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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 NE. The overall rating for this plan is not yet available for 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 $3.40. 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 Molina Medicare Complete Care HMO D-SNP plan features an annual drug deductible of $615. Under this plan, you will pay no copay for Tier 1 preferred generic drugs and Tier 6 select care drugs filled through standard pharmacies or standard mail order. This zero-cost coverage applies to one-month, two-month, and three-month supply options. For other medication tiers, standard pharmacy and standard mail order fills require coinsurance. Tier 2 generic drugs and Tier 3 preferred brand drugs both carry a 20% coinsurance, while Tier 4 non-preferred drugs require a 30% coinsurance. Tier 5 specialty drugs are subject to a 25% coinsurance for a one-month supply.
Additional Benefits
The Molina Medicare Complete Care (HMO D-SNP) plan offers comprehensive coverage with no copays for most medical services, including inpatient hospital stays, primary care, and specialist visits. While copays are largely eliminated, beneficiaries are responsible for coinsurance costs, which generally range from 20% for outpatient care and medical equipment to 30% for emergency services. Fortunately, essential services like home health care, skilled nursing, and unlimited transportation to approved medical locations are available with no copay and no coinsurance. For extra wellness care, this plan provides dental benefits with no copay and no coinsurance up to a $3,000 annual limit, alongside a $200 annual allowance for eyewear. Routine hearing exams, hearing aids, and over-the-counter items are also covered with no copayments. Please keep in mind that many services, including inpatient stays and durable medical equipment, require prior authorization before receiving care.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Molina Medicare Complete Care (HMO D-SNP) with no copay or coinsurance, though prior authorization is required for both acute and psychiatric stays. Additional days, non-Medicare-covered stays, and upgrades are not covered under this plan.
Outpatient Services See details
Molina Medicare Complete Care (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 most of these outpatient services, and there is no deductible for outpatient blood services, with the cost of the first three pints waived.
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 access 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. The plan also covers unlimited transportation to plan-approved health-related locations with no copay and no coinsurance, though transportation to any health-related location is 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 copayment, with the emergency coinsurance waived if you are admitted to the hospital within 24 hours. Worldwide emergency, urgent care, and emergency transportation are also covered up to a $10,000 maximum benefit with no copayment and no coinsurance.
Primary Care See details
Molina Medicare Complete Care (HMO D-SNP) covers primary care, specialist visits, mental health, and physical therapies with no copay and 30% coinsurance, though prior authorization is required for some services. Opioid treatment is fully covered with no copay and no coinsurance, while chiropractic and podiatry services are not covered.
Preventive Services See details
Molina Medicare Complete Care (HMO D-SNP) covers annual physical exams and select preventive services with no copay and no coinsurance, though additional preventive services are only partially covered, excluding in-home safety assessments, personal emergency response systems, and medical nutrition therapy. Kidney disease education and other specific screenings are covered with no copay and a 20% coinsurance.
Hearing Services See details
Molina Medicare Complete Care (HMO D-SNP) covers annual hearing exams and fitting evaluations with no copays, though routine exams require a 20% coinsurance with no deductible. Prescription hearing aids are partially covered with no copay or coinsurance for up to two devices every two years, excluding inner ear, outer ear, and over-the-ear types, while OTC hearing aids are covered with no copay or coinsurance.
Vision Services See details
Molina Medicare Complete Care (HMO D-SNP) covers vision services with no deductibles and no copays, though a 20% coinsurance applies to routine eye exams and contact lenses. Other eye exam services are not covered, but the plan provides a $200 annual allowance for eyewear, including eyeglasses, contact lenses, and upgrades.
Dental Services See details
Molina Medicare Complete Care (HMO D-SNP) partially covers dental services, offering Medicare-covered dental with no copay and 30% coinsurance, as well as preventive and comprehensive services with no copay and no coinsurance up to a $3,000 annual limit. Sub-services that are not covered include other diagnostic dental, other preventive dental, maxillofacial prosthetics, implants, fixed prosthodontics, and orthodontics.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Molina Medicare Complete Care (HMO D-SNP) with no copay, though prior authorization and step therapy are required. Associated Medicare Part B chemotherapy, radiation, and other drugs incur coinsurance ranging from no coinsurance to 20%, while covered Part B insulin has a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Molina Medicare Complete Care (HMO D-SNP) covers dialysis services 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 benefits, and coverage for certain items may be limited to preferred vendors and manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Molina Medicare Complete Care (HMO D-SNP) with no copay, subject to a 20% coinsurance and prior authorization. This coverage includes lab services, diagnostic tests, outpatient X-rays, and both diagnostic and therapeutic radiological services.
Home Health Services See details
Home Health Services are covered by Molina Medicare Complete Care (HMO D-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under Molina Medicare Complete Care (HMO D-SNP) with no copay, though only some services are covered in practice. Specifically, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require a 30% coinsurance and prior authorization.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by Molina Medicare Complete Care (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required and a prior three-day inpatient hospital stay is not. This benefit is partially covered because additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services under the Molina Medicare Complete Care (HMO D-SNP) plan are partially covered, featuring over-the-counter (OTC) items and meal benefits with no copay and no coinsurance. Acupuncture and other miscellaneous services are not covered, and the meal benefit requires prior authorization.
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