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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 $1900.00 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) offers an Enhanced Alternative drug benefit with an annual prescription drug deductible of $615.00. Under 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. Additionally, there is no copay for Tier 5 specialty drugs when using standard retail or standard mail-order pharmacies. For individuals who qualify for the Low-Income Subsidy, the Part D premium is reduced, resulting in no cost for coverage. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase where you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Central Health Embrace Care Plan (HMO C-SNP) offers robust coverage for essential medical services, often with no copay and no coinsurance. Members enjoy no copays or coinsurance for primary care visits, specialist consultations, routine vision and hearing exams, and home health services. For inpatient hospital stays, there is no copay for the first five days, though a daily copay of up to $200 applies for days six through nine. Emergency and urgent care services are covered with no coinsurance, requiring a $150 copay for emergency room visits that is waived if admitted. Additional benefits like covered preventive services, diabetic supplies, acupuncture, and up to 24 one-way transportation trips are available with no copay and no coinsurance. Other specialized treatments, such as outpatient surgeries, diagnostic radiology, and dental care, may require varying copays or coinsurance up to 20% depending on the service.
Inpatient Hospital See details
Inpatient hospital services are partially covered by the Central Health Embrace Care Plan (HMO C-SNP), as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered. Covered acute and psychiatric stays require no coinsurance, with cost-sharing ranging from no copay for days 1 to 5 up to a $200 daily copay for days 6 to 9.
Outpatient Services See details
Outpatient services are covered by Central Health Embrace Care Plan (HMO C-SNP) with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Patients will pay a $10 copay for outpatient substance abuse sessions, while outpatient hospital and observation services range from no copay to a $150 copay.
Partial Hospitalization See details
Central Health Embrace Care Plan (HMO C-SNP) covers partial hospitalization services with a copay ranging from $175.00 to $180.00 and no coinsurance. These covered services require both prior authorization and a doctor referral.
Ambulance and Transportation Services See details
Central Health Embrace Care Plan (HMO C-SNP) covers ground ambulance services with a $0 to $200 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay. Transportation benefits are partially covered, offering up to 24 one-way trips per year to plan-approved locations with no copay and no coinsurance, while trips to any health-related location are not covered. Prior authorization is required for both ambulance and transportation services.
Emergency Services See details
Emergency services are covered by the Central Health Embrace Care Plan (HMO C-SNP) with a $150 copay and no coinsurance, with the copay waived if you are admitted to the hospital within three days. Urgently needed services are available 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, therapy, podiatry, chiropractic, and opioid treatment services with no copay and no coinsurance. Mental health and psychiatric individual sessions require a $10 copay and no coinsurance, group sessions require a 20% coinsurance and no copay, and telehealth services range from no copay to a $10 copay and no coinsurance to 20% coinsurance.
Preventive Services See details
Preventive services are partially covered by the Central Health Embrace Care Plan (HMO C-SNP) with no copay and no coinsurance for covered benefits like annual physical exams, health education, and fitness programs. Sub-services that are not covered include in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, bathroom safety, and counseling.
Hearing Services See details
Central Health Embrace Care Plan (HMO C-SNP) offers routine hearing exams, fitting evaluations, and OTC hearing aids with no copay or coinsurance. Prescription hearing aids are partially covered with a copay ranging from $575 to $2,099, though prescription models for the inner ear, outer ear, and over the ear are not covered.
Vision Services See details
Central Health Embrace Care Plan (HMO C-SNP) covers routine eye exams and eyewear with no copay and no coinsurance. The plan includes one routine eye exam per year and provides a $300 annual combined maximum benefit for eyewear—including contact lenses, eyeglasses, and upgrades—with doctor referrals and prior authorization required.
Dental Services See details
Central Health Embrace Care Plan (HMO C-SNP) partially covers dental services, though maxillofacial prosthetics and orthodontics are not covered. Covered preventive and comprehensive dental procedures require no coinsurance, with copayments ranging from no copay up to $2,160 depending on the service.
Home Infusion bundled Services See details
Central Health Embrace Care Plan (HMO C-SNP) covers home infusion bundled services, which require prior authorization and step therapy. Covered Medicare Part B insulin has no copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered by the Central Health Embrace Care Plan (HMO C-SNP) with 20% coinsurance and no copay. Prior authorization and a doctor referral are required to receive these services.
Medical Equipment See details
Central Health Embrace Care Plan (HMO C-SNP) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with prior authorization required. Diabetic supplies and therapeutic shoes are covered with no copay and no coinsurance, while other durable medical equipment and prosthetics carry no copay and 0% to 20% coinsurance.
Diagnostic and Radiological Services See details
Central Health Embrace Care Plan (HMO C-SNP) covers diagnostic and radiological services, requiring prior authorization and a doctor referral. Members pay no copay and no coinsurance for lab services, diagnostic tests, and outpatient X-rays, while diagnostic radiological services require a copay of up to $100 with no coinsurance, and therapeutic radiological services carry a 20% coinsurance with 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. Prior authorization and a doctor referral are required to receive these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Central Health Embrace Care Plan (HMO C-SNP), as none of the sub-services—including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation—are covered in practice.
Skilled Nursing Facility (SNF) See details
Central Health Embrace Care Plan (HMO C-SNP) partially covers Skilled Nursing Facility (SNF) services, though additional days beyond the Medicare-covered limit are not covered. Under this plan, you will pay Medicare-defined copays and coinsurance per admission or stay, with no cost sharing on the day of discharge, and prior authorization and doctor referrals are required.
Other Services See details
Central Health Embrace Care Plan (HMO C-SNP) partially covers other services, offering acupuncture, meal benefits, and over-the-counter (OTC) items with no copay and no coinsurance. However, nicotine replacement therapy and Dual Eligible SNPs with Highly Integrated Services are not covered.
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