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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.
This summary reflects 2026 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.
Central Health Embrace Care Plan (HMO C-SNP) is a HMO C-SNP plan offered by Central Health Plan of California, Inc. available for the 2026 plan year 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
Health deductible: information not available.
This plan has a $615.00 drug deductible that applies only to drugs in certain tiers. You pay this amount toward covered prescriptions in those tiers before the plan's cost sharing begins; drugs in the other tiers are not subject to the deductible. See the full plan details page for the tier table.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $1900.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $1900.00 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:
Sign up for Central Health Embrace Care Plan (HMO C-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. Call-center hours (ET): Mon-Fri 8am-10pm; Sat 9am-8pm; Sun closed.
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. During the initial coverage phase, you will pay a 15% coinsurance for both preferred and standard generic drugs, 30% coinsurance for preferred brand drugs, and 25% coinsurance for non-preferred drugs through standard pharmacies or mail order. Notably, specialty tier drugs are available 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 covered Medicare Part D prescriptions. Additionally, if you qualify for the low-income subsidy, your Part D premium is reduced to $0.00.
Additional Benefits
The Central Health Embrace Care Plan (HMO C-SNP) offers robust coverage with no copay and no coinsurance for primary care, specialist visits, preventive services, and home health care. For hospital stays, members pay no copay for the first five days of inpatient care, while outpatient services range from no copay up to a $150 copay. Emergency care is available with a $150 copay, which is waived if admitted, and urgent care requires no copay. This plan also includes valuable everyday benefits, featuring no copay or coinsurance for routine vision exams, eyewear up to a $300 annual limit, and routine hearing exams. Preventive dental care features no copay, though comprehensive procedures like implants may require a copay up to $2,160. Additionally, members can access up to 24 one-way transportation trips per year to plan-approved locations with no copay or coinsurance.
Inpatient Hospital See details
Central Health Embrace Care Plan (HMO C-SNP) partially covers inpatient hospital services, offering no copay for the first five days of a stay, daily copays of up to $150 for longer stays, and no coinsurance. Prior authorization and doctor referrals are required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Central Health Embrace Care Plan (HMO C-SNP) covers outpatient services with no coinsurance and copays ranging from no copay up to $150. There is no copay for ambulatory surgical center and blood services, a $10 copay for outpatient substance abuse sessions, and a copay of up to $150 for outpatient hospital and observation services.
Partial Hospitalization See details
Central Health Embrace Care Plan (HMO C-SNP) covers partial hospitalization services with a copay ranging from $175 to $180 and no coinsurance. Prior authorization and a doctor referral are required to access these benefits.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered under the Central Health Embrace Care Plan (HMO C-SNP), requiring prior authorization. Ground ambulance services carry a $0 to $200 copay along with coinsurance, air ambulance services incur a 20% coinsurance and a copay, and plan-approved transportation is covered for up to 24 one-way trips per year with no copay or coinsurance, 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, with the copay waived if 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
Primary Care benefits are covered by the Central Health Embrace Care Plan (HMO C-SNP) with no copay and no coinsurance for primary care, specialist, therapy, chiropractic, and podiatry visits. Mental health and psychiatric services require a $10 copay with no coinsurance for individual sessions, and a 20% coinsurance with no copay for group sessions. Additional telehealth benefits are also available with copays ranging from no copay to $10 and coinsurance from no coinsurance to 20%.
Preventive Services See details
Preventive services are partially covered by Central Health Embrace Care Plan (HMO C-SNP) with no copay and no coinsurance for covered benefits such as annual physicals, health education, and fitness programs. However, several sub-services are not covered, including in-home safety assessments, personal emergency response systems, medical nutrition therapy, alternative therapies, therapeutic massage, and weight management programs.
Hearing Services See details
Central Health Embrace Care Plan (HMO C-SNP) covers routine hearing exams and OTC hearing aids with no copay or coinsurance. Prescription hearing aids are partially covered with a copay between $575 and $2,099 and no coinsurance, though inner ear, outer ear, and over the ear devices are not covered.
Vision Services See details
Vision services are covered by Central Health Embrace Care Plan (HMO C-SNP), featuring one routine eye exam per year and eyewear options with no copay or coinsurance. Covered eyewear, including frames, lenses, and contact lenses, is subject to a combined maximum benefit of $300 annually.
Dental Services See details
Dental services are partially covered by the Central Health Embrace Care Plan (HMO C-SNP), as maxillofacial prosthetics and orthodontics are not covered. Covered dental services feature no coinsurance, with copayments ranging from no copay for preventive care up to $2,160 for procedures like implants.
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. Medicare Part B insulin drugs are available with no copay, while chemotherapy, radiation, and other Part B drugs have no coinsurance to 20% coinsurance.
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 receive these covered services.
Medical Equipment See details
Central Health Embrace Care Plan (HMO C-SNP) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, subject to prior authorization. Diabetic supplies and therapeutic shoes or inserts have no copay and no coinsurance, while durable medical equipment, prosthetics, and medical supplies feature no copay and 0% to 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by the Central Health Embrace Care Plan (HMO C-SNP) with a required referral and prior authorization. There is no copay and no coinsurance for lab services, diagnostic tests, and outpatient X-rays, while diagnostic radiological services carry a copay of $0 to $100 (no coinsurance) and therapeutic radiological services require 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 access this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are technically covered under the Central Health Embrace Care Plan (HMO C-SNP) with no copay or coinsurance, but in practice, some services are covered while Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD Services are not covered. A doctor referral and prior authorization are required for these services.
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. The plan requires Medicare-defined coinsurance per stay with no copay, and both prior authorization and a doctor referral are required.
Other Services See details
Other Services are partially covered by Central Health Embrace Care Plan (HMO C-SNP), with no copay or coinsurance for acupuncture, meal benefits, and most over-the-counter items. Nicotine replacement therapy and highly integrated dual-eligible SNP services are not covered.
Plan Providers
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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1-877-649-2073 / TTY 711. Call-center hours (ET): Mon-Fri 8am-10pm; Sat 9am-8pm; Sun closed.
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