CenCal CareConnect (HMO D-SNP)

CenCal CareConnect (HMO D-SNP) is a HMO D-SNP plan offered by SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH available for enrollment in 2026 to people living in Central Coast California. The overall rating for this plan is not yet available for 2026.

It's important to know that CenCal CareConnect (HMO D-SNP) 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 CenCal CareConnect (HMO D-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.

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:

Drug Coverage

The CenCal CareConnect (HMO D-SNP) Medicare plan features an Enhanced Alternative drug benefit with a yearly prescription drug deductible of $615.00. For individuals who qualify for the low-income subsidy, the Part D premium is reduced to $12.00. During the initial coverage phase, standard pharmacy costs for a 30-day supply include an $11.00 copay for preferred generics, 25% coinsurance for standard generics and non-preferred drugs, 26% coinsurance for preferred brands, and no copay for specialty tier drugs. Once your total drug costs reach $2,100.00, you will transition into the next coverage phase. In the catastrophic coverage phase, which begins after your yearly out-of-pocket drug costs reach $2,100.00, you pay nothing for Medicare Part D covered drugs. This coverage structure ensures your prescription costs are fully covered once you reach the out-of-pocket limit.

Additional Benefits

The CenCal CareConnect (HMO D-SNP) plan offers comprehensive medical coverage, with many key services requiring no copay and a standard 20% coinsurance. This cost structure applies to primary care, outpatient services, emergency care, medical equipment, and diagnostic tests, though prior authorizations or doctor referrals are frequently required. Inpatient hospital stays and skilled nursing facility care are also covered, subject to Medicare-defined coinsurance and copays. For supplemental care, the plan features a $400 vision allowance every two years and up to $1,250 annually for prescription hearing aids, both with no copays or coinsurance. Additionally, members receive a $120 allowance every three months for over-the-counter items with no copay or coinsurance. While routine hearing and vision exams are covered, dental coverage is limited to Medicare-covered services which require no copay and a 20% coinsurance.