Champion Health Plan
Champion Health Plan is a Long Beach-based Medicare Advantage organization operating in California and Nevada, offering Chronic Condition Special Needs Plans (C-SNPs) primarily for ESRD and CKD beneficiaries, plus plans for Diabetes, Cardiovascular, and Behavioral Health conditions.
- Company typePrivate
- Founded2020
- HeadquartersLong Beach, United States
- Headcount—
- GTM typeB2C
- OfferingServices
What Champion Health Plan does
Champion Health Plan, founded in 2020, is a Medicare Advantage Prescription Drug (MAPD) organization operating under the holding entity Champion Health Plans USA, LLC, with operating subsidiaries Champion Health Plan of California, Inc. and Renal Payer Solutions, Inc. (dba Champion Health Plan of Nevada). The company is headquartered in Long Beach, California, and serves Medicare beneficiaries across 13 counties in California (Fresno, Imperial, Kern, Los Angeles, Madera, Orange, Riverside, San Bernardino, San Diego) and Nevada (Churchill, Clark, Carson City, Washoe). Champion holds a Medicare contract with CMS and CHAP accreditation, enabling it to offer Chronic Condition Special Needs Plans (C-SNPs).
Champion's product portfolio comprises seven health plans organized around chronic condition verticals. The HMO-POS C-SNP plans (Champion Advantage, Champion Connect, Champion Select) target CKD and ESRD beneficiaries with coordinated dialysis care, nephrology networks, and home-based dialysis support. HMO C-SNP plans (Champion Care, Champion Choice) serve members with Diabetes and Cardiovascular Disease, with Champion Choice integrating Medicaid (Medi-Cal) for dual-eligible beneficiaries. Champion Plus is an HMO C-SNP for serious behavioral health conditions including schizophrenia, schizoaffective disorder, bipolar disorder, and major depression. Champion Ally is an HMO MAPD plan for general Medicare beneficiaries. All plans combine Part A hospital, Part B medical, and Part D prescription drug coverage with supplemental benefits (dental via Delta Dental, vision via EyeMed, hearing via TruHearing, Silver&Fit fitness, transportation, OTC, and Food-as-Medicine allowances).
The company's revenue model relies on CMS capitation payments and member premiums for MAPD and C-SNP products, with Part D drug coverage administered through MedImpact Healthcare Systems (PBM) and Birdi (mail-order pharmacy). Pricing is not publicly disclosed but emphasizes $0 or low premiums with $0 copays for PCPs, nephrologists, dialysis centers, and specialists. Distribution combines licensed sales agents, an internal agent/broker network, a direct-to-consumer Plan Finder tool, mail enrollment, and Medicare.gov marketplace listings. Champion Health Plan had approximately 14 employees based on available data, reflecting a lean operational structure that relies heavily on contracted provider networks, outsourced ancillary benefits, and technology integrations rather than large in-house headcount. No funding rounds, executive team details, or membership figures are publicly disclosed.
Champion Health Plan firmographics
Firmographics- Name
- Champion Health Plan
- Legal name
- Champion Health Plans USA, LLC
- Website
- https://championhmo.com
- Company type
- Private
- Founded year
- 2020
- Operating status
- Operating
- Short description
- Champion Health Plan is a Long Beach-based Medicare Advantage organization operating in California and Nevada, offering Chronic Condition Special Needs Plans (C-SNPs) primarily for ESRD and CKD beneficiaries, plus plans for Diabetes, Cardiovascular, and Behavioral Health conditions.
- Ownership category
- akta.pro rank
Champion Health Plan industry classification
Industry- Product category
- Medicare Advantage Health Insurance
- NAICS
- Direct Health and Medical Insurance Carriers (524114)
- SIC
- Accident & Health Insurance (6321), Hospital & Medical Service Plans (6324)
- akta.pro primary industry
- MA-PD Plans (Medicare Advantage with Prescription Drug Coverage) (FSAIAGAG)
- akta.pro secondary industries
- MA Chronic Condition Management & Supplemental Benefits (SSBCI) (HLAEACAI), Medicare Advantage (MA) Plans (FSAIAGAA)
Keywords
Where Champion Health Plan is headquartered
LocationHeadquarters
- HQ city
- Long Beach
- HQ country
- United States
- HQ region
- North America
Offices2 records
Markets served
Champion Health Plan business model
Business model- GTM type
- B2C
- Offering type
- Services
- Cost components
- Personnel, Operations, Technology or R&D, Marketing or Sales, Others
Revenue model
- Medicare Advantage Premium Revenue: Champion Health Plan generates revenue through Medicare Advantage Prescription Drug (MAPD) plan premiums paid by CMS and members. The company operates as a Medicare Advantage organization with Medicare contract, receiving capitation payments and generating premium revenue from multiple plan types including HMO, HMO-POS C-SNP, and HMO C-SNP products.
