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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 2026 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 $1800.00 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 preferred and standard generic drugs, 30% coinsurance for preferred brand drugs, and 25% coinsurance for non-preferred drugs through standard pharmacy or standard mail services. Notably, there is no copay for specialty tier drugs under this plan. Once 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, individuals who qualify for the full Low-Income Subsidy will pay $0.00 for their Part D coverage. To ensure your specific medications are covered, please review the plan's formulary.
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, routine vision, and key preventive services. For emergency care, members pay a $150 copay with no coinsurance, while inpatient hospital stays feature no coinsurance and copays ranging from no copay up to $658. Outpatient hospital services require a copay ranging from no copay up to $150 with no coinsurance, while ambulatory surgical center services are covered with no copay. Supplemental benefits include dental care with no copay for preventive services and routine hearing exams with no copay or coinsurance. Members also benefit from home health services and up to 24 one-way transportation trips per year to plan-approved locations with no copay or coinsurance. Durable medical equipment and diabetic supplies are covered with no copay and coinsurance ranging from no coinsurance to 20%, ensuring affordable access to daily care needs.
Inpatient Hospital See details
Central Health Embrace Care Plan (HMO C-SNP) inpatient hospital services are partially covered, featuring no coinsurance and copayments ranging from no copay up to $658 depending on the duration and type of stay. Prior authorization and doctor referrals are required, and upgrades, additional days, and non-Medicare-covered stays for both acute and psychiatric care are not covered.
Outpatient Services See details
Central Health Embrace Care Plan (HMO C-SNP) covers outpatient services with no coinsurance, including outpatient hospital and observation services for a $0 to $150 copay and substance abuse sessions for a $10 copay. Ambulatory surgical center and blood services are covered with no copay, though most outpatient services require prior authorization and a doctor referral.
Partial Hospitalization See details
Central Health Embrace Care Plan (HMO C-SNP) covers partial hospitalization benefits with a copay of $175 or $180 and no coinsurance. Both prior authorization and a doctor referral are required to receive these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by the Central Health Embrace Care Plan (HMO C-SNP) with prior authorization required. Ground ambulance services require a copay of $0 to $200 with no coinsurance, air ambulance services require a 20% coinsurance with no copay, and transportation services are partially covered, offering up to 24 one-way trips per year to plan-approved locations with no copay or coinsurance while excluding transportation to any health-related location.
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 or coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $50,000 maximum with a $140 copay and no coinsurance.
Primary Care See details
Central Health Embrace Care Plan (HMO C-SNP) covers primary care, specialist, therapy, podiatry, and chiropractic services with no copays and no coinsurance. Mental health and psychiatric individual sessions require a $10 copay and no coinsurance, while group sessions have no copay and 20% coinsurance. Telehealth benefits are also available with a $0 to $10 copay and 20% coinsurance.
Preventive Services See details
Central Health Embrace Care Plan (HMO C-SNP) covers key preventive services with no copay or coinsurance, including annual physical exams, fitness benefits, and kidney disease education. However, the benefit is only partially covered, as several sub-services like in-home safety assessments, nutritional counseling, and personal emergency response systems are not covered.
Hearing Services See details
Central Health Embrace Care Plan (HMO C-SNP) covers routine hearing exams, fitting evaluations, and over-the-counter hearing aids with no copay and no coinsurance. Prescription hearing aids are partially covered with a copay ranging from $575 to $2,099 and no coinsurance, but inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Central Health Embrace Care Plan (HMO C-SNP) covers vision services with no deductible, copay, or coinsurance for annual routine eye exams and eyewear. Members receive a $300 annual maximum allowance for contacts and eyeglasses, with doctor referrals and prior authorizations required for some services.
Dental Services See details
Dental services are partially covered by the Central Health Embrace Care Plan (HMO C-SNP), with maxillofacial prosthetics and orthodontics being excluded from coverage. Covered procedures require no coinsurance, and copays range from no copay for preventive services up to $2,160 for complex treatments like implants.
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 and step therapy required. Medicare Part B insulin drugs feature 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
Central Health Embrace Care Plan (HMO C-SNP) covers dialysis services with a 20% coinsurance and no copay. 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, offering durable medical equipment, prosthetics, and medical supplies with no copay and 0% to 20% coinsurance. Diabetic supplies and therapeutic shoes are also covered with no copay and no coinsurance, with prior authorization required for these services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by the Central Health Embrace Care Plan (HMO C-SNP), requiring prior authorization and a doctor referral. There is no copay or coinsurance for diagnostic tests, lab services, and outpatient X-rays, though diagnostic radiological services have a copay of up to $100 and therapeutic radiological services require a 20% coinsurance.
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 these covered services.
Cardiac Rehabilitation Services See details
Central Health Embrace Care Plan (HMO C-SNP) indicates that some services are covered, but Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Because these services are not covered under the plan, there are no active copays or coinsurance, though prior authorization and a doctor referral are required.
Skilled Nursing Facility (SNF) See details
Central Health Embrace Care Plan (HMO C-SNP) partially covers Skilled Nursing Facility (SNF) services, requiring prior authorization, a doctor referral, and Medicare-defined coinsurance, though there is no copay or cost-sharing on the day of discharge. Standard stays do not require a prior three-day hospital stay, but additional days beyond Medicare-covered limits are not covered.
Other Services See details
Central Health Embrace Care Plan (HMO C-SNP) offers partially covered other services with no copay and no coinsurance, which include acupuncture, meal benefits, and over-the-counter items. Nicotine replacement therapy and dual eligible SNPs with highly integrated services are not covered.
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