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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 2025, 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 2.5 out of 5 stars in 2025.
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 $13.40. 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 $590.00 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 $9350.00 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) has a $590 deductible for prescription drugs. After the deductible is met, you will pay the costs for drugs in each tier until your total drug costs reach $2000. If you qualify for the low-income subsidy (LIS), your monthly Part D premium will be $13.40. Once your yearly out-of-pocket drug costs reach $2000, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Central Health Embrace Choice Plan (HMO C-SNP) offers a wide range of benefits with varying cost-sharing. Many services have no copay, including primary care, preventive services, hearing and vision exams, dental services, and home health services. The plan also covers outpatient services, partial hospitalization, ambulance, and emergency services, with costs depending on the specific service, such as a 20% coinsurance for ground ambulance and a copay between $0-$110 for emergency services. Additional benefits include coverage for home infusion, dialysis, medical equipment, diagnostic and radiological services, and other services like acupuncture and over-the-counter items, many of which have no copay. However, some services, such as inpatient hospital and skilled nursing facility stays, require prior authorization and may involve coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered and may include services not usually covered by Medicare plans, but require prior authorization and a doctor's referral. Additional Days for Inpatient Hospital-Acute are covered, but Non-Medicare-covered Stay for Inpatient Hospital-Acute, Upgrades for Inpatient Hospital-Acute, Additional Days for Inpatient Hospital Psychiatric, and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient services, including outpatient hospital services and observation services, are covered with a coinsurance between 0% and 20%. Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay, while outpatient substance abuse services are covered with a coinsurance of 20%.
Partial Hospitalization See details
Partial Hospitalization is covered with a $80 copay, and requires prior authorization and a doctor referral.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Central Health Embrace Choice Plan (HMO C-SNP). Ground and air ambulance services have a 20% coinsurance, while transportation services to a plan-approved health-related location have no copay, with a limit of 12 one-way trips per year. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including Urgently Needed Services and Worldwide Emergency Services, are covered by the Central Health Embrace Choice Plan (HMO C-SNP). Emergency Services have a copay between $0-$110, and Urgently Needed Services have no copay; Worldwide Emergency Services have a $110 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The Central Health Embrace Choice 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 services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Primary care physician services, chiropractic services, occupational therapy services, physical therapy and speech-language pathology services, and additional telehealth benefits have no copay. Physician specialist services have a coinsurance of 0-35%. Mental health specialty services, podiatry services, and psychiatric services have a $0 copay. Other health care professional services have a coinsurance of 0-35%.
Preventive Services See details
Preventive Services include no copay for annual physical exams, Medicare-covered preventive services, and several other services including Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, all of which require prior authorization and have no copay. In-Home Support Services, Health Education, Personal Emergency Response System (PERS) and Fitness Benefits also have no copay.
Hearing Services See details
The Central Health Embrace Choice Plan (HMO C-SNP) covers hearing exams, routine hearing exams, fitting/evaluation for hearing aids, and OTC hearing aids with no copay. Prescription hearing aids are covered with a copay between $49 and $1549, and inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
The Central Health Embrace Choice Plan (HMO C-SNP) covers vision services including eye exams with no copay, and eyewear with no copay. Eyewear has a combined maximum benefit of $300 per year for contact lenses.
Dental Services See details
Dental Services are covered with no copay. However, Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), Maxillofacial Prosthetics, Implant Services, Oral and Maxillofacial Surgery, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs are also covered, with coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Central Health Embrace Choice Plan (HMO C-SNP), requiring prior authorization and a doctor's referral. You will pay a 20% coinsurance for these services.
Medical Equipment See details
The Central Health Embrace Choice Plan (HMO C-SNP) covers medical equipment including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance with authorization required, while Durable Medical Equipment for use outside the home is not covered. Prosthetic devices have a 20% coinsurance, and medical supplies have a 20% coinsurance. Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Central Health Embrace Choice Plan (HMO C-SNP), with no copay. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of at most 20%, while Lab Services and Outpatient X-Ray Services have no coinsurance. Therapeutic Radiological Services have a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the Central Health Embrace Choice Plan (HMO C-SNP) with no copay and no coinsurance. Additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. A doctor referral and prior authorization are required for Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered, but additional days beyond Medicare-covered and non-Medicare-covered stays are not covered. Prior authorization and a doctor referral are required, and cost sharing applies, with coinsurance information available in the plan details.
Other Services See details
The Central Health Embrace Choice Plan (HMO C-SNP) covers acupuncture with no copay, but requires prior authorization and a doctor referral, with a limit of 12 treatments per year. Over-the-counter items and a meal benefit are also covered with no copay, but the meal benefit requires prior authorization. Other services such as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and others are not covered.
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