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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 Cook County. 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 no drug deductible. Your prescription medication coverage will start immediately.
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) features a $0 drug deductible, meaning your prescription coverage begins immediately with no upfront costs. You will pay no copay for Tier 1 preferred generic, Tier 2 generic, Tier 3 preferred brand, and Tier 6 select care drugs. This no-copay benefit applies to one-month, two-month, and three-month supplies filled at standard pharmacies or through standard mail order. For higher-tier prescriptions, cost-sharing is based on coinsurance rather than flat copays. Tier 4 non-preferred drugs carry a 30% coinsurance for standard pharmacy and standard mail-order fills of all supply lengths. Tier 5 specialty drugs require a 33% coinsurance for a one-month supply at standard pharmacies and standard mail order.
Additional Benefits
The Molina Medicare Complete Care Plus (HMO D-SNP) plan provides robust coverage for essential medical services with no copays for inpatient hospital stays, doctor visits, and emergency care. While there are no copays for these services, patients typically pay a 20% to 30% coinsurance for outpatient care, specialist visits, and emergency services. Additionally, home health services and skilled nursing facility stays are fully covered with no copay and no coinsurance. This plan also features valuable supplemental benefits, including dental, vision, hearing, and transportation services with no copays. Routine preventive and comprehensive dental care is covered with no coinsurance up to a $4,000 annual limit, and unlimited transportation to plan-approved locations is provided with no copay and no coinsurance. Members can also access over-the-counter items, meal benefits, and fitness programs with no copays and no coinsurance.
Inpatient Hospital See details
Inpatient hospital services are covered by Molina Medicare Complete Care Plus (HMO D-SNP) with no coinsurance and no copay, although Medicare-defined cost shares apply and prior authorization is required. This benefit is partially covered, as additional days, upgrades, and non-Medicare-covered stays 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 outpatient services, and there is no deductible for outpatient blood services.
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 receive these services.
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. Transportation services are partially covered, offering unlimited one-way trips 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 Plus (HMO D-SNP) covers emergency and urgently needed services with a 30% coinsurance and no copay, with the emergency coinsurance waived if you are admitted to the hospital within 24 hours. Worldwide emergency, urgent, and transportation services are also covered up to a $10,000 limit with no copay and no coinsurance.
Primary Care See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers primary care, specialist, and therapy services with no copay and a 20% to 30% coinsurance. Chiropractic services are partially covered, providing up to 20 routine visits per year with no copay and a 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), offering annual physical exams and select supplemental benefits like fitness and nutritional programs with no copay and no coinsurance. Some additional services, including in-home safety assessments, medical nutrition therapy, and weight management, are not covered. Kidney disease education and other screenings are covered with no copay and a 20% coinsurance.
Hearing Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers hearing exams with no copay and a 20% coinsurance for routine visits, as well as OTC hearing aids with no copay and no coinsurance. Prescription hearing aids are partially covered with no copay and no coinsurance, though inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) partially covers vision services, excluding other eye exam services but covering one annual routine exam with no copay and 20% coinsurance. Covered eyewear has no copay and a $300 annual limit, featuring no coinsurance for eyeglasses but a 20% coinsurance for contact lenses.
Dental Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) partially covers dental services, offering Medicare-covered dental care with no copay and 20% coinsurance, and other preventive and comprehensive dental services with no copay and no coinsurance up to a $4,000 annual maximum. Several sub-services are not covered under this plan, including other diagnostic dental services, other preventive dental services, maxillofacial prosthetics, implant services, fixed prosthodontics, and orthodontics.
Home Infusion bundled Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and other drugs, are covered with no coinsurance to 20% coinsurance, while insulin is covered with a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the Molina Medicare Complete Care Plus (HMO D-SNP) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Medical Equipment benefits under Molina Medicare Complete Care Plus (HMO D-SNP) are covered with no copay and a 20% coinsurance, with prior authorization required. This coverage includes durable medical equipment, prosthetics, medical supplies, and diabetic services, which may be subject to preferred vendor or manufacturer limitations.
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, subject to prior authorization. This coverage applies to lab services, diagnostic procedures, outpatient X-rays, and both diagnostic and therapeutic radiological services.
Home Health Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers home health services 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 Plus (HMO D-SNP) with no copay and require prior authorization, though some services are not covered in practice. Specifically, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services are not covered and carry 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 does not require a prior three-day inpatient hospital stay for admission, but additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered under the Molina Medicare Complete Care Plus (HMO D-SNP) plan, offering Over-the-Counter (OTC) items and meal benefits with no copay and no coinsurance. Acupuncture is not covered under this benefit, and prior authorization is required for the meal benefit.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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