Central Health Classic Care Plan II (HMO)
Central Health Medicare Plan · HMO · 2026 coverage
The big numbers
The plan premium is on top of your Part B premium.
- Monthly premium
- $0
- Most you pay in a year for covered care in network
- $2,499
- Lower than most plans here
- Drug deductible
- $110
- Higher than most plans here
- Medicare star rating
- 3 of 5
In plain English
Compared with the 20 other plans in Madera County that the same person could join.
What stands out
- No monthly premium
- At most $2,499 a year for covered care, lower than most plans here
- Dental, vision and hearing extras included
Watch out for
- $975 for a 5-day hospital stay, higher than most plans here
- $10 for specialist visits, higher than most plans here
- $150 for the emergency room, tied for highest here
- $110 drug deductible, higher than most plans here
What a year could cost
Premiums plus the plan’s copays for three example years. Medicines are not included.
- A light year$0$0 in premiums + $0 for care2 checkups and 2 lab tests.
- A busier year$40$0 in premiums + $40 for care4 checkups, 4 specialist visits, 4 lab tests, 1 X-ray and 1 urgent care visit.
- A hard year$1,895$0 in premiums + $1,895 for care6 checkups, 12 specialist visits, 6 lab tests, 2 scans, an ambulance ride, an ER visit and a 5-day hospital stay.Uses the highest listed cost for: MRI, CT and other scans, Ground ambulance.
The visit counts are examples we chose to show how costs add up, not a prediction. Your costs depend on the care you get.
What you pay for care
Your cost each time, at doctors and hospitals in the plan’s network.
- Primary care visit$0
- Specialist visit$10Higher than most plans hereReferral neededPlan approval may be needed
- Urgent care$0
- Emergency room$150Tied for highest hereNot charged if you stay in the hospital within 3 days
- Hospital stay$195 a day for days 1 to 6, then $0 for days 7 to 90Higher than most plans hereReferral neededPlan approval may be needed
- Lab tests$0Referral neededPlan approval may be needed
More care: surgery, X-rays, scans, ambulance, nursing home
- Outpatient surgery center$0 to $100Depends on the serviceReferral neededPlan approval may be needed
- Outpatient hospital care$0 to $250Depends on the service
- X-rays$0Referral neededPlan approval may be needed
- MRI, CT and other scans$0 to $200Depends on the serviceReferral neededPlan approval may be needed
- Ground ambulance$0 to $250Depends on the servicePlan approval may be needed
From the costs the plan filed with Medicare for 2026. A range like “$0 to $100” means the cost depends on the service or the place. “Lower than most” compares this plan with the 20 other plans in Madera County that the same person could join. Read the plan’s 2026 booklet (PDF)
What medicines cost
| Drug tier | Network pharmacy |
|---|---|
| 1Preferred Generic | $0 |
| 2Generic | $0 |
| 3Preferred BrandAfter the deductible | 15% of the price |
| 4Non-Preferred DrugAfter the deductible | 35% of the price |
| 5Specialty TierAfter the deductible | 31% of the price |
| 6Select Care Drugs | $0 |
For a 1-month supply. The $110 drug deductible applies only to the tiers marked. Covered insulin costs at most $35 for a month’s supply. Your medicine’s tier is on the plan’s drug list; check it below.
Check my medicines
See if this plan covers each medicine you take in 2026, and what a month costs.
Type the name on the bottle. Add the strength to narrow it down.
Add each medicine once. We’ll show if this plan covers it, what a month costs, and any rules.
Extras
Help Original Medicare doesn’t give you.
- Dental IncludedCleanings and exams: $0. Fillings, crowns and dentures covered.
- Vision IncludedYearly eye exam: $0. Glasses or contacts covered.Eyewear: plan pays up to $300 a year.
- Hearing IncludedHearing test: $0. Hearing aids covered.
- Over-the-counter items IncludedCovered for things like vitamins, pain relief and bandages.
- Fitness IncludedIncludes gym or fitness classes and an activity tracker.
- Rides to care Included12 one-way rides to medical visits a year.
Is my doctor in this plan?
Look up your doctors, then confirm with their office.
Call each doctor’s office and ask:
“Do you take Central Health Classic Care Plan II (HMO), plan number H5649-028, for 2026?”