- Part D Prescription Drug Revenue: Medicare Part D prescription drug coverage is integrated into MAPD plans, generating revenue through pharmacy benefit management and drug formulary administration via MedImpact Healthcare Systems.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Annual | Champion Advantage, Champion Connect, Champion Select (HMO-POS C-SNP for CKD/ESRD) |
| Subscription | Annual | Champion Care, Champion Choice (HMO C-SNP for Diabetes/Cardiovascular) |
| Subscription | Annual | Champion Plus (HMO C-SNP for Behavioral Health) |
| Subscription | Annual | Champion Ally (HMO MAPD) |
Go-to-market motion3 records
Distribution channels5 records
Marketing channels6 records
Champion Health Plan product offering
Product offeringCore offering
Champion Health Plan is a Medicare Advantage Prescription Drug (MAPD) health insurer offering seven distinct plans targeting Medicare beneficiaries with chronic conditions in California and Nevada. Core plans include HMO-POS C-SNP products for ESRD/CKD (Champion Advantage, Champion Connect, Champion Select), HMO C-SNP products for diabetes/cardiovascular and behavioral health (Champion Care, Champion Choice, Champion Plus), and a general MAPD HMO plan (Champion Ally). All plans combine Part A hospital, Part B medical, and Part D prescription drug coverage with $0 or low premiums, coordinated care teams, and supplemental benefits such as dental, vision, hearing, transportation, and food allowances.
Product overview
Champion Health Plan is a Medicare Advantage Prescription Drug (MAPD) plan organization offering seven distinct health insurance benefit plans designed primarily for Medicare beneficiaries with chronic conditions, particularly End Stage Renal Disease (ESRD) and Chronic Kidney Disease (CKD). The portfolio includes MAPD HMO plans (Champion Ally for general Medicare beneficiaries), Chronic Condition Special Needs Plans in HMO format (Champion Care, Champion Choice, and Champion Plus for diabetes/cardiovascular and behavioral health conditions), and HMO-POS C-SNP plans (Champion Advantage, Champion Connect, Champion Select for CKD/ESRD). All plans combine hospital, medical, and prescription drug coverage with coordinated care models. Champion Health Plan operates exclusively in California and Nevada, serving Medicare beneficiaries with chronic conditions through a network of providers. The plans include additional benefits beyond Original Medicare such as dental, vision, hearing, transportation, food allowances, over-the-counter products, home-based dialysis support, and fitness programs.
Differentiator
Problem solved
Functional benefit
Brands
- Champion Advantage: HMO-POS C-SNP plan for individuals with Chronic Kidney Disease (CKD) and End-Stage Renal Disease (ESRD)
- Champion Connect
- Champion Select
- Champion Care
- Champion Choice
- Champion Plus
- Champion Ally
Products and services
- Champion Advantage HMO-POS Chronic Condition Special Needs Plan (C-SNP) for Medicare beneficiaries with Chronic Kidney Disease (CKD) and End-Stage Renal Disease (ESRD). Provides specialized support for dialysis and kidney care with limited out-of-network access when medically necessary and prior authorized. Combines Part A hospital, Part B medical, and Part D prescription drug coverage with coordinated care teams and supplemental benefits.
- Champion Connect HMO-POS Chronic Condition Special Needs Plan (C-SNP) for Medicare beneficiaries with Chronic Kidney Disease (CKD) and End-Stage Renal Disease (ESRD). Offers specialized dialysis and kidney care support with out-of-network options when prior authorized. Combines Part A, Part B, and Part D coverage with coordinated care management.
