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Molina Medicare Complete Care (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Molina Medicare Complete Care (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 (HMO D-SNP) in 2025, please refer to our full plan details page.
Molina Medicare Complete Care (HMO D-SNP) is a HMO D-SNP plan offered by Molina Healthcare, Inc. available for enrollment in 2025 to people living in Select Counties in Utah. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that Molina Medicare Complete Care (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 (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 (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 (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $40.80. 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 $590.00 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 $9350.00 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 (HMO D-SNP) plan has a $590.00 deductible for prescription drugs. After the deductible, you'll pay the costs for drugs in each tier until your total drug costs reach $2000.00, at which point you enter the next coverage phase. If you qualify for the low-income subsidy, your Part D premium will be $40.80. Once your yearly out-of-pocket drug costs reach $2000.00, you will pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Molina Medicare Complete Care (HMO D-SNP) plan offers a wide range of benefits with varying cost-sharing. Many services, including outpatient, partial hospitalization, ambulance, emergency, primary care, preventive, vision, dental, home infusion, dialysis, medical equipment, diagnostic, and skilled nursing services, have a coinsurance, often 20%. Some services, like home health services and diagnostic and radiological services, have no copay. The plan also includes coverage for hearing exams, with a limit on hearing aids, and covers acupuncture and over-the-counter items. Additionally, the plan offers a meal benefit, but requires prior authorization for several services, including partial hospitalization, home health, cardiac rehabilitation, and skilled nursing facilities.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered, but additional days, non-Medicare-covered stays, and upgrades for acute care, and additional days and non-Medicare-covered stays for psychiatric care are not covered. For both acute and psychiatric care, there is a copay.
Outpatient Services See details
Outpatient services, including outpatient hospital services and observation services, are covered with a 20% coinsurance. Ambulatory Surgical Center (ASC) Services, Outpatient Substance Abuse Services (Individual and Group Sessions), and Outpatient Blood Services are also covered, with a 20% coinsurance for the latter two.
Partial Hospitalization See details
Partial Hospitalization is covered by the Molina Medicare Complete Care (HMO D-SNP) plan, but requires prior authorization. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the Molina Medicare Complete Care (HMO D-SNP) plan. Ground and Air Ambulance Services have a 20% coinsurance, and Transportation Services to any health-related location are covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by Molina Medicare Complete Care (HMO D-SNP). Emergency Services and Urgently Needed Services have a 20% coinsurance, while Worldwide Emergency Services has a maximum plan benefit coverage of $10,000.
Primary Care See details
The Molina Medicare Complete Care (HMO D-SNP) plan covers Primary Care Physician Services, Chiropractic Services, Physician Specialist Services, Physical Therapy, Speech-Language Pathology Services, Mental Health Specialty Services, Psychiatric Services, and Other Health Care Professional services with a 20% coinsurance. Occupational Therapy Services also have a 20% coinsurance, and Routine Chiropractic Care is not covered.
Preventive Services See details
Preventive Services, including Medicare-covered services, annual physical exams, and additional preventive services, are covered by this plan. Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit are covered with a 20% coinsurance. Other services like In-Home Safety Assessment, Medical Nutrition Therapy (MNT), and others are not covered.
Hearing Services See details
The Molina Medicare Complete Care (HMO D-SNP) plan covers hearing exams with at most 20% coinsurance, one routine hearing exam per year, and one fitting/evaluation for a hearing aid per year. Prescription hearing aids are partially covered; Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered. OTC hearing aids are covered, with a limit of 2 hearing aids every two years.
Vision Services See details
The Molina Medicare Complete Care (HMO D-SNP) plan covers vision services, including routine eye exams with 1 visit per year, and eyewear. Eyewear has a 20% coinsurance for contact lenses, with a combined maximum benefit of $300 per year for contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames.
Dental Services See details
The Molina Medicare Complete Care (HMO D-SNP) plan covers various dental services, including oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatments, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable), and oral and maxillofacial surgery. The plan also covers orthodontic services with a maximum benefit of $1150 per year, but does not cover maxillofacial prosthetics, implant services, prosthodontics (fixed), or orthodontics.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. Medicare Part B Insulin Drugs have a $35 copay with 0-20% coinsurance, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the Molina Medicare Complete Care (HMO D-SNP) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, while Prosthetic Devices and Medical Supplies have a 20% coinsurance and Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. All diagnostic and radiological services have no copay, and have a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the Molina Medicare Complete Care (HMO D-SNP) plan with no copay and no coinsurance, but Additional Hours of Care and Personal Care Services are not covered. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization. This plan does not offer additional days beyond Medicare-covered SNF services, and non-Medicare-covered SNF stays are not covered.
Other Services See details
The Molina Medicare Complete Care (HMO D-SNP) plan covers acupuncture with a limit of 12 treatments per year, and it also covers over-the-counter (OTC) items including nicotine replacement therapy and Naloxone. Additionally, the plan offers a meal benefit that requires prior authorization. However, services such as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, private duty nursing services, and others are not covered.
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