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Central Health Embrace Choice Plan (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Central Health Embrace Choice 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 Choice Plan (HMO C-SNP) in 2026, please refer to our full plan details page.
Central Health Embrace Choice 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 Choice 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 Choice 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 Choice 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 Choice 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 $9250.00 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 Choice Plan (HMO C-SNP) features an Enhanced Alternative drug benefit with an annual prescription drug deductible of $615.00. After meeting this deductible, you will pay a 15% coinsurance for Tier 1 preferred generics and Tier 2 standard generics, 30% coinsurance for Tier 3 preferred brands, and 25% coinsurance for Tier 4 non-preferred drugs at standard pharmacies. Notably, there is no copay for Tier 5 specialty drugs during this initial coverage phase. Once your yearly out-of-pocket drug costs reach $2,100.00, you will enter the catastrophic coverage phase and pay nothing for your covered Medicare Part D prescription drugs. Furthermore, individuals who qualify for the low-income subsidy (LIS) can reduce their Part D premium to $0.00.
Additional Benefits
The Central Health Embrace Choice Plan (HMO C-SNP) offers robust coverage with no copays for primary care, preventive services, home health, and dental care up to a $1,600 annual limit. For specialized medical needs, the plan features no copay and a 20% coinsurance for durable medical equipment, dialysis, and ambulance services, while inpatient hospital stays follow Medicare-defined deductibles and coinsurance. Emergency care is accessible with a $115 copay, which is waived upon admission, and urgent care requires no copay or coinsurance. Members also benefit from comprehensive vision care, including a routine exam and a $300 annual eyewear allowance with no copays, coinsurance, or deductibles. Routine hearing exams and over-the-counter hearing aids are covered with no copay, while prescription hearing aids require a copay ranging from $49.00 to $1,549.00. Additionally, the plan covers up to 12 one-way transportation trips, acupuncture, and meals with no copay or coinsurance.
Inpatient Hospital See details
Inpatient hospital services are partially covered by the Central Health Embrace Choice Plan (HMO C-SNP), which charges Medicare-defined deductibles and coinsurance but requires no copays. While unlimited additional acute care days are covered with no coinsurance, upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Central Health Embrace Choice Plan (HMO C-SNP) covers outpatient services with no copay and no coinsurance for ambulatory surgical center services, and no copay for blood services. Outpatient hospital, observation, and substance abuse services require no copay and a coinsurance ranging from 0% to 20%, with prior authorization and doctor referrals required for most services.
Partial Hospitalization See details
Central Health Embrace Choice Plan (HMO C-SNP) covers partial hospitalization benefits with a copay of $105.00 or $110.00 and no coinsurance. Prior authorization and a doctor referral are required for these services.
Ambulance and Transportation Services See details
Central Health Embrace Choice Plan (HMO C-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. Transportation services are partially covered, offering up to 12 one-way trips per year to plan-approved health-related locations with no copay or coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
Central Health Embrace Choice Plan (HMO C-SNP) covers emergency services with a $115 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 and no coinsurance, while worldwide emergency, urgent, and transportation services have a $110 copay and no coinsurance up to a $50,000 maximum benefit.
Primary Care See details
Central Health Embrace Choice Plan (HMO C-SNP) covers primary care, therapy, chiropractic, podiatry, psychiatric, and opioid treatment services with no copay and no coinsurance. Specialist visits and other healthcare professional services require up to 30% coinsurance with no copay, while telehealth benefits range from no copay to a $30 copay and up to 30% coinsurance.
Preventive Services See details
Preventive services are covered by the Central Health Embrace Choice Plan (HMO C-SNP) with no copay and no coinsurance for annual physicals, kidney disease education, and select screenings. Additional preventive benefits are only partially covered, excluding services such as weight management, alternative therapies, and in-home safety assessments.
Hearing Services See details
Hearing services are partially covered by Central Health Embrace Choice Plan (HMO C-SNP), featuring no copay or coinsurance for annual routine exams, fitting evaluations, and OTC hearing aids. Prescription hearing aids require prior authorization and a copay ranging from $49.00 to $1,549.00, while inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Central Health Embrace Choice Plan (HMO C-SNP) covers vision services with no copays, no coinsurance, and no deductibles, though prior authorization and referrals are required. The plan includes one routine eye exam per year and a $300 annual allowance for eyewear, which covers contact lenses, eyeglasses, lenses, frames, and upgrades.
Dental Services See details
Central Health Embrace Choice Plan (HMO C-SNP) covers preventive and comprehensive dental services with no copay and no coinsurance, up to a $1,600 annual limit. Prior authorization is required for Medicare-covered and comprehensive services, while basic preventive care like exams and cleanings is unlimited.
Home Infusion bundled Services See details
Home infusion bundled services are covered by the Central Health Embrace Choice Plan (HMO C-SNP) with prior authorization, featuring no copay and no coinsurance to 20% coinsurance for chemotherapy, radiation, and other Medicare Part B drugs. Covered Medicare Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Central Health Embrace Choice Plan (HMO C-SNP) covers Dialysis Services with a 20% coinsurance and no copay. Prior authorization and a doctor referral are required to access this benefit.
Medical Equipment See details
Central Health Embrace Choice Plan (HMO C-SNP) covers durable medical equipment, prosthetics, and medical supplies with a 20% coinsurance and no copay. Diabetic supplies and therapeutic shoes or inserts are also covered with no copay and no coinsurance, though prior authorization is required for these medical equipment benefits.
Diagnostic and Radiological Services See details
Central Health Embrace Choice Plan (HMO C-SNP) covers diagnostic and radiological services with no copays, though prior authorizations and doctor referrals are required. Lab and outpatient X-ray services feature no coinsurance, while diagnostic procedures, therapeutic services, and radiological tests carry a coinsurance of up to 20%.
Home Health Services See details
Home Health Services are covered under the Central Health Embrace Choice Plan (HMO C-SNP) with no copay and no coinsurance. Prior authorization and a doctor referral are required to access these covered services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by the Central Health Embrace Choice Plan (HMO C-SNP) where some services are covered, but in practice, Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD services are not covered. Since these specific services are not covered, there is no copay or coinsurance benefit available for them.
Skilled Nursing Facility (SNF) See details
Central Health Embrace Choice Plan (HMO C-SNP) partially covers Skilled Nursing Facility (SNF) services, which require a doctor referral and prior authorization. Covered stays are subject to Medicare-defined coinsurance with no copay, but additional days beyond what Medicare covers are not covered.
Other Services See details
Central Health Embrace Choice Plan (HMO C-SNP) partially covers other services, providing acupuncture, over-the-counter (OTC) items, and meal benefits with no copay or coinsurance. Dual Eligible SNPs with Highly Integrated Services are not covered.
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