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
- Higher than most 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 21 other plans in Sacramento County that the same person could join.
What stands out
- No monthly premium
- $750 for a 5-day hospital stay, lower than most plans here
- $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, higher than most 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 90Lower 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$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 21 other plans in Sacramento 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?”