maximum Out-of-Pocket Responsibility (MOOP)
Medicare Drug Coverage Yearly Deductible
Primary Care Visits
Preventive Screenings****
X-Rays
Diagnostic Radiology Services
Laboratory Services
Immunizations
Specialist Visits
Physical Therapy
Medicare-Covered Acupuncture
Emergency Care
Preventive Dental Services*****
Optional Comprehensive Dental Coverage*****
Eyeglasses or Contact lenses*****
Medicare-covered Diagnostic Hearing Exam
Hearing Aids*****
Over-the-Counter (OTC) Allowance
Grocery Flex Card
Transportation Services
Acupuncture (Supplemental benefit)
$38*
$3,000 per year
$0
$0 copay
$0 copay**
$0 copay**
$50 copay**
$0 copay**
$0 copay**
$0 copay**
$15 copay**
$0 copay**
$90 copay****
$0 copay (Limit 2 dental exams and cleanings per year)
$16.75 monthly premium, in addition to monthly plan premium.
1 pair of glasses or contact lenses per 2 years (Up to $150 plan allowance from a VSP provider per 2 years)
$20 copay**
$600 - $2,075 copay per hearing aid (Limit 2 per year)
$100 allowance per quarter (allowance expires quarterly)
One-time $100 allowance*** (allowance expires on January 31, 2028)
$0 copay, 12 round trips to and from plan-approved health-related locations for covered medical services. Restrictions apply.
$0 copay**

*Premium may vary based on the level of Extra Help you receive. Please contact the plan for further details.
**Prior authorization and referral rules may apply.
***Must qualify by completing Annual Wellness Visit.
****Preventive Screenings apply to Medicare-covered preventive services that meet Medicare coverage requirements. Other diagnostic tests and screenings may be subject to applicable cost sharing.
*****Supplemental Benefit: These benefits are not covered under Original Medicare but are included in your CCHP plan.

Ready to Enroll?

Complete the enrollment form & return to our Sales Department.

Call

1-888-681-3888 (TTY 1-877-681-8898)
7 days a week from 8 a.m. to 8 p.m.

Visit

445 Grant Avenue, San Francisco, CA 94108
Monday – Saturday: 9 a.m. – 5 p.m.

845 Jackson Street, San Francisco, CA 94133
Monday – Friday: 9 a.m. – 5 p.m.

386 Gellert Boulevard, Daly City, CA 94015
Monday – Friday: 9 a.m. – 5 p.m.

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Exceptional Member Support

Our approachable and dedicated team of friendly, knowledgeable Member Services representatives are here to answer questions or concerns related to your covered services or the care you receive. Always accessible and ready to assist, you can reach us via email, phone, or even in-person. As our member, we ensure you get the help you need, whenever you need it.