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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.
This summary reflects 2026 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.
Molina Medicare Complete Care Plus (HMO D-SNP) is a HMO D-SNP plan offered by Molina Healthcare of Illinois, Inc. available for the 2026 plan year to people living in Southern counties in IL. CMS star rating not 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
Health deductible: information not available.
This plan has a $100.00 drug deductible that applies only to drugs in certain tiers. You pay this amount toward covered prescriptions in those tiers before the plan's cost sharing begins; drugs in the other tiers are not subject to the deductible. See the full plan details page for the tier table.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $9250.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $9250.00 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. Call-center hours (ET): Mon-Fri 8am-10pm; Sat 9am-8pm; Sun closed.
Drug Coverage
The Molina Medicare Complete Care Plus (HMO D-SNP) plan features an annual drug deductible of $100. Under this plan, you will pay no copay for Tier 1 preferred generic drugs and Tier 6 select care drugs through standard pharmacies or standard mail order. For Tier 2 generic medications, standard pharmacy and mail-order prescriptions cost a low copay of $2.00 for a one-month supply or $4.00 for two- and three-month supplies. Higher-tier prescription drugs require coinsurance, with Tier 3 preferred brand drugs at 20% coinsurance and Tier 4 non-preferred drugs at 30% coinsurance. Tier 5 specialty drugs carry a 31% coinsurance for a one-month supply. These cost-sharing rates apply to both standard retail pharmacy purchases and standard mail-order deliveries.
Additional Benefits
Molina Medicare Complete Care Plus (HMO D-SNP) offers robust medical coverage featuring no copay for most essential health services. Inpatient hospital stays, home health care, and skilled nursing facility services are fully covered with no copay and no coinsurance. For outpatient services, specialist visits, emergency care, and diagnostic testing, members generally pay no copay but will be responsible for a coinsurance ranging from 20% to 30%. In addition to medical care, this plan provides valuable supplemental benefits with no copay and no coinsurance for over-the-counter items, select meals, and unlimited transportation to approved health locations. Vision benefits include a $250 annual eyewear allowance with no copay, while dental services are covered with no copay and no coinsurance up to a $4,000 yearly limit. Hearing exams and hearing aids are also covered with no copay, though routine hearing and vision exams carry a 20% coinsurance.
Inpatient Hospital See details
Molina Medicare Complete Care Plus (HMO D-SNP) partially covers inpatient hospital services, offering acute and psychiatric care with no copay and no coinsurance, though prior authorization is required. Additional hospital days, non-Medicare-covered stays, and acute care upgrades are not covered.
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 of these covered services, and there is no deductible for outpatient blood services.
Partial Hospitalization See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers partial hospitalization services with no copay and a 30% coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services under Molina Medicare Complete Care Plus (HMO D-SNP) are covered, with ground and air ambulance services requiring a 20% coinsurance and no copay. The plan also provides unlimited transportation to plan-approved health-related locations with no copay and no coinsurance, though transportation to non-approved health-related locations is not covered.
Emergency Services See details
Emergency services and urgently needed services are covered by Molina Medicare Complete Care Plus (HMO D-SNP) with a 30% coinsurance and no copay, with the emergency care coinsurance waived if you are admitted to the hospital within 24 hours. Worldwide emergency, urgent, and transportation services are also covered with no copay and no coinsurance, up to a maximum benefit limit of $10,000.
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 benefits are partially covered, offering up to 20 routine visits per year with no copay and 30% coinsurance, while other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by Molina Medicare Complete Care Plus (HMO D-SNP), with annual physical exams, fitness benefits, and nutritional training available with no copay and no coinsurance. Other services like kidney disease education and glaucoma screenings require no copay and a 20% coinsurance, while sub-services such as in-home support, alternative therapies, and weight management are not covered.
Hearing Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers hearing exams with no copay, though routine exams require a 20% coinsurance. Prescription and over-the-counter hearing aids are covered with no copay and no coinsurance, but prescription aids for the inner ear, outer ear, and over the ear are not covered.
Vision Services See details
Vision Services are partially covered by Molina Medicare Complete Care Plus (HMO D-SNP), offering one routine eye exam annually with no copay and a 20% coinsurance, though other eye exam services are not covered. Eyewear is covered up to a $250 annual limit with no copay, featuring no coinsurance for eyeglasses and a 20% coinsurance for contact lenses.
Dental Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) dental services are partially covered, featuring Medicare-covered dental with no copay and 20% coinsurance, and other dental services with no copay and no coinsurance up to a $4,000 annual maximum. Sub-services that are not covered under this plan include other diagnostic services, other preventive services, maxillofacial prosthetics, implant services, fixed prosthodontics, and orthodontics.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by Molina Medicare Complete Care Plus (HMO D-SNP) with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy, radiation, and insulin, require a 0% to 20% coinsurance, with insulin drugs also carrying a $35 copay.
Dialysis Services See details
Dialysis Services are covered under 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 durable medical equipment, prosthetics, and diabetic supplies with no copay and a 20% coinsurance. Prior authorization is required for these services, and certain items may be limited to preferred manufacturers or vendors.
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, with prior authorization required. This coverage applies to diagnostic procedures, lab services, diagnostic and therapeutic radiological services, and outpatient X-rays.
Home Health Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers home health services with no copay and no coinsurance, though prior authorization is required for these services.
Cardiac Rehabilitation Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) offers Cardiac Rehabilitation Services with no copay, though only some services are covered in practice. Specifically, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) 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, although prior authorization is required. The plan allows SNF admission without a prior three-day inpatient hospital stay, but additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services under Molina Medicare Complete Care Plus (HMO D-SNP) are partially covered, offering over-the-counter (OTC) items and select meal benefits with no copay and no coinsurance. Acupuncture is not covered under this plan, and prior authorization is required for the meal benefit.
Plan Providers
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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1-877-649-2073 / TTY 711. Call-center hours (ET): Mon-Fri 8am-10pm; Sat 9am-8pm; Sun closed.
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* 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.
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