A non-government entity
Central Health Classic Care Plan I (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Central Health Classic Care Plan I (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Central Health Classic Care Plan I (HMO) in 2025, please refer to our full plan details page.
Central Health Classic Care Plan I (HMO) is a HMO plan offered by Molina Healthcare, Inc. available for enrollment in 2025 to people living in Counties: LA, Ora, Riv, SBD, SD. This plan received an overall rating of 2.5 out of 5 stars in 2025.
It's important to know that Central Health Classic Care Plan I (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Central Health Classic Care Plan I (HMO).
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 Classic Care Plan I (HMO), 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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $999.00 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:
Sign up for Central Health Classic Care Plan I (HMO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Central Health Classic Care Plan I (HMO) has a $0 deductible for prescription drugs. In the initial coverage phase, you will pay different copays or coinsurance amounts depending on the drug tier and pharmacy used. For example, you will pay no copay for preferred generic drugs at a standard pharmacy and a $47 copay for standard generic drugs at a standard pharmacy. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase where you pay nothing for Medicare Part D covered drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit.
Additional Benefits
The Central Health Classic Care Plan I (HMO) offers comprehensive coverage with no copays for many services. This includes inpatient hospital stays, outpatient services, primary care, preventive services, hearing exams, vision exams and eyewear, dental services, and home health services. The plan also covers ambulance and transportation, emergency services, and offers additional benefits like acupuncture and over-the-counter items. This plan has varying copays for some services, such as outpatient hospital services, emergency services, hearing aids, and prescription drugs. There is also coinsurance for services like outpatient substance abuse, air ambulance, dialysis, and therapeutic radiological services. Some services, such as cardiac rehabilitation, and additional hours of care, are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both with no copay for a Medicare-covered stay and requiring prior authorization and a doctor's referral. Additional Days for Inpatient Hospital-Acute are covered with no copay, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, and Additional Days for Inpatient Hospital Psychiatric and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered, including all outpatient hospital services, observation services, and ambulatory surgical center services. Outpatient hospital and observation services have a copay of $0-$65, while ambulatory surgical center services have no copay. Individual and group sessions for outpatient substance abuse have a 20% coinsurance, and outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the Central Health Classic Care Plan I (HMO) with a $100 copay. Prior authorization and a doctor referral are required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the Central Health Classic Care Plan I (HMO). Ground ambulance services have a copay between $0 and $100, while air ambulance services have a 20% coinsurance. Transportation Services to plan-approved health-related locations are covered, with no copay, and up to 24 one-way trips per year. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Central Health Classic Care Plan I (HMO). Emergency Services have a copay between $0 and $100, and Urgently Needed Services have no copay; both have no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation each have a $140 copay and no coinsurance.
Primary Care See details
Primary Care benefits include Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services. Chiropractic Services, Routine Chiropractic Care, Primary Care Physician Services, Physician Specialist Services, Mental Health Specialty Services, Other Health Care Professional, Psychiatric Services, Additional Telehealth Benefits, Opioid Treatment Program Services, and Physical Therapy and Speech-Language Pathology Services have no copay. Occupational Therapy Services, Physical Therapy and Speech-Language Pathology Services require authorization and referral.
Preventive Services See details
Preventive services are covered, including annual physical exams with no copay. Additional preventive services, kidney disease education services, and other preventive services are covered with no copay for specific services such as glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit.
Hearing Services See details
The Central Health Classic Care Plan I (HMO) covers hearing services, including hearing exams with no copay. Routine hearing exams and fitting/evaluation for hearing aids are covered, with 1 visit per year and no copay. Prescription hearing aids are partially covered, with a copay between $49 and $1549 for all types of hearing aids, but not for inner, outer, or over-the-ear hearing aids. OTC hearing aids are covered with no copay.
Vision Services See details
Vision Services includes coverage for eye exams and eyewear. Eye exams and eyewear have no copay. Eyewear has a combined maximum benefit of $300.00 per year.
Dental Services See details
Dental services include coverage for Medicare dental services with no copay, and other dental services that include oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventative dental services, all with no copay, and restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), implant services, and oral and maxillofacial surgery, all with varying copays. Maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. The plan covers 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 Classic Care Plan I (HMO) with prior authorization and a doctor's referral. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has no copay and a coinsurance of 0% to 20%, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have no copay and a coinsurance of 0% to 20%. Diabetic Equipment has no copay for Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts, and no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services with a copay, and lab services with no copay. Diagnostic Procedures/Tests have no copay, and Outpatient X-Ray Services have no copay. Therapeutic Radiological Services have a coinsurance of 20%.
Home Health Services See details
Home Health Services are covered under the Central Health Classic Care Plan I (HMO) with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Central Health Classic Care Plan I (HMO). Prior authorization and a doctor referral are required for these services, but the plan does not cover the services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Central Health Classic Care Plan I (HMO) with prior authorization and a doctor's referral. There is no copay for days 1-20, and a $90 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
The Central Health Classic Care Plan I (HMO) covers acupuncture with no copay, and covers over-the-counter items with no copay. The plan also offers a meal benefit with a copay between $0-$5. However, dual eligible SNPs, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, and several other services are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved