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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 2025, 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 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 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 $100.00 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:
Sign up for Central Health Classic Care Plan II (HMO)
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Drug Coverage
The Central Health Classic Care Plan II (HMO) has a $100 deductible for prescription drugs. During the initial coverage phase, you'll pay varying copays or coinsurance depending on the drug tier and pharmacy you use. For example, you'll pay no copay for preferred generic drugs at standard or mail order pharmacies, while standard generic drugs have a $35 copay. After your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The Central Health Classic Care Plan II (HMO) provides a wide range of benefits with varying cost-sharing. Inpatient hospital stays have a copay, while outpatient services and many primary care services have no copay. Emergency and hearing services are also covered, often with no copay. This plan offers additional coverage for vision and dental services, with copays for some dental procedures and no copay for eye exams and eyewear. The plan also includes benefits for ambulance, home infusion, and medical equipment, with some services requiring coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, with a $150 copay for days 1-6 and no copay for days 7-90 for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. Additional Days for Inpatient Hospital-Acute are covered with no copay, but Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered, including outpatient hospital services with a copay of $0-$250 per visit, observation services with a copay of $0-$250 per stay, and ambulatory surgical center services with no copay. Outpatient substance abuse services have a copay of $10 per session, and outpatient blood services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Central Health Classic Care Plan II (HMO) with a $100 copay, and requires prior authorization and a doctor's referral.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required. Ground ambulance services have a copay between $0 and $250, while air ambulance services have a 20% coinsurance. Transportation Services to a plan-approved health-related location are covered with no copay for 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 by the Central Health Classic Care Plan II (HMO). Emergency services have a copay ranging from $0 to $140, while urgently needed services have no copay, and worldwide emergency coverage has a $140 copay.
Primary Care See details
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 are covered. Primary Care Physician Services, Chiropractic Services, Routine Chiropractic Care, Occupational Therapy Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services have no copay. Physician Specialist Services have a $10 copay. Individual and Group Sessions for Mental Health and Psychiatric Services have a $10 copay and 20% coinsurance, respectively.
Preventive Services See details
The Central Health Classic Care Plan II (HMO) covers preventive services, including an annual physical exam with no copay. Other services like Health Education, Personal Emergency Response System (PERS), Fitness Benefit, Enhanced Disease Management, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit are covered with no copay, while services like In-Home Safety Assessment, Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, and Telemonitoring Services, Home and Bathroom Safety Devices and Modifications, Counseling Services are not covered.
Hearing Services See details
The Central Health Classic Care Plan II (HMO) covers hearing exams with no copay. The plan also covers routine hearing exams and fitting/evaluation for hearing aids with no copay, once per year. Prescription hearing aids are covered, with a copay between $575 and $2099 for all types, two times per year, but inner ear, outer ear, and over the ear hearing aids are not covered. OTC hearing aids are covered with no copay.
Vision Services See details
The Central Health Classic Care Plan II (HMO) offers vision services including routine eye exams and eyewear. Eye exams have no copay, and eyewear has a $300 combined maximum plan benefit coverage amount per year with no copay for contact lenses.
Dental Services See details
Dental Services include coverage for Medicare Dental Services with no copay, and other services with varying copays. Oral exams, dental x-rays, prophylaxis (cleaning), and fluoride treatments have no copay, while other diagnostic and preventive services have copays ranging from $0 to $20; restorative services, endodontics, periodontics, prosthodontics (removable), implant services, prosthodontics (fixed), and oral and maxillofacial surgery have copays ranging from $25 to $2160. Maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Central Health Classic Care Plan II (HMO) and require prior authorization and a doctor referral. There is a 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a coinsurance of 0% to 20%, Prosthetic Devices with a coinsurance of 0% to 20%, and Medical Supplies with a coinsurance of 0% to 20%. Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have no copay, and Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, diagnostic procedures/tests, lab services, all radiological services, diagnostic radiological services, therapeutic radiological services, and outpatient X-Ray services. Diagnostic Procedures/Tests and Lab Services have no copay, while Diagnostic Radiological Services have a copay of up to $200, and Therapeutic Radiological Services have a coinsurance of at least 20%.
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. 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 II (HMO). The plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the Central Health Classic Care Plan II (HMO), but require prior authorization and a doctor's referral. Additional days beyond Medicare-covered SNF and non-Medicare-covered SNF stays are not covered.
Other Services See details
Other Services includes acupuncture with no copay, and over-the-counter items, also with no copay, and meal benefits with a copay of $0-$5; however, services for Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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