A non-government entity
Central Health Medi-Medi Plan II (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 II (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 II (HMO D-SNP) in 2026, please refer to our full plan details page.
Central Health Medi-Medi Plan II (HMO D-SNP) is a HMO D-SNP plan offered by Molina Healthcare, Inc. available for enrollment in 2025 to people living in Ventura County. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Central Health Medi-Medi Plan II (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 II (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 II (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 II (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. 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 $250.00 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 $9250.00 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 II (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
Central Health Medi-Medi Plan II (HMO D-SNP) features an Enhanced Alternative drug benefit with a $250.00 annual prescription drug deductible. If you qualify for the low-income subsidy, your Part D premium is reduced to $0.00. During the initial coverage phase, you pay for your prescriptions at standard pharmacies or standard mail-order services until total drug costs reach $2,100.00. For a 30-day supply, you will pay a $4.00 copay for Tier 1 preferred generics, 20% coinsurance for Tier 2 standard generics, 30% coinsurance for Tier 3 preferred brands, 27% coinsurance for Tier 4 non-preferred drugs, and no copay for Tier 5 specialty drugs. Once your yearly out-of-pocket costs reach $2,100.00, you enter the catastrophic coverage phase and pay nothing for covered Medicare Part D drugs.
Additional Benefits
The Central Health Medi-Medi Plan II (HMO D-SNP) offers comprehensive coverage with many services featuring no copayments, though some cost-sharing applies. For primary care and specialist visits, members pay a 28% coinsurance, while outpatient services generally carry a 20% coinsurance with no copay. Emergency care requires a $110 copay, which is waived if you are admitted, and inpatient hospital stays are covered with no plan-specific copay under Original Medicare-defined coinsurance. This plan provides strong everyday benefits, offering routine vision exams and up to $300 annually for eyewear with no copays, no coinsurance, and no deductibles. Members also enjoy no copays and no coinsurance for home health services, diabetic supplies, and up to 48 one-way transportation trips to plan-approved locations per year. Other valuable extras such as acupuncture, over-the-counter items, and meal benefits are also available with no copay and no coinsurance.
Inpatient Hospital See details
Central Health Medi-Medi Plan II (HMO D-SNP) partially covers inpatient acute and psychiatric hospital stays, which require doctor referrals, prior authorization, and Original Medicare-defined coinsurance with no plan-specific copay. However, certain sub-services such as additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Central Health Medi-Medi Plan II (HMO D-SNP) covers outpatient services, including hospital, observation, ambulatory surgical center, and substance abuse services, with no copay and 20% coinsurance. Outpatient blood services are also covered with no copay, no coinsurance, and no deductible.
Partial Hospitalization See details
Partial hospitalization benefits are covered by Central Health Medi-Medi Plan II (HMO D-SNP) with a $105.00 copay and no coinsurance. Prior authorization and a doctor referral are required for this benefit.
Ambulance and Transportation Services See details
Central Health Medi-Medi Plan II (HMO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, requiring prior authorization. Transportation services are partially covered, offering up to 48 one-way trips per year to plan-approved health-related locations with no copay and no coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
Central Health Medi-Medi Plan II (HMO D-SNP) covers emergency services with a $110 copay and no coinsurance, which is waived if you are admitted to the hospital within three days. Urgently needed services and worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance, up to a $50,000 plan benefit limit.
Primary Care See details
Primary care benefits are covered by Central Health Medi-Medi Plan II (HMO D-SNP), with primary care and specialist visits requiring a 28% coinsurance, and various therapy services requiring copays between $35 and $55. Chiropractic services are partially covered as routine chiropractic care is not covered, podiatry is not covered, and additional services range from no copay up to a 50% coinsurance.
Preventive Services See details
Preventive services are partially covered by the Central Health Medi-Medi Plan II (HMO D-SNP) with no copays and no coinsurance for covered options like fitness and health education. Sub-services not covered under this plan include annual physical exams, in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, smoking cessation, enhanced disease management, telemonitoring, home/bathroom safety, and counseling.
Hearing Services See details
Hearing services are partially covered by Central Health Medi-Medi Plan II (HMO D-SNP) with no deductible, though specific copay and coinsurance costs are not listed. The plan covers one routine hearing exam and one fitting evaluation annually, unlimited OTC hearing aids, and up to two prescription hearing aids every two years, while inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Central Health Medi-Medi Plan II (HMO D-SNP) covers vision services with no copays, no coinsurance, and no deductibles, including one routine eye exam per year and up to $300 annually for eyewear. Prior authorization and a doctor referral are required for these services, which cover contact lenses, eyeglasses, frames, lenses, and upgrades.
Dental Services See details
Dental services are partially covered by the Central Health Medi-Medi Plan II (HMO D-SNP), which provides Medicare-covered dental care with no copay and no coinsurance, though prior authorization is required. Other dental sub-services, including restorative, endodontic, periodontic, orthodontic, prosthodontic, oral surgery, maxillofacial, adjunctive general, and implant services, are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are partially covered by Central Health Medi-Medi Plan II (HMO D-SNP) under prior authorization, excluding Part D home infusion drugs. Covered Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance with no deductible, while chemotherapy and other Part B drugs carry no copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by Central Health Medi-Medi Plan II (HMO D-SNP) with a 20% coinsurance and no copay. Prior authorization and a doctor referral are required to access this benefit.
Medical Equipment See details
Central Health Medi-Medi Plan II (HMO D-SNP) covers durable medical equipment, prosthetics, and medical supplies with a 20% coinsurance and no copay. Diabetic supplies and therapeutic shoes or inserts are also covered with no copay and no coinsurance, though prior authorization is required for medical equipment benefits.
Diagnostic and Radiological Services See details
Central Health Medi-Medi Plan II (HMO D-SNP) covers diagnostic and radiological services with no copay, though prior authorization and doctor referrals are required. Lab services feature no coinsurance, while diagnostic procedures, radiological services, and outpatient X-rays are subject to a 20% coinsurance.
Home Health Services See details
Central Health Medi-Medi Plan II (HMO D-SNP) covers Home Health Services with no copay and no coinsurance. Prior authorization and a doctor referral are required to access this benefit.
Cardiac Rehabilitation Services See details
Central Health Medi-Medi Plan II (HMO D-SNP) notes that some services are covered, but cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered. Since these services are not covered, no copays or coinsurance apply.
Skilled Nursing Facility (SNF) See details
Central Health Medi-Medi Plan II (HMO D-SNP) partially covers Skilled Nursing Facility (SNF) services, which require prior authorization, a doctor referral, Medicare-defined coinsurance, and no copay. Additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by Central Health Medi-Medi Plan II (HMO D-SNP), offering acupuncture, over-the-counter items, and meal benefits with no copay and no coinsurance. Dual eligible SNPs with highly integrated services are not covered under this plan, and prior authorization is required for acupuncture and meal benefits.
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