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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 2025, 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 2025.
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 $17.70. 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 Select (HMO D-SNP) plan has a $590 deductible for prescription drugs. After meeting the deductible, you'll pay the costs for your drugs, which are not specified in the provided information, until your total drug costs reach $2000. Once your total drug costs reach $2000, you enter the catastrophic coverage phase and pay nothing for covered Part D drugs. If you qualify for the low-income subsidy (LIS), your premium may be reduced to $17.70.
Additional Benefits
The Molina Medicare Complete Care Select (HMO D-SNP) plan offers a range of benefits with varying cost-sharing. Inpatient hospital stays have a copay of $325 for days 1-6, and no copay for days 7-90, while outpatient services have copays and coinsurance depending on the service. Emergency and urgent care services have copays, and primary care visits have a $15-$45 copay depending on the service. The plan includes coverage for preventive, vision, hearing, and dental services, with copays or coinsurance applying to some services. Home health services have no copay, and ambulance services have 20% coinsurance. Additional benefits include coverage for home infusion bundled services, dialysis services, and medical equipment with coinsurance, and a meal benefit with prior authorization.
Inpatient Hospital See details
The Molina Medicare Complete Care Select (HMO D-SNP) plan covers inpatient hospital stays with a copay of $325 for days 1-6, and no copay for days 7-90. Additional days, non-Medicare covered stays, and upgrades for Inpatient Hospital-Acute are not covered, and the plan also does not cover additional days or non-Medicare-covered stays for Inpatient Hospital Psychiatric.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a 20% coinsurance, Observation Services with a $325 copay per day, Ambulatory Surgical Center (ASC) Services with a $50 copay, and Outpatient Substance Abuse Services including individual and group sessions with a $30 copay. Outpatient Blood Services are also covered with a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered by the Molina Medicare Complete Care Select (HMO D-SNP) plan. There is a $70 copay for this benefit, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance services are covered, with a 20% coinsurance for both ground and air ambulance services. 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 the Molina Medicare Complete Care Select (HMO D-SNP) plan. Emergency Services have a $100 copay, Urgently Needed Services have a $30 copay, and Worldwide Emergency Services have a maximum plan benefit coverage of $10,000.
Primary Care See details
The Molina Medicare Complete Care Select (HMO D-SNP) plan covers primary care physician services, chiropractic services with a $15 copay for routine care, occupational therapy services with 0-20% coinsurance, physician specialist services with a $30 copay, and mental health specialty services with a $45 copay for individual and group sessions. The plan also covers other health care professional services with a $0-$15 copay, psychiatric services with a $45 copay for individual and group sessions, physical therapy and speech-language pathology services with 0-20% coinsurance, additional telehealth benefits, and opioid treatment program services. Podiatry services are not covered.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services, annual physical exams, and additional preventive services, with prior authorization required for the latter. This plan also covers Health Education, Personal Emergency Response Systems, Nutritional/Dietary Benefits (up to 12 visits), Additional Sessions of Smoking and Tobacco Cessation Counseling (up to 8 visits), Fitness Benefits (physical and memory fitness), Remote Access Technologies, Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKGs following a Welcome Visit, while In-Home Safety Assessments, Medical Nutrition Therapy, Post-discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Enhanced Disease Management, Telemonitoring Services, Home and Bathroom Safety Devices and Modifications, and Counseling Services are not covered.
Hearing Services See details
Hearing Services include routine hearing exams with a $30 copay, fitting/evaluation for hearing aids, and OTC hearing aids. Prescription hearing aids are partially covered, but do not include inner ear, outer ear, or over the ear hearing aids.
Vision Services See details
Vision services include routine eye exams once per year. Eyewear, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades, are covered with a 20% coinsurance for contact lenses, with a combined maximum of $200 per year for all eyewear.
Dental Services See details
Dental services, including oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatments, and restorative services, are covered. Orthodontic services are covered with a maximum benefit of $500 per year, and maxillofacial prosthetics, implant services, prosthodontics (fixed), and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and coinsurance between 0-20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is coinsurance between 0-20%.
Dialysis Services See details
Dialysis Services are covered by the Molina Medicare Complete Care Select (HMO D-SNP) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME) and Prosthetics/Medical Supplies, is covered with a 20% coinsurance, and no copay. However, Durable Medical Equipment for use outside the home, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with prior authorization required. Diagnostic Procedures/Tests and Lab Services have a coinsurance of at most 20%, with no copay. Therapeutic Radiological Services have a coinsurance of at most 20%, with a minimum coinsurance of 20%, and no copay. Outpatient X-Ray Services are not covered.
Home Health Services See details
Home Health Services are covered by the Molina Medicare Complete Care Select (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 none of the sub-services are covered, including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Molina Medicare Complete Care Select (HMO D-SNP) plan, with no copay for days 1-20, and a $200 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The Molina Medicare Complete Care Select (HMO D-SNP) plan covers acupuncture with a $15 copay for up to 12 treatments per year, and also covers over-the-counter items including nicotine replacement therapy and Naloxone. The plan also provides a meal benefit, but requires prior authorization. Other services such as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), and more are not covered.
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