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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 2025, 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 2025 to people living in Select counties in Nevada. The overall rating for this plan is not yet available for 2025.
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 $14.00. 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 $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 Molina Medicare Complete Care (HMO D-SNP) plan has a $590.00 deductible for prescription drugs. After the deductible, the plan covers the cost of your prescriptions. If you qualify for the low-income subsidy, you will pay $14.00. Once your total drug costs reach $2000.00, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The Molina Medicare Complete Care (HMO D-SNP) plan provides coverage for a wide range of services. This plan offers coverage for Inpatient Hospital, Outpatient Services, Partial Hospitalization, Emergency Services, Primary Care, Preventive Services, Hearing Services, Vision Services, Dental Services, Home Infusion Services, Dialysis Services, Medical Equipment, Diagnostic and Radiological Services, Home Health Services, Cardiac Rehabilitation Services, Skilled Nursing Facility (SNF), and Other Services. Many services, such as Home Health Services and Ambulance Services, have no copay, while others have a 20% coinsurance. This plan also includes benefits for hearing aids, and vision services. Other benefits include coverage for dental services, and home infusion services. The plan provides additional benefits like coverage for Over-the-Counter (OTC) Items and a Meal Benefit.
Inpatient Hospital See details
Inpatient Hospital benefits are covered for the Molina Medicare Complete Care (HMO D-SNP) plan. The plan covers Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, but does not specify the copay or coinsurance.
Outpatient Services See details
Outpatient Services are covered, including outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital and observation services have a 20% coinsurance, while outpatient blood services also have a 20% coinsurance, and the plan waives the three-pint deductible. Individual and group sessions for outpatient substance abuse have a coinsurance between 20% and 20%.
Partial Hospitalization See details
Partial hospitalization is covered by the Molina Medicare Complete Care (HMO D-SNP) plan, but requires prior authorization. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance Services are covered with no copay and a 20% coinsurance for both ground and air ambulance services. Transportation Services are partially covered; transportation to any health-related location is not covered, but transportation to any health-related location is covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Molina Medicare Complete Care (HMO D-SNP) plan. Emergency Services and Urgently Needed Services have a 20% coinsurance, while Worldwide Emergency Services has a maximum plan benefit coverage of $10,000.
Primary Care See details
The Molina Medicare Complete Care (HMO D-SNP) plan covers Primary Care Physician Services, Physician Specialist Services, and Physical Therapy and Speech-Language Pathology Services with a 20% coinsurance. Chiropractic Services are not covered, and Routine Foot Care has a 20% coinsurance. Mental Health Specialty Services, Psychiatric Services, and Podiatry Services have a 20% coinsurance. Additional Telehealth Benefits are covered.
Preventive Services See details
Preventive Services, including Medicare-covered services, annual physical exams, and additional services like Health Education, Nutritional/Dietary Benefits, Additional Sessions of Smoking and Tobacco Cessation Counseling, Fitness Benefit, Remote Access Technologies, and Kidney Disease Education Services are covered. Other Preventive Services, like Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, have a 20% coinsurance.
Hearing Services See details
Hearing Services include routine hearing exams with a coinsurance of at most 20%, fitting/evaluation for hearing aids, and prescription hearing aids. Prescription hearing aids (all types) are covered for 2 every two years, while inner ear, outer ear, and over the ear prescription hearing aids are not covered. OTC hearing aids are also covered.
Vision Services See details
Vision services are covered, but routine eye exams are not covered. Eyewear benefits include contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades. This plan offers a combined maximum benefit of $200 per year for all eyewear.
Dental Services See details
The Molina Medicare Complete Care (HMO D-SNP) plan covers dental services with a 20% coinsurance. Oral exams, dental x-rays, cleaning, fluoride treatments, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics, and oral and maxillofacial surgery are covered, but some have limitations on the number of visits per year. Maxillofacial prosthetics, implant services, prosthodontics (fixed), and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay with a coinsurance between 0% and 20%. 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 by the Molina Medicare Complete Care (HMO D-SNP) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance and requires prior authorization, while DME for use outside the home is not covered. Prosthetics/Medical Supplies have a 20% coinsurance, and Diabetic Equipment has a coinsurance for some services.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with a coinsurance of at most 20% for Diagnostic Procedures/Tests, Lab Services, and Outpatient X-Ray Services. Diagnostic and Therapeutic Radiological Services are not covered.
Home Health Services See details
Home Health Services are covered by the Molina Medicare Complete Care (HMO D-SNP) plan with no copay and no coinsurance, but prior authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization. The plan does not cover additional days beyond Medicare-covered SNF days, or non-Medicare-covered SNF stays.
Other Services See details
The Molina Medicare Complete Care (HMO D-SNP) plan covers Over-the-Counter (OTC) Items, including Nicotine Replacement Therapy (NRT) and Naloxone, and a Meal Benefit, but does not cover Acupuncture, 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. The Meal Benefit requires prior authorization.
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