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SeniorCare Complete (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for SeniorCare Complete (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on SeniorCare Complete (HMO D-SNP) in 2025, please refer to our full plan details page.
SeniorCare Complete (HMO D-SNP) is a HMO D-SNP plan offered by South Country Health Alliance available for enrollment in 2025 to people living in Select Counties in Minnesota. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that SeniorCare Complete (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:
SeniorCare Complete (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 SeniorCare Complete (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 SeniorCare Complete (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $38.70. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $2.00. 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 $590.00 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 $9350.00 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 SeniorCare Complete (HMO D-SNP) plan has a $590 deductible for prescription drugs. After meeting the deductible, you will pay costs for drugs in each tier until your total drug costs reach $2000, at which point you enter the next coverage phase. If you qualify for the low-income subsidy (LIS), your Part D premium is $38.70. Once your yearly out-of-pocket drug costs reach $2000, you will pay nothing for Medicare Part D covered drugs.
Additional Benefits
The SeniorCare Complete (HMO D-SNP) plan offers a range of benefits with varying cost-sharing. Many services, including outpatient, emergency, and primary care, have a 20% coinsurance, while some preventive services, like screenings, also have a 20% coinsurance. Other services such as home health, lab services, and diabetic equipment have no copay or coinsurance, and the plan also covers a meal benefit for chronic illness. The plan covers inpatient hospital stays, partial hospitalization, ambulance services, and dialysis with coinsurance, but does not cover certain services like cardiac rehabilitation, and also excludes certain home health and vision services. Hearing and dental services are partially covered, with varying coinsurance amounts, and there are also specific cost-sharing structures for home infusion bundled services.
Inpatient Hospital See details
Inpatient Hospital benefits, including Acute and Psychiatric, are covered, but additional days and non-Medicare-covered stays for both are not covered. The coinsurance for Inpatient Hospital services follows the guidelines of Original Medicare.
Outpatient Services See details
Outpatient services are covered, including outpatient hospital services and observation services, both with a 20% coinsurance. Ambulatory Surgical Center (ASC) Services and Outpatient Substance Abuse Services are also covered, with a coinsurance of at least 20%. Outpatient blood services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the SeniorCare Complete (HMO D-SNP) plan, with a 20% coinsurance.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the SeniorCare Complete (HMO D-SNP) plan. Ground and Air Ambulance Services have a 20% coinsurance, with no copay. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including urgently needed services, are covered by SeniorCare Complete (HMO D-SNP) with a 20% coinsurance, but no copay. Worldwide emergency services and transportation are not covered.
Primary Care See details
The SeniorCare Complete (HMO D-SNP) plan covers primary care physician services, chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Most services have a 20% coinsurance, while routine chiropractic care and podiatry services are not covered.
Preventive Services See details
Preventive Services are covered, with the exception of annual physical exams, health education, in-home safety assessments, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, and remote access technologies. Kidney Disease Education Services, Glaucoma Screenings, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKGs following the Welcome Visit have a 20% coinsurance.
Hearing Services See details
Hearing services are partially covered by the SeniorCare Complete (HMO D-SNP) plan. Hearing exams have a coinsurance of at most 20%, while routine hearing exams, fitting/evaluation for hearing aids, prescription hearing aids of all types, and OTC hearing aids are not covered.
Vision Services See details
Vision Services offers coverage for eye exams with a 20% coinsurance. Eyewear is partially covered, but contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames are not covered, though upgrades are covered.
Dental Services See details
The SeniorCare Complete (HMO D-SNP) plan offers dental services with 20% coinsurance for Medicare dental services, and covers orthodontic services, but does not cover restorative services, adjunctive general services, endodontics, periodontics, removable prosthodontics, maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics. Prosthodontics, fixed benefits are covered with a limit of 1 visit per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the SeniorCare Complete (HMO D-SNP) plan. You will pay 20% coinsurance for dialysis services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment with coinsurance for Medicare-covered supplies and therapeutic shoes/inserts, all with no copay. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the SeniorCare Complete (HMO D-SNP) plan. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of at most 20%, while Lab Services have no coinsurance.
Home Health Services See details
Home Health Services are covered by the SeniorCare Complete (HMO D-SNP) plan with no copay and no coinsurance; however, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the SeniorCare Complete (HMO D-SNP) plan. This includes Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the SeniorCare Complete (HMO D-SNP) plan, but the coinsurance amount is not specified. Additional days beyond Medicare-covered SNF stays and non-Medicare-covered SNF stays are not covered.
Other Services See details
Other Services for the SeniorCare Complete (HMO D-SNP) plan are partially covered, with acupuncture, over-the-counter items, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services not covered. The plan does provide a meal benefit for a chronic illness, without a maximum plan benefit coverage amount.
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