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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 2026, 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 3.5 out of 5 stars in 2026.
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 $26.30. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your 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 SeniorCare Complete (HMO D-SNP) prescription drug plan features an annual drug deductible of $615. This deductible is the amount you must pay out-of-pocket for your prescription medications before the plan begins to cover its share of the costs. Specific drug coverage tier details, including individual copays and coinsurance rates, are currently unavailable for this plan. Prospective members should consult the plan's comprehensive formulary to determine how their specific medications are categorized and covered.
Additional Benefits
SeniorCare Complete (HMO D-SNP) offers comprehensive coverage featuring no copays for the vast majority of its medical services. Members can access inpatient hospital stays, skilled nursing facility care, and home health services with no copay and no coinsurance. For other essential medical needs, including primary care visits, specialist consultations, and emergency care, the plan features no copay and a standard 20% coinsurance. Additionally, the plan provides coverage for diagnostic services, medical equipment, and dialysis, which generally require a 20% coinsurance and no copay. Beneficiaries also receive extra benefits such as a $90 quarterly over-the-counter reimbursement, diagnostic hearing exams with no coinsurance, and a $148.80 annual allowance for eyewear upgrades. For prescription drugs, Medicare Part B chemotherapy drugs have no copay, while Part B insulin drugs carry a $35 copay.
Inpatient Hospital See details
SeniorCare Complete (HMO D-SNP) partially covers inpatient hospital services, providing acute and psychiatric hospital stays with no copay and no coinsurance. However, additional days, non-Medicare-covered stays, and upgrades are not covered under this plan.
Outpatient Services See details
SeniorCare Complete (HMO D-SNP) covers outpatient services, including outpatient hospital, ambulatory surgical center, substance abuse, and blood services, with no copay and a 20% coinsurance. Prior authorization is required for ambulatory surgical center and outpatient hospital services.
Partial Hospitalization See details
Partial hospitalization is covered under the SeniorCare Complete (HMO D-SNP) plan with no copay and a 20% coinsurance.
Ambulance and Transportation Services See details
SeniorCare Complete (HMO D-SNP) covers Medicare-covered ground and air ambulance services with a 20% coinsurance and no copay, which is not waived upon hospital admission. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
SeniorCare Complete (HMO D-SNP) covers emergency services and urgently needed services with no copay and a 20% coinsurance, which is waived if you are admitted to the hospital within three days. Worldwide emergency, urgent, and transportation services are not covered.
Primary Care See details
SeniorCare Complete (HMO D-SNP) covers primary care, specialist, therapy, mental health, psychiatric, and opioid treatment services with no copay and 20% coinsurance. Chiropractic and podiatry services are not covered under these benefits.
Preventive Services See details
Preventive services are partially covered under SeniorCare Complete (HMO D-SNP), offering Medicare-covered preventive care, memory fitness, and home safety modifications with no copay and no coinsurance, while excluding annual physical exams, health education, and in-home safety assessments. Kidney disease education and screenings like glaucoma and diabetes self-management are covered with no copay and a 20% coinsurance.
Hearing Services See details
Hearing services through SeniorCare Complete (HMO D-SNP) include diagnostic hearing exams with no copay, no deductible, and no coinsurance, while routine exams and fitting evaluations are not covered. For hearing aids, some services are covered, but OTC hearing aids and all prescription hearing aid types—including inner ear, outer ear, and over the ear—are not covered.
Vision Services See details
SeniorCare Complete (HMO D-SNP) offers partial coverage for vision services with no copay and a 20% coinsurance, providing up to $148.80 annually for eyewear upgrades. However, routine eye exams, contact lenses, and standard eyeglasses are not covered by the plan.
Dental Services See details
SeniorCare Complete (HMO D-SNP) provides partial dental coverage, offering Medicare-covered dental services with no copay, 20% coinsurance, and required prior authorization. Restorative services are covered with no copay and no coinsurance for one annual visit, while preventive care, exams, x-rays, cleanings, endodontics, periodontics, and oral surgery are not covered.
Home Infusion bundled Services See details
SeniorCare Complete (HMO D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs have no copay and 0% to 20% coinsurance, while Part B insulin drugs require a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under SeniorCare Complete (HMO D-SNP) with no copay and a 20% coinsurance.
Medical Equipment See details
SeniorCare Complete (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with no copay and a 20% coinsurance. Prior authorization is required for durable medical equipment and prosthetics, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
SeniorCare Complete (HMO D-SNP) covers diagnostic and radiological services with prior authorization required and no copays. While lab services require no coinsurance, a 20% coinsurance applies to diagnostic procedures, diagnostic and therapeutic radiological services, and outpatient X-rays.
Home Health Services See details
Home Health Services are covered by SeniorCare Complete (HMO D-SNP) with no copay and no coinsurance.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by SeniorCare Complete (HMO D-SNP) with no copay, but some services are covered while cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
SeniorCare Complete (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, requiring a prior three-day inpatient hospital stay before admission. Additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
SeniorCare Complete (HMO D-SNP) provides partially covered other services, including a meal benefit for chronic illness and over-the-counter (OTC) items with no copay and no coinsurance. Under this benefit, members receive up to $90 every three months for OTC items via reimbursement, while acupuncture and other services are not covered.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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