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Central Health Embrace Care Plan (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Central Health Embrace Care Plan (HMO C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Central Health Embrace Care Plan (HMO C-SNP) in 2026, please refer to our full plan details page.
Central Health Embrace Care Plan (HMO C-SNP) is a HMO C-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 3 out of 5 stars in 2026.
It's important to know that Central Health Embrace Care Plan (HMO C-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 Embrace Care Plan (HMO C-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 Embrace Care Plan (HMO C-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 Embrace Care Plan (HMO C-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 $615.00 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 $799.00 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 Embrace Care Plan (HMO C-SNP) features an Enhanced Alternative drug benefit with a yearly prescription drug deductible of $615.00. During the initial coverage phase, you will pay a 15% coinsurance for Tier 1 preferred generic and Tier 2 standard generic drugs, 30% coinsurance for Tier 3 preferred brand drugs, and 25% coinsurance for Tier 4 non-preferred drugs through standard pharmacy or standard mail services. Tier 5 specialty drugs are covered with no copay during this initial phase. After your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and will pay nothing for Medicare Part D covered drugs. Additionally, beneficiaries who qualify for the low-income subsidy, or Extra Help, will receive a reduced Part D premium of $0.00.
Additional Benefits
The Central Health Embrace Care Plan (HMO C-SNP) offers robust coverage with no copays and no coinsurance for many essential services, including primary care, specialist visits, home health, and inpatient hospital stays up to 60 days. Outpatient hospital services and emergency care require low to moderate copays, while services like dialysis and durable medical equipment typically require a coinsurance of up to 20 percent. This plan is designed to minimize out-of-pocket costs for major medical needs while ensuring affordable access to critical care. Additionally, members enjoy comprehensive supplemental benefits with no copays for routine dental, vision, and hearing exams, alongside up to 24 free one-way transportation trips per year. Everyday wellness is highly supported with no copays for annual physicals, fitness programs, acupuncture, and over-the-counter items. While specialized treatments like prescription hearing aids or complex dental procedures require copays, the plan provides outstanding value for routine and preventive healthcare.
Inpatient Hospital See details
Central Health Embrace Care Plan (HMO C-SNP) partially covers inpatient hospital benefits with no copay and no coinsurance for Medicare-covered acute stays and psychiatric stays up to 60 days, though psychiatric days 61-90 require a $400 copay. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered, and both prior authorization and doctor referrals are required.
Outpatient Services See details
Central Health Embrace Care Plan (HMO C-SNP) covers outpatient services with no copay and no coinsurance for ambulatory surgical center, observation, and blood services. Outpatient hospital services require a $0 to $75 copay and no coinsurance, while outpatient substance abuse services have a 20% coinsurance and no copay.
Partial Hospitalization See details
Partial hospitalization benefits are covered under the Central Health Embrace Care Plan (HMO C-SNP) with a $130.00 copay and no coinsurance. Prior authorization and a doctor referral are required to receive these services.
Ambulance and Transportation Services See details
Central Health Embrace Care Plan (HMO C-SNP) covers ambulance services with no coinsurance and a copay of $0 to $250 for ground transport and $200 for air transport. Transportation services are partially covered with no copay or coinsurance for up to 24 yearly one-way trips to plan-approved locations, while transportation to any health-related location is not covered.
Emergency Services See details
Central Health Embrace Care Plan (HMO C-SNP) covers emergency services with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within three days. Urgently needed services are covered with no copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $50,000 maximum with a $140 copay and no coinsurance per service.
Primary Care See details
Central Health Embrace Care Plan (HMO C-SNP) covers primary care, specialist, and therapy services with no copay and no coinsurance. Chiropractic services are partially covered, with routine chiropractic care not covered, while telehealth benefits are available with a $0 to $40 copay and 0% to 20% coinsurance.
Preventive Services See details
Central Health Embrace Care Plan (HMO C-SNP) partially covers preventive services with no copay and no coinsurance for covered benefits like annual physicals, fitness, and health education. Sub-services not covered under this plan include in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs for chemotherapy hair loss, weight management, alternative therapies, therapeutic massage, adult day health, nutritional or dietary benefits, palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, home and bathroom safety devices, and counseling.
Hearing Services See details
Central Health Embrace Care Plan (HMO C-SNP) covers routine hearing exams, fitting evaluations, and OTC hearing aids with no copay and no coinsurance. Prescription hearing aids are partially covered with a copay ranging from $49.00 to $1,549.00 and no coinsurance, though inner ear, outer ear, and over the ear types are not covered.
Vision Services See details
Central Health Embrace Care Plan (HMO C-SNP) offers vision services with no copay and no coinsurance for annual routine eye exams and eyewear. The plan features a $300 annual maximum benefit for eyewear, including contact lenses, frames, lenses, and upgrades, with prior authorization and doctor referrals required.
Dental Services See details
Dental services are partially covered by the Central Health Embrace Care Plan (HMO C-SNP), featuring no coinsurance and copays ranging from no copay for preventive care up to $2,160 for implants. While most diagnostic, preventive, and restorative services are covered, maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Central Health Embrace Care Plan (HMO C-SNP) with prior authorization, featuring no copay and no coinsurance for Medicare Part B insulin drugs. Other covered Medicare Part B drugs, including chemotherapy and radiation therapies, require no copay and a coinsurance ranging from no coinsurance up to 20%.
Dialysis Services See details
Central Health Embrace Care Plan (HMO C-SNP) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization and a doctor referral are required to access these covered services.
Medical Equipment See details
Central Health Embrace Care Plan (HMO C-SNP) covers medical equipment, including durable medical equipment and prosthetics, with a 0% to 20% coinsurance and no copay. Diabetic supplies and therapeutic shoes are covered with no copay and no coinsurance, and prior authorization is required.
Diagnostic and Radiological Services See details
Central Health Embrace Care Plan (HMO C-SNP) covers diagnostic and radiological services with prior authorization and a doctor referral. Members pay no copay and no coinsurance for lab services, diagnostic procedures, and outpatient X-rays, while diagnostic radiological services require a copay up to $75 (no coinsurance) and therapeutic radiological services require a 20% coinsurance (no copay).
Home Health Services See details
Central Health Embrace Care Plan (HMO C-SNP) covers home health services with no copay and no coinsurance. A doctor referral and prior authorization are required to receive these services.
Cardiac Rehabilitation Services See details
Central Health Embrace Care Plan (HMO C-SNP) offers Cardiac Rehabilitation Services; however, while some services are covered, Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD services are not covered, meaning no copays or coinsurance apply.
Skilled Nursing Facility (SNF) See details
Central Health Embrace Care Plan (HMO C-SNP) partially covers Skilled Nursing Facility (SNF) services with no copay and Medicare-defined coinsurance per stay, though prior authorization and a doctor referral are required. Additional days beyond those covered by Medicare are not covered.
Other Services See details
Central Health Embrace Care Plan (HMO C-SNP) covers other services, including acupuncture, over-the-counter items, and meal benefits, with no copay and no coinsurance. However, nicotine replacement therapy and Dual Eligible SNPs with Highly Integrated Services are not covered under this plan.
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