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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 $2750.00 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 an enhanced alternative drug benefit with a $0 deductible. During the initial coverage phase, you will pay a copay for your prescriptions, which varies depending on the drug tier and whether you use a preferred or standard pharmacy. For example, preferred generic drugs have a $9 copay, while standard generic drugs have a $47 copay. 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 managing costs. Many services, including primary care, preventive services, vision, dental, and home health services, come with no copay. For inpatient hospital stays, you may encounter a copay, starting after the first five days. The plan also covers a range of outpatient services, with copays varying by service, and covers emergency and ambulance services. Additionally, you'll find coverage for hearing aids, medical equipment, and other services like acupuncture and home infusion, with varying copays or coinsurance depending on the specific service.
Inpatient Hospital See details
Inpatient Hospital benefits are covered under the Central Health Embrace Care Plan, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services, both requiring prior authorization and a doctor's referral. For Inpatient Hospital-Acute, there is no copay for days 1-5, a $200 copay for days 6-9, and a $35 copay for days 10-90, with no coinsurance; however, additional days, non-Medicare-covered stays, and upgrades are not covered. For Inpatient Hospital Psychiatric, there is no copay for days 1-5, a $200 copay for days 6-9, and a $35 copay for days 10-90, with no coinsurance, and additional days and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient Services, including outpatient hospital services and observation services, have a copay between $0 and $150. Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay, while individual and group sessions for outpatient substance abuse have a copay of $10.
Partial Hospitalization See details
Partial Hospitalization is covered, and requires prior authorization and a doctor's referral. You will have a $130 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including both ground and air ambulance services. Ground ambulance services have a copay between $0 and $200, and air ambulance services have a 20% coinsurance. Transportation services to plan-approved health-related locations are covered with no copay for up to 24 one-way trips per year, and transportation services to any health-related location are 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 ranging from $0 to $140, while Urgently Needed Services have no copay. Worldwide Emergency Services have a copay of $140 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. Primary care physician services, chiropractic services, physician specialist services, physical therapy and speech-language pathology services, and additional telehealth benefits have no copay. Individual and group sessions for mental health and psychiatric services have a $10 and 20% coinsurance, respectively.
Preventive Services See details
Preventive services are covered, including annual physical exams and additional preventive services. Annual physical exams have no copay, and the additional preventive services, Health Education, Personal Emergency Response System (PERS), In-Home Support Services and Fitness Benefit have no copay. Additional preventive services include Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, all of which have no copay.
Hearing Services See details
Hearing services include hearing exams, routine hearing exams, fitting/evaluation for hearing aids, prescription hearing aids, and OTC hearing aids. Hearing exams and routine hearing exams have no copay. Fitting/evaluation for hearing aids has no copay. Prescription hearing aids (all types) have a copay between $575 and $2099, while prescription hearing aids - inner ear, outer ear, and over the ear are not covered. OTC hearing aids have no copay.
Vision Services See details
The Central Health Embrace Care Plan (HMO C-SNP) covers vision services, including eye exams with no copay, and eyewear with no copay, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames. Eyewear has a combined maximum benefit of $300.00 every year.
Dental Services See details
Dental services include coverage for Medicare dental services with no copay, and Other Dental Services with Oral Exams, Dental X-Rays, Prophylaxis (Cleaning), and Fluoride Treatments with no copay, and Other Diagnostic Dental Services with a copay of $0-$6. Restorative Services have a copay of $25-$400, Adjunctive General Services have a copay of $0-$300, Endodontics has a copay of $25-$720, Periodontics has a copay of $0-$780, Prosthodontics, removable has a copay of $0-$600, Implant Services has a copay of $45-$2160, Prosthodontics, fixed has a copay of $0-$840, and Oral and Maxillofacial Surgery has a copay of $0-$380. Maxillofacial Prosthetics and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but prior authorization is required. Medicare Part B Insulin Drugs have no copay, while 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. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with no copay and 0% to 20% coinsurance, Prosthetics/Medical Supplies - Non-Medicare benefit with no copay and coinsurance for Medicare-covered Prosthetic Devices and Medical Supplies, and Diabetic Equipment with no copay and coinsurance for Medicare-covered Diabetes 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 are covered, including diagnostic procedures, lab services, and radiological services. Diagnostic Procedures/Tests have no copay, and lab services have no copay. Diagnostic Radiological Services have a copay of at most $100, and Therapeutic Radiological Services have a coinsurance of at most 20%. Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered under the Central Health Embrace Care Plan (HMO C-SNP) with no copay and no coinsurance, but additional hours of care and personal care services are not covered. This benefit requires authorization and a referral.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Central Health Embrace Care Plan (HMO C-SNP). Specifically, Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Central Health Embrace Care Plan (HMO C-SNP) and require prior authorization and a doctor's referral. The plan does not cover additional days beyond Medicare-covered SNF, or non-Medicare-covered SNF stays.
Other Services See details
Other Services includes acupuncture with no copay, up to 12 treatments per year, and requires a doctor referral and prior authorization. Over-the-counter items and meal benefits are also covered with no copay, and the meal benefit requires prior authorization. However, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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