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Molina Medicare Complete Care Select (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Molina Medicare Complete Care Select (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 Select (HMO D-SNP) in 2026, please refer to our full plan details page.
Molina Medicare Complete Care Select (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 2026.
It's important to know that Molina Medicare Complete Care Select (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 Select (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 Select (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 Select (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 $375.00 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 Select (HMO D-SNP) plan features an annual prescription drug deductible of $375. Under this plan, there is no copay for Tier 1 preferred generic drugs and Tier 6 select care drugs filled through standard pharmacies or standard mail order. Tier 2 generic drugs are also highly affordable, requiring only a $4 copay for a one-month supply and an $8 copay for a two- or three-month supply. For higher-tier prescriptions, your cost-sharing is structured as a percentage of the drug cost. You will pay a 20% coinsurance for Tier 3 preferred brand drugs and a 30% coinsurance for Tier 4 non-preferred drugs through standard pharmacy and mail-order options. Specialty medications in Tier 5 require a 27% coinsurance for a one-month supply.
Additional Benefits
Molina Medicare Complete Care Select (HMO D-SNP) provides robust medical coverage with no copay for primary care visits, preventive services, and home health care. Inpatient hospital stays require a $325 daily copay for days one through six, while outpatient hospital services incur a 20% coinsurance and no copay. Emergency room visits have a $100 copay, which is waived upon admission, and specialist visits require a $30 copay. Supplemental coverage includes dental and vision benefits with no copay, offering up to $1,200 annually for dental care and a $250 annual limit for eyewear. Members also receive unlimited one-way transportation to approved health locations and routine hearing exams for a $30 copay, alongside no-copay hearing aids. Necessary medical resources like dialysis and durable medical equipment are covered with no copay and a 20% coinsurance.
Inpatient Hospital See details
Molina Medicare Complete Care Select (HMO D-SNP) partially covers inpatient hospital services with no coinsurance, requiring prior authorization and a $325 daily copay for days 1 through 6 of acute care (no copay for days 7 through 90), while psychiatric stays incur Medicare-defined cost sharing. Additional days, non-Medicare-covered stays, and upgrades are not covered under this benefit.
Outpatient Services See details
Molina Medicare Complete Care Select (HMO D-SNP) covers outpatient hospital services with a 20% coinsurance and no copay, and observation services with a $325 daily copay and no coinsurance. Ambulatory surgical center services require a $50 copay and no coinsurance, outpatient substance abuse sessions cost a $30 copay and no coinsurance, and outpatient blood services have a 20% coinsurance and no copay.
Partial Hospitalization See details
Partial hospitalization is covered by Molina Medicare Complete Care Select (HMO D-SNP) with a $70.00 copay and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
Molina Medicare Complete Care Select (HMO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. The plan also provides unlimited one-way transportation 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 Select (HMO D-SNP) covers emergency services with a $100 copay and no coinsurance, with the copay waived if admitted to the hospital within 24 hours. Urgently needed services require a $30 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay or coinsurance up to a $10,000 maximum benefit.
Primary Care See details
Molina Medicare Complete Care Select (HMO D-SNP) covers primary care provider services and opioid treatment with no copay and no coinsurance, while specialist visits require a $30 copay and no coinsurance. Physical, occupational, and speech therapies are covered with no copay and 0% to 20% coinsurance, but chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive services are covered by Molina Medicare Complete Care Select (HMO D-SNP) with no copay and no coinsurance for annual physical exams, kidney disease education, and diabetes self-management training. Additional preventive services are partially covered with no copay and no coinsurance, though prior authorization is required, and services such as in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs for chemotherapy-related hair loss, weight management, alternative therapies, therapeutic massage, adult day health, home-based palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home and bathroom safety devices, and counseling are not covered.
Hearing Services See details
Molina Medicare Complete Care Select (HMO D-SNP) covers hearing services, including routine hearing exams for a $30 copay and no coinsurance, and unlimited OTC hearing aids with no copay and no coinsurance. Prescription hearing aids are partially covered with no copay and no coinsurance for up to two aids every two years, though inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Molina Medicare Complete Care Select (HMO D-SNP), offering one routine eye exam per year with no copay and no coinsurance, while other eye exam services are not covered. Covered eyewear, which includes eyeglasses, frames, and contact lenses, has no copay and a $250 annual limit, though contact lenses require a 20% coinsurance.
Dental Services See details
Dental services are partially covered by Molina Medicare Complete Care Select (HMO D-SNP) with no copay and no coinsurance for covered preventive and comprehensive care, up to a $1,200 annual maximum. Non-covered services under this plan include other diagnostic services, other preventive services, maxillofacial prosthetics, implants, fixed prosthodontics, and orthodontics.
Home Infusion bundled Services See details
Molina Medicare Complete Care Select (HMO D-SNP) covers Home Infusion bundled Services with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs have no copay and coinsurance ranging from no coinsurance to 20%, while Part B insulin is covered with a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis services are covered under the Molina Medicare Complete Care Select (HMO D-SNP) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Molina Medicare Complete Care Select (HMO D-SNP) covers durable medical equipment and prosthetics with no copay and a 20% coinsurance, subject to prior authorization. Diabetic equipment is partially covered with no copay and no coinsurance, though diabetic supplies and therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are partially covered under Molina Medicare Complete Care Select (HMO D-SNP), as outpatient X-ray services are not covered. Covered diagnostic procedures, lab services, and diagnostic radiological services have no copay and no coinsurance, while therapeutic radiological services have no copay and a 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the Molina Medicare Complete Care Select (HMO D-SNP) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Molina Medicare Complete Care Select (HMO D-SNP) does not cover Cardiac Rehabilitation Services, meaning there is no coverage for cardiac, intensive cardiac, pulmonary, or supervised exercise therapy (SET) rehabilitation. As these services are not covered, there are no plan-associated copays or coinsurance, and you will be responsible for the full cost of treatment.
Skilled Nursing Facility (SNF) See details
Molina Medicare Complete Care Select (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1 to 20 and a $200 daily copay for days 21 to 100. Prior authorization is required, no prior three-day hospital stay is needed, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services covered by Molina Medicare Complete Care Select (HMO D-SNP) include acupuncture with a $15 copay and no coinsurance, limited to 12 treatments per year. Over-the-counter (OTC) items and a limited-duration meal benefit are also covered with no copay and no coinsurance, though prior authorization is required for meals.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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