Central Health Valor Care Plan (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
- $4,400
- Highest of 8 plans here
- Drug coverage
- Not included
- You would need a separate drug plan
- Medicare star rating
- 3 of 5
In plain English
Compared with the 7 other plans in Imperial County that the same person could join.
What stands out
- No monthly premium
- $0 for specialist visits, tied for lowest here
- Dental, vision and hearing extras included
Watch out for
- Up to $4,400 a year for covered care, highest of 8 plans here
- You need a referral to see a specialist
- Covers only the plan’s own doctors and hospitals, except in an emergency or for urgent care
- Does not include drug coverage
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$0$0 in premiums + $0 for careTied for lowest here4 checkups, 4 specialist visits, 4 lab tests, 1 X-ray and 1 urgent care visit.
- A hard year$1,355$0 in premiums + $1,355 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$0Tied for lowest hereReferral neededPlan approval may be needed
- Urgent care$0
- Emergency room$130Not charged if you stay in the hospital within 3 days
- Hospital stay$150 a day for days 1 to 6, then $0 for days 7 to 90Referral 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$0Tied for lowest hereReferral neededPlan approval may be needed
- Outpatient hospital care$0 to $295Depends on the service
- X-rays$0Referral neededPlan approval may be needed
- MRI, CT and other scans$0 to $100Depends on the serviceReferral neededPlan approval may be needed
- Ground ambulance$0 to $275Depends 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 7 other plans in Imperial County that the same person could join. Read the plan’s 2026 booklet (PDF)
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 $400 a year.
- Hearing IncludedHearing test: $0. Hearing aids covered.
- Over-the-counter items Not included
- Fitness IncludedIncludes gym or fitness classes and an activity tracker.
- Rides to care Not included
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 Valor Care Plan (HMO), plan number H5649-030, for 2026?”