A non-government entity
Central Health Medi-Medi Plan I (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Central Health Medi-Medi Plan I (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Central Health Medi-Medi Plan I (HMO D-SNP) in 2025, please refer to our full plan details page.
Central Health Medi-Medi Plan I (HMO D-SNP) is a HMO D-SNP plan offered by Molina Healthcare, Inc. available for enrollment in 2025 to people living in Counties: LA, Riv, Sac, SBD and SD. This plan received an overall rating of 2.5 out of 5 stars in 2025.
It's important to know that Central Health Medi-Medi Plan I (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Central Health Medi-Medi Plan I (HMO D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Central Health Medi-Medi Plan I (HMO D-SNP).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Central Health Medi-Medi Plan I (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $13.60. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $590.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $9350.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
Sign up for Central Health Medi-Medi Plan I (HMO D-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Central Health Medi-Medi Plan I (HMO D-SNP) has a prescription drug deductible of $590.00. After your deductible is met, you will pay the costs for your drugs based on the specific tier. This plan may reduce your premium if you qualify for the low-income subsidy (LIS). If you qualify for full LIS, your Part D premium is $13.60.
Additional Benefits
The Central Health Medi-Medi Plan I (HMO D-SNP) offers a range of benefits with varying costs. Inpatient hospital, outpatient, partial hospitalization, and ambulance services are covered with coinsurance or copays. This plan also includes benefits such as primary care, preventive services, vision, hearing, and dental services, many of which have no copay. Additional benefits include home health services, cardiac rehabilitation, skilled nursing facility care, and other services like acupuncture, OTC items, and meal benefits. Prescription hearing aids and eyewear are covered up to a certain amount. Diagnostic and radiological services, dialysis, and home infusion services are also covered with either a coinsurance or a copay.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered with prior authorization and a doctor's referral. Additional days for inpatient hospital, non-Medicare-covered stays, and upgrades are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services and observation services, are covered with a 20% coinsurance. Ambulatory Surgical Center (ASC) Services and Outpatient Substance Abuse Services are covered with a coinsurance of 20%. Outpatient Blood Services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Central Health Medi-Medi Plan I (HMO D-SNP) with a copay of $80, and requires prior authorization and a doctor referral.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with a 20% coinsurance for both ground and air ambulance services. Transportation Services to a plan-approved health-related location are covered with no copay, up to 24 one-way trips per year via rideshare, bus/subway, medical transport, and other options. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered, with a $110 copay, but no coinsurance; the copay is waived if you are admitted to the hospital within 3 days. Urgently Needed Services are covered with no copay and no coinsurance. Worldwide Emergency Services are covered, with a maximum plan benefit of $100,000 and no copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The Central Health Medi-Medi Plan I (HMO D-SNP) plan covers Primary Care Physician Services with a 28% coinsurance, Chiropractic Services with no copay, Occupational Therapy Services with a $35 copay, Physician Specialist Services with a 28% coinsurance, Mental Health Specialty Services with a $50 copay for individual and group sessions, Physical Therapy and Speech-Language Pathology Services with a $50 copay, and Additional Telehealth Benefits with no copay. This plan also covers Other Health Care Professional services with a coinsurance between 0% and 35%, Psychiatric Services with a $45 copay for individual and group sessions, and Opioid Treatment Program Services with a 50% coinsurance.
Preventive Services See details
Preventive Services include coverage for Medicare-covered zero dollar services, additional preventive services, kidney disease education services, and other preventive services. Annual physical exams, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, and counseling services are not covered. Health education, in-home safety assessments, personal emergency response systems, in-home support services, fitness benefits, remote access technologies, home and bathroom safety devices and modifications, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit have no copay.
Hearing Services See details
Hearing services include coverage for hearing exams with no copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered up to a plan-specified amount per year, and OTC hearing aids are covered with no copay. Prescription hearing aids for inner ear, outer ear, and over the ear are not covered.
Vision Services See details
Vision services include eye exams, eyewear, and upgrades. Eye exams have no copay, and routine eye exams are covered once per year. Eyewear, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames, are covered, with a combined maximum benefit of $300 per year, and contact lenses have no copay.
Dental Services See details
Dental services are covered, including oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable), and oral and maxillofacial surgery, all with no copay. Orthodontic services are covered with a maximum benefit of $1000 per year. Maxillofacial prosthetics, implant services, prosthodontics (fixed), and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay, Medicare Part B Chemotherapy/Radiation Drugs with 0-20% coinsurance, and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required for these services.
Dialysis Services See details
Dialysis Services are covered with prior authorization and a doctor's referral. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies with 20% coinsurance; however, Durable Medical Equipment for use outside the home is not covered. Diabetic Equipment is covered, with no copay for Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services. Diagnostic Procedures/Tests and Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services have a coinsurance of at most 20%, and Lab Services have no copay.
Home Health Services See details
Home Health Services are covered under the Central Health Medi-Medi Plan I (HMO D-SNP) with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization and a doctor's referral are required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered, but additional days beyond Medicare-covered and non-Medicare-covered stays are not covered. Prior authorization and a doctor referral are required, and the plan charges the Medicare-defined cost share for tier 1.
Other Services See details
Other Services includes acupuncture with no copay, Over-the-Counter (OTC) items with no copay, and meal benefits with no copay, but also lists several services that are not covered. Acupuncture requires prior authorization and a doctor referral.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved