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Central Health Classic Care Plan II (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Central Health Classic Care Plan II (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 II (HMO) in 2026, please refer to our full plan details page.
Central Health Classic Care Plan II (HMO) is a HMO plan offered by Molina Healthcare, Inc. available for enrollment in 2025 to people living in Counties: Fre, Imp, Kgs, Mad, Tul, Ven. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Central Health Classic Care Plan II (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 II (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 II (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 a $110.00 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 $2499.00 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 Classic Care Plan II (HMO) features an Enhanced Alternative drug benefit with an annual prescription drug deductible of $110.00. After meeting this deductible, you will pay no copay for Tier 1 preferred generics and Tier 5 specialty drugs at standard pharmacies and through standard mail. For other tiers, you will pay a coinsurance of 15% for Tier 2 standard generics, 35% for Tier 3 preferred brands, and 31% for Tier 4 non-preferred drugs. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and pay nothing for covered Medicare Part D drugs. Additionally, if you qualify for the low-income subsidy, your Part D premium is reduced to $0.00. This plan offers a clear pathway to managing your medication costs with significant savings on generic and specialty prescriptions.
Additional Benefits
The Central Health Classic Care Plan II (HMO) provides affordable medical coverage featuring no copay for primary care visits, physical therapy, and home health services. For inpatient hospital stays, members pay a $195 daily copay for days one through six, with no copay for days seven through 90 and no coinsurance. Emergency care is covered with a $150 copay, which is waived if you are admitted to the hospital, while urgent care visits require no copay. This plan also includes key ancillary benefits, such as routine vision exams and eyewear with no copay up to a $300 annual allowance, as well as hearing exams and over-the-counter hearing aids with no copay. Covered dental services require no coinsurance with copays starting at no copay, and acupuncture and over-the-counter items are also available with no copay. Additionally, members can access up to 12 one-way plan-approved transportation trips per year with no copay.
Inpatient Hospital See details
Central Health Classic Care Plan II (HMO) partially covers inpatient hospital stays with a copay of $195 per day for days 1 through 6, no copay for days 7 through 90, and no coinsurance. Under this plan, upgrades, non-Medicare-covered stays, and additional days for psychiatric care are not covered.
Outpatient Services See details
Central Health Classic Care Plan II (HMO) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient substance abuse sessions require a $10 copay, while outpatient hospital and observation services range from no copay up to a $250 copay.
Partial Hospitalization See details
Central Health Classic Care Plan II (HMO) covers partial hospitalization benefits with a $100 copay and no coinsurance. Prior authorization and a doctor referral are required to access these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by Central Health Classic Care Plan II (HMO), which excludes transportation to any health-related location. Ground ambulance services require a $0 to $250 copay and coinsurance, air ambulance services require a 20% coinsurance and a copay, and plan-approved transportation is covered with no copay or coinsurance for up to 12 one-way trips per year.
Emergency Services See details
Central Health Classic Care Plan II (HMO) 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 have no copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $50,000 maximum with a $150 copay and no coinsurance.
Primary Care See details
Central Health Classic Care Plan II (HMO) partially covers primary care and professional services, as podiatry services are not covered. Members pay no copay and no coinsurance for primary care, physical therapy, occupational therapy, and chiropractic visits, while specialist services require a $10 copay and mental health or psychiatric sessions range from a $10 copay to 20% coinsurance.
Preventive Services See details
Central Health Classic Care Plan II (HMO) provides partially covered preventive services with no copays and no coinsurance for covered care, including annual physical exams, fitness benefits, and kidney disease education. However, the plan does not cover in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, additional smoking cessation, telemonitoring, home modifications, and counseling.
Hearing Services See details
Central Health Classic Care Plan II (HMO) covers hearing services with no copay and no coinsurance for exams, fitting evaluations, and OTC hearing aids. Prescription hearing aids are partially covered with no coinsurance and a copay between $575 and $2,099, though inner ear, outer ear, and over-the-ear prescription aids are not covered.
Vision Services See details
Central Health Classic Care Plan II (HMO) covers annual routine eye exams and eyewear with no copay, no deductible, and no coinsurance. The plan provides a combined maximum benefit of $300 per year for contacts, lenses, and frames, though doctor referrals and prior authorizations are required.
Dental Services See details
Central Health Classic Care Plan II (HMO) offers partially covered dental services, excluding maxillofacial prosthetics and orthodontics. Covered dental care requires no coinsurance, with copays ranging from no copay up to $2,160 depending on the specific procedure.
Home Infusion bundled Services See details
Central Health Classic Care Plan II (HMO) covers home infusion bundled services with prior authorization required. Medicare Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance, while chemotherapy, radiation, and other Part B drugs require no copay and carry no coinsurance to 20% coinsurance.
Dialysis Services See details
Central Health Classic Care Plan II (HMO) covers Dialysis Services with a 20% coinsurance and no copay. Prior authorization and a doctor referral are required to access these services.
Medical Equipment See details
Central Health Classic Care Plan II (HMO) covers durable medical equipment, prosthetics, and diabetic supplies, with prior authorization required. Durable medical equipment and prosthetics have no copay and a 0% to 20% coinsurance, while diabetic supplies and therapeutic shoes are available with no copay and no coinsurance.
Diagnostic and Radiological Services See details
Central Health Classic Care Plan II (HMO) covers diagnostic tests, lab services, and outpatient X-rays with no copay and no coinsurance. Diagnostic radiological services require a copay of $0 to $200 with no coinsurance, while therapeutic radiological services have a 20% coinsurance and no copay.
Home Health Services See details
Home health services are covered by the Central Health Classic Care Plan II (HMO) with no copay and no coinsurance. Prior authorization and a doctor referral are required to access these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Central Health Classic Care Plan II (HMO), as none of the sub-services, including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation, are covered by the plan.
Skilled Nursing Facility (SNF) See details
Central Health Classic Care Plan II (HMO) partially covers Skilled Nursing Facility (SNF) services, as additional days beyond those covered by Medicare are not covered. Covered stays require prior authorization and a doctor referral, and are subject to Medicare-defined coinsurance with no copay.
Other Services See details
Other Services are partially covered by Central Health Classic Care Plan II (HMO), offering acupuncture and over-the-counter items with no copay or coinsurance, alongside meal benefits with a $0 to $5 copay and no coinsurance. Specific sub-services such as nicotine replacement therapy and highly integrated dual-eligible SNP services are not covered under this plan.
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