- Champion Select HMO-POS Chronic Condition Special Needs Plan (C-SNP) for Medicare beneficiaries with Chronic Kidney Disease (CKD) and End-Stage Renal Disease (ESRD). Provides kidney care coordination with point-of-service flexibility. Combines Part A, Part B, and Part D coverage with chronic condition management.
- Champion Ally Medicare Advantage Prescription Drug (MAPD) HMO plan for Medicare beneficiaries with or without a chronic medical condition. Combines Part A hospital, Part B medical, and Part D prescription drug coverage with extra benefits such as dental, vision, hearing, transportation, food allowance, and the Silver&Fit fitness program.
- Champion Care HMO Chronic Condition Special Needs Plan (C-SNP) designed for Medicare beneficiaries with Diabetes and/or cardiovascular disease. Features coordinated care through an in-network Primary Care Physician and combines Part A, Part B, and Part D coverage with chronic condition management.
- Champion Choice HMO Chronic Condition Special Needs Plan (C-SNP) for Medicare beneficiaries with Diabetes and/or cardiovascular disease. Integrates with Medicaid (Medi-Cal) to improve care coordination and deliver enhanced benefits for dual-eligible members. Combines Part A, Part B, and Part D coverage with chronic condition management.
- Champion Plus HMO Chronic Condition Special Needs Plan (C-SNP) for Medicare beneficiaries with serious behavioral health conditions including Schizophrenia, Schizoaffective Disorder, Bipolar Disorder, Major Depression, and Paranoid Disorders. Provides direct access to psychiatrists coordinated with the member's Primary Care Physician and combines Part A, Part B, and Part D coverage.
Quantifiable outcome
- Extra Help estimated value of $5,100 per year for qualifying low-income beneficiaries
- +2 more outcomes
Companies that use Champion Health Plan
Customer profileSegments7 records
Ideal customer profiles4 records
Champion Health Plan technology and API
TechnologyAPI detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Integration11 records
AI capability4 records
Feature3 records
Champion Health Plan partnerships and signals
Strategic signalPartnerships
Seven partnerships are on record, tiered core and standard.
- MedImpact Healthcare Systems, Inc.corePharmacy benefit manager providing formulary management, pharmacy network access, and Part D prescription drug administration. Handles prior authorization, coverage determinations, and exceptions for Part D medications. Contact: MedImpact Prior Authorization Dept, 10181 Scripps Gateway Court, San Diego, CA 92131. Phone: 844-282-5341.
- EyeMed Vision CarestandardVision care provider offering routine vision exams and glasses through EyeMed network. Members access services via member portal or call 888-767-3885, TTY 711.
- TruHearingstandardHearing care provider offering hearing exams and hearing aids through TruHearing network for most plan types.
- Delta DentalstandardDental insurance provider offering coverage to keep members' teeth healthy. Access via insuringmiles.com/champion or call 800-508-4883, TTY 711.
- American Specialty Health Fitness (Silver&Fit Program)standardHealthy aging and exercise program providing digital tools, on-demand workout videos, workout plans, digital resources in Well-Being Club, and virtual personal training. ASH Fitness is a subsidiary of American Specialty Health Incorporated.
- Birdi (MedImpact Direct Mail Pharmacy)coreMail pharmacy for home delivery of maintenance medications with up to 90-day supply. Accepts manufacturer coupons. Contact: 1-855-873-8739 (TTY 711). Orders processed and shipped within 5 business days.
- American Specialty Health (Chiropractic and Acupuncture)standardNetwork provider for chiropractic and acupuncture services. Members access through ASHLink portal or call 800-848-3555, TTY 711.
Scale indicators5 records
Recent moves6 records
Expansion highlights5 records
Champion Health Plan competitors and assessment
Company assessmentDirect peers
- Alignment Health Plan: California-licensed Medicare Advantage HMO plan offering multiple MAPD and C-SNP products with a tech-enabled care coordination platform. Direct competitor for ESRD/CKD and dual-eligible MA members in Champion's California counties.
- SCAN Health Plan: California-based not-for-profit MA plan with strong C-SNP focus on seniors with chronic conditions, including dual-eligibles. Competes directly for chronic-condition MA members in Champion's overlapping California service area.
- Brand New Day: California-focused Medicare Advantage HMO specializing in C-SNP plans for ESRD, diabetes, cardiovascular, and dementia populations. Closest head-to-head competitor given nearly identical chronic-condition SNP portfolio.
- Clever Care Health Plan: California Medicare Advantage HMO offering culturally tailored MAPD and C-SNP plans with multi-language support. Comparable niche MA positioning in California counties with similar dual-eligible and LIS targeting.
- Central Health Plan of California: California-focused MA HMO serving Los Angeles, Orange, San Bernardino, Riverside, and Kern counties with MAPD and chronic-condition coverage. Competes for the same dual-eligible and chronic-condition enrollees.
Broad incumbents
- Blue Shield of California: Large California-domestic health plan offering MAPD and C-SNP products across most of Champion's California counties. Overlaps on chronic-condition MA but with much broader portfolio and scale.
- Humana: National MA leader with significant C-SNP footprint and dual-eligible (DSNP) products in Nevada and California. Competes in the same geographic markets with much larger network and capital base.
- UnitedHealthcare: Largest national MA carrier and dominant ESRD/CKD MA player following acquisition of dialysis-clinic-aligned capability. Overlaps with Champion in California and Nevada MA markets at a much larger scale.
- Aetna (CVS Health): National MA carrier with C-SNP offerings in California and Nevada. Leverages CVS Health pharmacy and care delivery infrastructure that Champion partially mimics through its MedImpact partnership.
Emerging players
- Devoted Health: Tech-enabled Medicare Advantage plan operating in multiple western states including California and Nevada, with growing C-SNP presence. Comparable in mission and tech-stack orientation to Champion.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat4 records
Key risks6 records
Key highlights7 records
Customer concentration
Champion Health Plan compliance and trust
Trust signalCompliance4 records
Champion Health Plan financial estimates
Financial estimateRevenue estimate
Valuation estimate
Champion Health Plan leadership team
Management profileNumber of profiles
Champion Health Plan subsidiaries and ownership
Company hierarchySubsidiaries3 records
Champion Health Plan funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Champion Health Plan M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Champion Health Plan
What does Champion Health Plan do?
Champion Health Plan is a Medicare Advantage Prescription Drug (MAPD) health insurer offering seven distinct plans targeting Medicare beneficiaries with chronic conditions in California and Nevada. Core plans include HMO-POS C-SNP products for ESRD/CKD (Champion Advantage, Champion Connect, Champion Select), HMO C-SNP products for diabetes/cardiovascular and behavioral health (Champion Care, Champion Choice, Champion Plus), and a general MAPD HMO plan (Champion Ally). All plans combine Part A hospital, Part B medical, and Part D prescription drug coverage with $0 or low premiums, coordinated care teams, and supplemental benefits such as dental, vision, hearing, transportation, and food allowances.
Is Champion Health Plan a public or private company?
Champion Health Plan is a private company. It is classified as founder individual operated bootstrapped and is currently operating.
When was Champion Health Plan founded?
Champion Health Plan was founded in 2020.
Where is Champion Health Plan based?
Champion Health Plan is headquartered in Long Beach, United States, in the North America region.
How does Champion Health Plan make money?
Two revenue lines are on record. Medicare Advantage Premium Revenue is the primary driver. The others are part D Prescription Drug Revenue.
Who are Champion Health Plan's main competitors?
Direct peers on record are Alignment Health Plan, SCAN Health Plan, Brand New Day, Clever Care Health Plan and Central Health Plan of California. Broad incumbents are Blue Shield of California, Humana, UnitedHealthcare and Aetna (CVS Health). Devoted Health is listed as an emerging player.
Does Champion Health Plan have an API?
No public API is recorded for Champion Health Plan.
What industry is Champion Health Plan in?
Champion Health Plan's product category is Medicare Advantage Health Insurance. Its primary akta.pro industry code is FSAIAGAG, MA-PD Plans (Medicare Advantage with Prescription Drug Coverage), with a secondary code of HLAEACAI, MA Chronic Condition Management & Supplemental Benefits (SSBCI). Its NAICS code is 524114 and its SIC code is 6321.