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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 2026, 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 2026 to people living in Select counties in ID. This plan received an overall rating of 3 out of 5 stars in 2026.
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 $37.60. 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 $615.00 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 (HMO D-SNP) plan features an annual prescription drug deductible of $615. Beneficiaries pay no copay for Tier 1 preferred generic drugs and Tier 6 select care drugs when using standard pharmacies or standard mail order services. This cost savings applies to one-month, two-month, and three-month supply options. For other drug categories, you will pay a percentage of the drug cost through coinsurance at standard pharmacies and standard mail order. Tier 2 generic drugs and Tier 3 preferred brand drugs both carry a 20% coinsurance, while Tier 4 non-preferred drugs require a 30% coinsurance. Tier 5 specialty drugs have a 25% coinsurance, which is limited to a one-month supply.
Additional Benefits
The Molina Medicare Complete Care (HMO D-SNP) plan offers comprehensive medical coverage featuring no copays for major services like inpatient hospital care, primary care, and specialist visits. While there are no copays for these essential services, outpatient care, diagnostic tests, and emergency services typically require a 20% to 30% coinsurance. Additionally, the plan provides valuable supplemental benefits including vision, hearing, and transportation services with no copays and often no coinsurance. Members can benefit from routine eye exams, OTC hearing aids, and unlimited one-way trips to plan-approved medical locations at no cost, though routine dental care is not covered.
Inpatient Hospital See details
Inpatient hospital care is partially covered by Molina Medicare Complete Care (HMO D-SNP), offering acute and psychiatric services with no copays and no coinsurance, although prior authorization is required. This plan does not cover additional hospital days, upgrades, or non-Medicare-covered stays.
Outpatient Services See details
Molina Medicare Complete Care (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
Molina Medicare Complete Care (HMO D-SNP) covers partial hospitalization services with no copay and a 30% coinsurance. Prior authorization is required to access this covered benefit.
Ambulance and Transportation Services See details
Molina Medicare Complete Care (HMO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, while transportation services are partially covered with no copay and no coinsurance. Under this plan, unlimited one-way trips to plan-approved health-related locations are covered, but transportation to any health-related location is not covered.
Emergency Services See details
Molina Medicare Complete Care (HMO D-SNP) covers emergency and urgently needed services with a 30% coinsurance and no copay, with cost sharing counting toward the plan-level deductible. 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 (HMO D-SNP) covers primary care, specialist, therapy, and mental health services with no copays and coinsurance ranging from 20% to 30%. Chiropractic care is 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
Molina Medicare Complete Care (HMO D-SNP) covers preventive services, including annual physical exams, fitness benefits, and nutritional therapy, with no copay and no coinsurance. While many supplemental benefits like in-home safety assessments and weight management programs are not covered, other services such as kidney disease education and glaucoma screenings are covered with no copay and a 20% coinsurance.
Hearing Services See details
Molina Medicare Complete Care (HMO D-SNP) covers hearing services, including annual routine exams with no deductible, no copay, and a 20% coinsurance, alongside unlimited OTC hearing aids with no copay or coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance for up to two devices every two years, though inner ear, outer ear, and over the ear models are not covered.
Vision Services See details
Vision services are partially covered by Molina Medicare Complete Care (HMO D-SNP), offering covered exams and eyewear with no copay, no coinsurance, and no deductible. This benefit includes one routine eye exam per year and up to a $200 annual maximum for contacts, eyeglasses, and upgrades, though other eye exam services are not covered.
Dental Services See details
Molina Medicare Complete Care (HMO D-SNP) covers Medicare-approved dental services with no copay and no coinsurance. However, other routine and comprehensive dental services, including oral exams, cleanings, x-rays, restorative care, and orthodontics, are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Molina Medicare Complete Care (HMO D-SNP) with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and insulin, carry a coinsurance ranging from no coinsurance to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
Molina Medicare Complete Care (HMO D-SNP) covers dialysis services with no copay and a 20% coinsurance.
Medical Equipment See details
Molina Medicare Complete Care (HMO D-SNP) covers durable medical equipment (DME), prosthetics, medical supplies, and diabetic equipment with no copay and a 20% coinsurance. Prior authorization is required for these benefits, and certain equipment or supplies may be limited to preferred vendors and specified manufacturers.
Diagnostic and Radiological Services See details
Molina Medicare Complete Care (HMO D-SNP) covers diagnostic and radiological services with no copay and a 20% coinsurance, though prior authorization is required. Covered services include outpatient diagnostic procedures, lab services, X-rays, and both diagnostic and therapeutic radiological services.
Home Health Services See details
Home Health Services are covered under the Molina Medicare Complete Care (HMO D-SNP) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Molina Medicare Complete Care (HMO D-SNP) covers some cardiac rehabilitation services with no copay and no coinsurance, subject to prior authorization. However, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require a 30% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Molina Medicare Complete Care (HMO D-SNP) with no copayment and no coinsurance, although prior authorization is required. Standard Medicare-covered days do not require a prior three-day inpatient hospital stay, but additional days beyond the Medicare-defined limit are not covered.
Other Services See details
Other Services are partially covered by Molina Medicare Complete Care (HMO D-SNP), featuring over-the-counter (OTC) items and meal benefits with no copay and no coinsurance, though meals require prior authorization. Acupuncture and other additional services are not covered under this benefit.
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