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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 Central counties in IL. The overall rating for this plan is not yet available for 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:
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Drug Coverage
The Molina Medicare Complete Care Plus (HMO D-SNP) drug plan features an annual drug deductible of $615. Members will enjoy no copay for Tier 1 preferred generics, Tier 2 generics, and Tier 6 select care drugs when using standard pharmacies or standard mail order services. This ensures that many common and essential medications are available at no cost to you. For higher-tier medications, the plan transitions to a coinsurance model. You will pay a 20% coinsurance for Tier 3 preferred brand drugs and a 30% coinsurance for Tier 4 non-preferred drugs. Specialty medications in Tier 5 carry a 25% coinsurance for a one-month supply through standard retail or standard mail order.
Additional Benefits
The Molina Medicare Complete Care Plus (HMO D-SNP) plan offers robust healthcare coverage featuring no copays for the majority of its medical and hospital services. Beneficiaries can access inpatient hospital stays, skilled nursing, and home health services with no copay and no coinsurance. However, many outpatient services, emergency care, specialist visits, and diagnostic tests will require a coinsurance ranging from 20% to 30%. In addition to core medical care, this plan provides valuable supplemental benefits to help reduce out-of-pocket costs. Members receive routine dental coverage with no copay and no coinsurance up to a $3,600 annual limit, alongside a $250 yearly allowance for eyewear. The plan also features hearing aid coverage, unlimited transportation to plan-approved health locations, and over-the-counter items with no copay and no coinsurance.
Inpatient Hospital See details
Molina Medicare Complete Care Plus (HMO D-SNP) partially covers inpatient hospital services, providing acute and psychiatric hospital stays with no copay and no coinsurance, though prior authorization is required. Additional hospital days, non-Medicare-covered stays, and acute room upgrades are not covered.
Outpatient Services See details
Outpatient services are covered under the Molina Medicare Complete Care Plus (HMO D-SNP) with no copays, but a 20% coinsurance applies to outpatient hospital, observation, ambulatory surgical center, substance abuse, and blood services. Prior authorization is required for most outpatient services, and the deductible is waived for the first three pints of blood.
Partial Hospitalization See details
Partial hospitalization is covered by Molina Medicare Complete Care Plus (HMO D-SNP) 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 Plus (HMO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, though prior authorization is required. Transportation services are partially covered, offering unlimited one-way trips to plan-approved health-related locations with no copay and no coinsurance, but transportation to any health-related location is not covered.
Emergency Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers emergency and urgently needed services with a 30% coinsurance and no copay, which do not count toward the plan-level deductible. Worldwide emergency, urgent, and transportation services are also covered with no copay and no coinsurance up to a $10,000 maximum limit.
Primary Care See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers primary care, specialist, mental health, and therapy services with no copay and coinsurance ranging from 20% to 30%. Chiropractic services are partially covered, with other chiropractic services excluded, though routine care is covered for up to 20 visits per year with no copay and 30% coinsurance.
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 physical exams, fitness, and nutrition programs, while kidney disease education and specific screenings require a 20% coinsurance and no copay. Sub-services that are not covered under this plan include in-home safety assessments, medical nutrition therapy, medication reconciliation, readmission prevention, chemotherapy wigs, weight management, alternative therapies, therapeutic massage, adult day health, palliative care, in-home support, caregiver support, disease management, telemonitoring, home safety modifications, and counseling.
Hearing Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) provides hearing services with no copay for exams and hearing aids, though routine hearing exams carry a 20% coinsurance. OTC hearing aids are covered with no copay or coinsurance, while 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 models.
Vision Services See details
Vision services are partially covered by Molina Medicare Complete Care Plus (HMO D-SNP), offering no copays, no deductibles, and a 20% coinsurance for routine eye exams and contact lenses. The plan covers one routine eye exam annually (other eye exam services are not covered) and provides a $250 yearly allowance for eyewear, including glasses and contact lenses.
Dental Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers Medicare-approved dental services with no copay and a 20% coinsurance, and other dental benefits with no copay and no coinsurance up to a $3,600 annual limit. While preventive and comprehensive services like cleanings and extractions are covered, some services including implants, orthodontics, fixed prosthodontics, and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by Molina Medicare Complete Care Plus (HMO D-SNP) with no copay, subject to prior authorization. Under this benefit, Medicare Part B chemotherapy and other drugs have no coinsurance to 20% coinsurance, while Medicare Part B insulin drugs require 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 no copay and a 20% coinsurance.
Medical Equipment See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers medical equipment, including durable medical equipment (DME), prosthetics, medical supplies, and diabetic equipment, with no copay and a 20% coinsurance. Prior authorization is required for these services, and certain vendor or manufacturer limitations may apply.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Molina Medicare Complete Care Plus (HMO D-SNP) with no copay and a 20% coinsurance, subject to prior authorization. This coverage applies to diagnostic procedures, lab services, diagnostic and therapeutic radiological services, and outpatient X-ray services.
Home Health Services See details
Home health services are covered by Molina Medicare Complete Care Plus (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers Cardiac Rehabilitation Services with no copay, but in practice only some services are covered because cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require a 30% coinsurance.
Skilled Nursing Facility (SNF) See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, though prior authorization is required. The plan allows admission with less than a three-day inpatient hospital stay, but 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), which offers over-the-counter (OTC) items and a meal benefit with no copay and no coinsurance. Acupuncture is not covered under this plan, and prior authorization is required to access the meal benefit.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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