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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 2025, 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 2.5 out of 5 stars in 2025.
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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $999.00 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) has a $0 deductible for prescription drugs. During the initial coverage phase, you'll pay a copay for your prescriptions depending on the drug tier and pharmacy. For example, you'll pay a $9 copay for preferred generic drugs at a standard pharmacy. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for your Part D covered drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit.
Additional Benefits
The Central Health Embrace Care Plan (HMO C-SNP) offers comprehensive coverage with a focus on no copays for many services. The plan includes no copay for primary care, preventive services, hearing and vision exams, and many dental services. Many outpatient services and emergency services have no copay as well. This plan provides coverage for inpatient and outpatient hospital services, with varying copays and coinsurance depending on the service. You can also expect coverage for ambulance, transportation, and home health services, as well as medical equipment and diagnostic services.
Inpatient Hospital See details
Inpatient Hospital benefits include coverage for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services, both of which require prior authorization and a doctor referral. Inpatient Hospital-Acute has no copay for a Medicare-covered stay, and additional days are unlimited; however, non-Medicare-covered stays and upgrades are not covered. Inpatient Hospital Psychiatric has no copay for days 1-60, and a $400 copay for days 61-90, but additional days and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient Services are covered, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital and observation services have a copay between $0 and $75, while ambulatory surgical center services and outpatient blood services have no copay. Outpatient substance abuse services have a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered by the Central Health Embrace Care Plan (HMO C-SNP), with a $130 copay. Prior authorization and a doctor referral are required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Central Health Embrace Care Plan (HMO C-SNP). Ground ambulance services have a copay between $0 and $100, while air ambulance services have a $200 copay; there is no coinsurance for either service. Transportation services to plan-approved health-related locations are covered with no copay, up to 24 one-way trips per year, and transportation to any health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Central Health Embrace Care Plan (HMO C-SNP). Emergency Services have a copay between $0 and $140, and no coinsurance; Urgently Needed Services have no copay and no coinsurance; and Worldwide Emergency Services have a $140 copay and no coinsurance for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The Central Health Embrace Care Plan (HMO C-SNP) covers primary care physician services, chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, podiatry services, other health care professional, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services with no copay for most services. Chiropractic and podiatry services require a doctor referral and prior authorization. Mental health specialty services, psychiatric services, and opioid treatment program services have $0 minimum and maximum copays.
Preventive Services See details
Preventive services are covered, including annual physical exams with no copay. Additional preventive services, kidney disease education, and other preventive services are also covered. Glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit have no copay.
Hearing Services See details
The Central Health Embrace Care Plan (HMO C-SNP) covers hearing exams with no copay. Routine hearing exams and fitting/evaluation for hearing aids are covered with no copay, once per year. Prescription hearing aids are partially covered, with Prescription Hearing Aids (all types) costing between $49 and $1549 per pair every three years, while Prescription Hearing Aids - Inner Ear, Outer Ear, and Over the Ear are not covered. OTC hearing aids are covered with no copay.
Vision Services See details
Vision Services include eye exams and eyewear. Eye exams have no copay, and eyewear has no copay, with a combined maximum plan benefit coverage amount of $300.00 per year.
Dental Services See details
The Central Health Embrace Care Plan (HMO C-SNP) covers dental services, including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services with no copay for oral exams, dental x-rays, prophylaxis (cleaning), and fluoride treatment. Restorative services, adjunctive general services, endodontics, periodontics, removable prosthodontics, implant services, fixed prosthodontics, and oral and maxillofacial surgery are covered with copays ranging from $0 to $2160. 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). Medicare Part B Insulin Drugs have no copay. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Central Health Embrace Care Plan (HMO C-SNP), but require prior authorization and a doctor's referral. The coinsurance for Dialysis Services is 20%.
Medical Equipment See details
The Central Health Embrace Care Plan (HMO C-SNP) covers medical equipment, including durable medical equipment with no copay and 0-20% coinsurance, and also covers prosthetic devices and medical supplies with no copay and 0-20% coinsurance. Diabetic equipment is covered with a copay for Medicare-covered diabetes supplies and diabetic therapeutic shoes or inserts, and there is a copay of $0 for both diabetic supplies and diabetic therapeutic shoes/inserts. Durable medical equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, lab services with no copay, diagnostic radiological services with a copay of at most $75, therapeutic radiological services with a coinsurance of at most 20%, and outpatient X-ray services with no copay. All services require prior authorization and a doctor's referral.
Home Health Services See details
Home Health Services are covered by the Central Health Embrace Care Plan (HMO C-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 not covered by the Central Health Embrace Care Plan (HMO C-SNP). Prior authorization and a doctor's referral are required for this service.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Central Health Embrace Care Plan (HMO C-SNP), but require prior authorization and a doctor's referral. This plan uses the Medicare-defined cost share for tier 1, but it does not cover additional days beyond Medicare-covered SNF stays, and does not cover non-Medicare-covered SNF stays.
Other Services See details
The Central Health Embrace Care Plan (HMO C-SNP) covers acupuncture with no copay, and up to 12 treatments per year; it also covers over-the-counter items and meal benefits with no copay. However, this plan does not cover Dual Eligible SNPs with Highly Integrated Services, or any of the listed "Other Services" such as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services.
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