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Molina Medicare Complete Care Plus (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Molina Medicare Complete Care Plus (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 Plus (HMO D-SNP) in 2026, please refer to our full plan details page.
Molina Medicare Complete Care Plus (HMO D-SNP) is a HMO D-SNP plan offered by Molina Healthcare, Inc. available for enrollment in 2026 to people living in Counties: LA, Riv, SBD, SD, Sac. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Molina Medicare Complete Care Plus (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 Plus (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 Plus (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 Plus (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.
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:
Sign up for Molina Medicare Complete Care Plus (HMO D-SNP)
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Drug Coverage
The Molina Medicare Complete Care Plus (HMO D-SNP) plan offers an Enhanced Alternative drug benefit with a $615.00 prescription drug deductible. If you qualify for the Low-Income Subsidy, also known as LIS or Extra Help, your Part D premium is reduced to $0. During the initial coverage phase, standard pharmacy and mail-order costs for a 30-day supply include a $4.00 copay for Tier 1 preferred generics, 20% coinsurance for Tier 2 standard generics, 30% coinsurance for Tier 3 preferred brands, and 25% coinsurance for Tier 4 non-preferred drugs. Notably, there is no copay for Tier 5 specialty tier drugs. After your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and will pay nothing for covered Medicare Part D prescriptions.
Additional Benefits
Molina Medicare Complete Care Plus (HMO D-SNP) offers comprehensive coverage where many medical services feature no copay, though coinsurance typically applies. For primary care, outpatient services, diagnostics, and emergency care, members will pay no copay and a coinsurance ranging from 20% to 30%. Inpatient hospital stays and skilled nursing facility care are also covered, requiring prior authorization and Medicare-defined copays and coinsurance. The plan also includes key supplemental benefits like dental, vision, and hearing care, which generally require no copay and a 20% coinsurance. Additionally, members can access covered over-the-counter items, acupuncture, and meal benefits with no copay or coinsurance. Note that some services, such as routine transportation and cardiac rehabilitation, are not covered under this plan.
Inpatient Hospital See details
Molina Medicare Complete Care Plus (HMO D-SNP) partially covers inpatient acute and psychiatric hospital stays, requiring prior authorization and charging Medicare-defined cost-sharing for copays and coinsurance. Specific exclusions not covered by the plan include additional days, upgrades for acute care, and non-Medicare-covered stays.
Outpatient Services See details
Molina Medicare Complete Care Plus (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 outpatient services, and there is no deductible for blood services.
Partial Hospitalization See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers partial hospitalization benefits with a 30% coinsurance and no copay. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are partially covered by Molina Medicare Complete Care Plus (HMO D-SNP), which offers ground and air ambulance services with a 20% coinsurance and no copay. Transportation services to plan-approved or any other health-related locations are not covered.
Emergency Services See details
Emergency services are covered by Molina Medicare Complete Care Plus (HMO D-SNP) with a 30% coinsurance and no copay, and the emergency coinsurance is waived if you are admitted to the hospital within 24 hours. Urgently needed services also require a 30% coinsurance and no copay, while worldwide emergency, urgent, and transportation services are covered up to a $10,000 maximum limit.
Primary Care See details
Primary Care benefits under Molina Medicare Complete Care Plus (HMO D-SNP) are partially covered with no copay and a coinsurance of 20% to 30% for covered services. Routine chiropractic care and podiatry services are not covered under this plan.
Preventive Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) offers partially covered preventive services with no copay and no coinsurance for annual physicals, but requires a 20% coinsurance and no copay for kidney disease education and other specific screenings. Sub-services such as In-Home Safety Assessments, PERS, Medical Nutrition Therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, home palliative care, in-home support, caregiver support, additional smoking cessation, disease management, telemonitoring, home safety modifications, and counseling are not covered.
Hearing Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) hearing services are covered with no copay and up to 20% coinsurance for exams. While routine exams, fitting evaluations, and OTC hearing aids are covered, prescription hearing aids are only partially covered, with inner ear, outer ear, and over-the-ear hearing aids not covered.
Vision Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers vision services with no copay and a 20% coinsurance for routine eye exams and contact lenses. The plan includes one routine eye exam per year and a $250 annual combined maximum allowance for eyewear, including contacts, lenses, frames, and upgrades.
Dental Services See details
Dental services are partially covered under Molina Medicare Complete Care Plus (HMO D-SNP), with Medicare-covered dental care requiring a 20% coinsurance and no copay. While preventive and restorative treatments are covered, maxillofacial prosthetics, implant services, fixed prosthodontics, and orthodontics are not covered.
Home Infusion bundled Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers home infusion bundled services with prior authorization required, providing chemotherapy, radiation, and other Part B drugs with no copay and no coinsurance to 20% coinsurance. Medicare Part B insulin drugs are covered under this benefit with a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by Molina Medicare Complete Care Plus (HMO D-SNP) with a 20% coinsurance and no copay.
Medical Equipment See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment. These services require prior authorization and are available with no copay and a 20% coinsurance.
Diagnostic and Radiological Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers diagnostic and radiological services, including lab work, diagnostic tests, and outpatient X-rays, with no copay and a 20% coinsurance. Prior authorization is required for these covered services.
Home Health Services See details
Home Health Services are covered under the Molina Medicare Complete Care Plus (HMO D-SNP) plan, requiring prior authorization before receiving care. No copay or coinsurance costs are specified for this covered benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Molina Medicare Complete Care Plus (HMO D-SNP) plan, which includes all sub-services such as intensive cardiac, pulmonary, and SET for PAD rehabilitation. Because these benefits are not covered, there are no associated copays or coinsurance.
Skilled Nursing Facility (SNF) See details
Molina Medicare Complete Care Plus (HMO D-SNP) partially covers Skilled Nursing Facility (SNF) services, requiring prior authorization and charging Medicare-defined copays and coinsurance. While a three-day prior inpatient hospital stay is not required for admission, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by Molina Medicare Complete Care Plus (HMO D-SNP), featuring acupuncture, over-the-counter items, and meal benefits with no copay or coinsurance. While these supplemental services are covered, Dual Eligible SNPs with Highly Integrated Services are not covered.
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