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Central Health Dual Access Plan (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Central Health Dual Access Plan (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 Dual Access Plan (HMO D-SNP) in 2025, please refer to our full plan details page.
Central Health Dual Access Plan (HMO D-SNP) is a HMO D-SNP plan offered by Molina Healthcare, Inc. available for enrollment in 2025 to people living in Select counties in CA. This plan received an overall rating of 2.5 out of 5 stars in 2025.
It's important to know that Central Health Dual Access Plan (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 Dual Access Plan (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 Dual Access Plan (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 Dual Access Plan (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $2.20. 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:
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Drug Coverage
The Central Health Dual Access Plan (HMO D-SNP) has a $590 deductible for prescription drugs. Once you meet your deductible, you will pay the costs for your drugs, but the specific costs for each tier are not listed. If you qualify for the low-income subsidy, you will pay $2.20 for Part D drugs. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, and you will pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Central Health Dual Access Plan (HMO D-SNP) offers a range of covered services with varying cost-sharing. Many preventive services like annual physical exams, vision exams, and hearing exams have no copay, along with other services like home health and ambulance services. The plan covers inpatient and outpatient services, but cost-sharing, including coinsurance and deductibles, may apply. This plan also includes coverage for services like primary care, hearing aids, and dental, with some services having copays or coinsurance. Emergency services, diagnostic services, and medical equipment are also covered. Some services, such as outpatient, specialist, and home infusion services require prior authorization and/or a doctor's referral.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric, are covered, but additional days and non-Medicare-covered stays are not covered. Cost sharing details, including coinsurance and deductible, are available in the plan documents.
Outpatient Services See details
Outpatient services, including outpatient hospital services and observation services, are covered with a 20% coinsurance, and require prior authorization and a doctor referral. Ambulatory Surgical Center (ASC) Services and Outpatient Substance Abuse Services are also covered, with a coinsurance of at least 20%. Outpatient blood services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the Central Health Dual Access Plan (HMO D-SNP) with prior authorization and a doctor referral required. The copay for this benefit is $80.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Central Health Dual Access Plan (HMO D-SNP), with both ground and air ambulance services subject to a 20% coinsurance. Transportation Services to a plan-approved health-related location are covered with no copay, up to 24 one-way trips per year, but transportation to any health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Central Health Dual Access Plan (HMO D-SNP). Emergency Services and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have a $110 copay, while Urgently Needed Services has no copay.
Primary Care See details
The Central Health Dual Access Plan (HMO D-SNP) covers primary care physician services with a 35% coinsurance. Chiropractic services have no copay, and routine chiropractic care has no copay for up to 30 visits per year. Occupational therapy services have a $35 copay, while physician specialist services have a 35% coinsurance. Individual and group sessions for mental health specialty services have a $50 copay. Physical therapy and speech-language pathology services have a $50 copay. Additional telehealth benefits have no copay.
Preventive Services See details
The Central Health Dual Access Plan (HMO D-SNP) covers preventive services including an annual physical exam with no copay. Other services like Health Education, Personal Emergency Response System (PERS), In-Home Support Services, Fitness Benefit, Remote Access Technologies, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit have no copay. In-Home Safety Assessment, Medical Nutrition Therapy (MNT), 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 Benefit, Home-Based Palliative Care, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, Home and Bathroom Safety Devices and Modifications, and Counseling Services are not covered.
Hearing Services See details
The Central Health Dual Access Plan (HMO D-SNP) covers hearing exams with no copay, and routine hearing exams and fitting/evaluation for hearing aids with no copay. Prescription hearing aids (all types) have a copay between $49 and $1549, and OTC hearing aids have no copay.
Vision Services See details
The Central Health Dual Access Plan (HMO D-SNP) covers vision services, including eye exams and eyewear. Eye exams have no copay, and eyewear has no copay. Eyewear has a combined maximum benefit of $300.00 every year.
Dental Services See details
Dental Services are covered, including Medicare Dental Services with no copay. However, Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics, Maxillofacial Prosthetics, Implant Services, Prosthodontics, fixed, Oral and Maxillofacial Surgery, 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, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered by the Central Health Dual Access Plan (HMO D-SNP), but prior authorization and a doctor referral are required. You will have to pay 20% coinsurance for dialysis services.
Medical Equipment See details
Medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, is covered by the Central Health Dual Access Plan. Durable medical equipment has a 20% coinsurance and requires authorization, while durable medical equipment for use outside of the home is not covered. Prosthetic devices have a 20% coinsurance, and medical supplies have a 20% coinsurance. Diabetic supplies and diabetic therapeutic shoes/inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Central Health Dual Access Plan (HMO D-SNP), with no copay for all diagnostic and radiological services. Diagnostic Procedures/Tests, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services have a coinsurance of at most 20%, while Lab Services have no coinsurance.
Home Health Services See details
Home Health Services are covered under the Central Health Dual Access Plan (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 Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services. A doctor referral and prior authorization are required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but additional days beyond Medicare-covered SNF stays, and non-Medicare-covered SNF stays are not covered. Prior authorization and a doctor referral are required, and the plan charges the Medicare-defined cost share for tier 1, with cost sharing charged per admission or stay.
Other Services See details
The Central Health Dual Access Plan (HMO D-SNP) covers acupuncture with no copay, and a limit of 30 treatments per year, and also covers over-the-counter items and meal benefits with no copay, but does not cover Dual Eligible SNPs with Highly Integrated Services, or other services like Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services.
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