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Molina Medicare Complete Care (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Molina Medicare Complete Care (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Molina Medicare Complete Care (HMO D-SNP) in 2026, please refer to our full plan details page.
Molina Medicare Complete Care (HMO D-SNP) is a HMO D-SNP plan offered by Molina Healthcare, Inc. available for enrollment in 2026 to people living in Select counties in IA. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Molina Medicare Complete Care (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Molina Medicare Complete Care (HMO D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Molina Medicare Complete Care (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.
For Molina Medicare Complete Care (HMO D-SNP), 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. Additionally, this plan comes with a Part B Premium reduction of $0.50. You must continue to pay paying your reduced 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 $615.00 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 $9250.00 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:
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Drug Coverage
The Molina Medicare Complete Care (HMO D-SNP) plan features an annual drug deductible of $615. Members pay no copay for Tier 1 preferred generic drugs and Tier 6 select care drugs when using standard retail pharmacies or standard mail order services. For other drug tiers, prescription costs are covered through coinsurance during the initial coverage phase. Tier 2 generic and Tier 3 preferred brand drugs both carry a 20% coinsurance, while Tier 4 non-preferred drugs require a 30% coinsurance. Tier 5 specialty medications carry a 25% coinsurance for a one-month supply through standard pharmacies or mail order.
Additional Benefits
The Molina Medicare Complete Care (HMO D-SNP) plan offers comprehensive coverage with no copays for most medical services, though coinsurance applies to several key benefits. You will pay no copay and no coinsurance for inpatient hospital stays, skilled nursing facility care, home health services, and covered dental treatments. However, outpatient services, diagnostic tests, dialysis, and durable medical equipment require a 20% coinsurance, while primary care, specialist visits, and emergency services carry a 30% coinsurance. For extra health needs, the plan provides routine hearing exams, hearing aids, and up to 30 acupuncture treatments with no copay. Vision care features a $200 annual eyewear allowance and no deductibles, though routine eye exams require a 20% coinsurance. Additionally, worldwide emergency coverage is available up to a $10,000 limit with no copay and no coinsurance.
Inpatient Hospital See details
Inpatient hospital services under Molina Medicare Complete Care (HMO D-SNP) are partially covered with no copay and no coinsurance, although prior authorization is required. While acute and psychiatric stays are covered, additional hospital days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Molina Medicare Complete Care (HMO D-SNP) covers outpatient services with no copayments, though a 20% coinsurance applies to outpatient hospital, ambulatory surgical center, outpatient substance abuse, and blood services. Prior authorization is required for most of these outpatient services, and there is no deductible for outpatient blood services.
Partial Hospitalization See details
Molina Medicare Complete Care (HMO D-SNP) covers partial hospitalization services with no copay and a 30% coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
Molina Medicare Complete Care (HMO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, with prior authorization required. Transportation services to plan-approved or any health-related locations are not covered.
Emergency Services See details
Molina Medicare Complete Care (HMO D-SNP) covers emergency and urgently needed services with a 30% coinsurance and no copay, both of which count toward the plan-level deductible. Worldwide emergency coverage, including urgent care and emergency transportation, is also provided with no copay and no coinsurance up to a $10,000 maximum benefit limit.
Primary Care See details
Primary care benefits under Molina Medicare Complete Care (HMO D-SNP) are covered with no copay and a 30% coinsurance for primary care providers, specialists, therapy services, and mental health care. Podiatry services and routine chiropractic care are not covered, though opioid treatment program services are covered with no copay and no coinsurance.
Preventive Services See details
Molina Medicare Complete Care (HMO D-SNP) covers preventive services with no copay and no coinsurance for annual physicals, while kidney disease education and other screenings require a 20% coinsurance and no copay. Additional preventive benefits are partially covered with no copay and no coinsurance, but do not cover in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, home-based palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home safety modifications, or counseling.
Hearing Services See details
Hearing services are covered by Molina Medicare Complete Care (HMO D-SNP) with no copay for exams and hearing aids, though routine exams require a 20% coinsurance and no deductible. While OTC hearing aids are fully covered with no copay or coinsurance, prescription hearing aids are only partially covered, as inner ear, outer ear, and over the ear models are not covered.
Vision Services See details
Molina Medicare Complete Care (HMO D-SNP) partially covers vision services with no deductibles and no copays, featuring a $200 annual eyewear allowance and one routine eye exam per year. A 20% coinsurance applies to routine exams (prior authorization required) and contact lenses, while other eye exam services are not covered.
Dental Services See details
Dental Services are partially covered by Molina Medicare Complete Care (HMO D-SNP) with no copay and no coinsurance for covered preventive and comprehensive treatments. While key services like cleanings, exams, fillings, and oral surgery are covered, other diagnostic and preventive services, maxillofacial prosthetics, implants, fixed prosthodontics, and orthodontics are not covered.
Home Infusion bundled Services See details
Molina Medicare Complete Care (HMO D-SNP) covers home infusion bundled services with no copay, though prior authorization is required and step therapy may apply. Associated Medicare Part B chemotherapy, insulin, and other drugs carry a coinsurance of 0% to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
Dialysis Services are covered by Molina Medicare Complete Care (HMO D-SNP) with no copay and a 20% coinsurance.
Medical Equipment See details
Molina Medicare Complete Care (HMO D-SNP) covers durable medical equipment, prosthetics, medical supplies, and diabetic equipment with no copay and a 20% coinsurance. Prior authorization is required for these services, and select equipment and supplies may be limited to preferred vendors or manufacturers.
Diagnostic and Radiological Services See details
Molina Medicare Complete Care (HMO D-SNP) covers diagnostic and radiological services with no copay and a 20% coinsurance, subject to prior authorization. Covered benefits include diagnostic procedures, lab services, therapeutic radiological services, and outpatient X-rays.
Home Health Services See details
Molina Medicare Complete Care (HMO D-SNP) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Molina Medicare Complete Care (HMO D-SNP) offers cardiac rehabilitation benefits with no copay and prior authorization required, though only some services are covered. Standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered and require a 30% coinsurance.
Skilled Nursing Facility (SNF) See details
Molina Medicare Complete Care (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, though prior authorization is required. This benefit allows for admission with less than a three-day prior inpatient hospital stay, but additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Molina Medicare Complete Care (HMO D-SNP) provides partial coverage for other services, offering acupuncture up to 30 treatments per year, over-the-counter items, and qualifying meal benefits with no copay and no coinsurance. Prior authorization is required for the meal benefit, while highly integrated services for dual-eligible SNPs and other select services are not covered.
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