A non-government entity
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. Additionally, this plan comes with a Part B Premium reduction of $1.00. 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 $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)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Molina Medicare Complete Care Plus (HMO D-SNP) plan offers an enhanced alternative drug benefit with an annual prescription drug deductible of $615.00. If you qualify for the Low-Income Subsidy (LIS), your Part D premium can be reduced to $0.00. After meeting your deductible, you enter the initial coverage phase where you pay standard pharmacy or standard mail copays and coinsurance until your total drug costs reach $2,100.00. During this initial phase, Tier 1 preferred generics require a $4.00 copay, while Tier 5 specialty drugs have no copay. Tiers 2, 3, and 4 require coinsurance ranging from 20% to 30% at standard pharmacies and standard mail. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and pay nothing for covered Part D drugs.
Additional Benefits
The Molina Medicare Complete Care Plus (HMO D-SNP) plan offers comprehensive coverage where most outpatient, diagnostic, and emergency services require no copay, instead utilizing a 20% to 30% coinsurance. Inpatient hospital stays and skilled nursing facility care align with Medicare-defined copays and coinsurance, and many of these medical services require prior authorization. While cardiac rehabilitation and routine medical transportation are not covered, emergency services include worldwide coverage up to a $10,000 limit. For everyday health needs, this plan provides robust dental, vision, and hearing benefits to lower your out-of-pocket costs. Routine dental cleanings and exams feature no copay and no coinsurance up to a $3,600 annual limit, while vision and hearing services generally require no copay and a 20% coinsurance. Additionally, you can take advantage of acupuncture, meal benefits, and over-the-counter items with no copay or coinsurance.
Inpatient Hospital See details
Molina Medicare Complete Care Plus (HMO D-SNP) partially covers inpatient acute and psychiatric hospital stays, with cost-sharing such as copays and coinsurance matching Medicare-defined amounts. Prior authorization is required, and the plan does not cover additional days, non-Medicare-covered stays, or room upgrades.
Outpatient Services See details
Outpatient services under Molina Medicare Complete Care Plus (HMO D-SNP) are covered with no copays and a 20% coinsurance. This benefit includes outpatient hospital care, ambulatory surgical center services, observation services, blood services, and outpatient substance abuse treatment, most of which require prior authorization.
Partial Hospitalization See details
Partial hospitalization benefits are covered by Molina Medicare Complete Care Plus (HMO D-SNP) with a 30% coinsurance and no copay. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are partially covered by Molina Medicare Complete Care Plus (HMO D-SNP), as transportation services to plan-approved or any health-related locations are not covered. Covered ground and air ambulance services require a 20% coinsurance and no copay, and prior authorization is required.
Emergency Services See details
Emergency services are covered by Molina Medicare Complete Care Plus (HMO D-SNP) with a 30% coinsurance and no copay for both emergency and urgently needed care. This plan also covers worldwide emergency, urgent, and transportation services up to a maximum benefit limit of $10,000.
Primary Care See details
Primary Care benefits are partially covered by Molina Medicare Complete Care Plus (HMO D-SNP), with covered services requiring no copay and a coinsurance of 20% to 30%. Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
Preventive services under Molina Medicare Complete Care Plus (HMO D-SNP) are covered with no copay and no coinsurance for annual physicals and standard preventive care, while a 20% coinsurance and no copay apply to kidney disease education, glaucoma screenings, and diabetes training. Additional preventive benefits are partially covered, excluding sub-services such as in-home safety assessments, personal emergency response systems, medical nutrition therapy, wigs, alternative therapies, and therapeutic massage.
Hearing Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers hearing services, offering annual routine exams and fitting evaluations with no copay and up to 20% coinsurance. Prescription hearing aids are partially covered, excluding inner ear, outer ear, and over-the-ear models, while unlimited over-the-counter hearing aids are covered with no copays or coinsurance.
Vision Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers vision services with no copay and a 20% coinsurance for both eye exams and eyewear. The benefit includes one routine eye exam per year and up to a $250 annual combined maximum for contact lenses, eyeglass lenses, frames, and upgrades.
Dental Services See details
Dental services are partially covered by Molina Medicare Complete Care Plus (HMO D-SNP), with Medicare-covered dental care requiring a 20% coinsurance and no copay. Other covered services like cleanings, exams, and fillings have no copay and no coinsurance up to a $3,600 annual limit, but 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, requiring a $35 copay and no coinsurance to 20% coinsurance for Part B insulin. Other covered Part B chemotherapy, radiation, and miscellaneous drugs have no copay and range from no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Molina Medicare Complete Care Plus (HMO D-SNP) plan, requiring 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, and diabetic supplies, with a 20% coinsurance and no copay. Prior authorization is required for these benefits, and some items may be limited to specified manufacturers or preferred vendors.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under Molina Medicare Complete Care Plus (HMO D-SNP) with no copay and a 20% coinsurance. This coverage includes lab services, diagnostic procedures, therapeutic radiological services, and outpatient X-rays, all of which require prior authorization.
Home Health Services See details
Home Health Services are covered under the Molina Medicare Complete Care Plus (HMO D-SNP) plan, though prior authorization is required before you can receive these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under Molina Medicare Complete Care Plus (HMO D-SNP), as all sub-services—including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation—are excluded from plan coverage.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by Molina Medicare Complete Care Plus (HMO D-SNP), requiring prior authorization and charging Medicare-defined copay and coinsurance rates. While standard SNF stays are covered and do not require a prior three-day inpatient hospital stay, additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by Molina Medicare Complete Care Plus (HMO D-SNP) with no copay or coinsurance for acupuncture, meal benefits, and over-the-counter items. Dual Eligible SNPs with Highly Integrated Services are not covered under this plan.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
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.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved