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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 Washington. 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 $4.40. 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 the deductible is met, you will pay the costs for your drugs based on the tier and pharmacy type. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs. If you qualify for the low-income subsidy, you may have a reduced monthly premium.
Additional Benefits
The Molina Medicare Complete Care Select (HMO D-SNP) plan offers a range of benefits, including coverage for inpatient and outpatient services with varying copays and coinsurance. It also includes coverage for primary care, preventive services, hearing, vision, and dental services, often with copays or coinsurance. Additionally, the plan provides coverage for ambulance, emergency, and home health services, along with medical equipment and diagnostic services. This plan offers additional coverage for services like home infusion, dialysis, and cardiac rehabilitation. It also includes benefits for skilled nursing facilities, with specific copay structures. The plan covers over-the-counter items and meal benefits, but excludes certain services like acupuncture and private duty nursing.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered by Molina Medicare Complete Care Select (HMO D-SNP). For Inpatient Hospital-Acute, you will pay a $325 copay for days 1-6, and no copay for days 7-90; additional days, non-Medicare-covered stays, and upgrades are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a 20% coinsurance, Observation Services with a $325 copay, Ambulatory Surgical Center (ASC) Services with a $50 copay, and Outpatient Substance Abuse Services with a $30 copay for individual and group sessions. Outpatient Blood Services are covered with a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered by the Molina Medicare Complete Care Select (HMO D-SNP) plan, but requires prior authorization. The copay for this benefit is $70.
Ambulance and Transportation Services See details
Ambulance and Transportation Services includes coverage for ground and air ambulance services, each with a 20% coinsurance, and transportation services to any health-related location. Transportation services to plan-approved health-related locations are not 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, while Urgently Needed Services have a $30 copay, and there is no coinsurance for either. Worldwide Emergency Services have a maximum benefit coverage of $10,000.
Primary Care See details
Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered under the Molina Medicare Complete Care Select (HMO D-SNP) plan. Chiropractic services have a $15 copay, physician specialist services have a $30 copay, and individual and group mental health and psychiatric sessions have a $45 copay. Occupational therapy services have a 0-20% coinsurance, and physical therapy and speech-language pathology services have a 0-20% coinsurance. Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
The Molina Medicare Complete Care Select (HMO D-SNP) plan covers preventive services including annual physical exams, health education, personal emergency response systems, alternative therapies (12 visits), nutritional/dietary benefits (12 visits), additional sessions of smoking and tobacco cessation counseling (8 visits), fitness benefits, remote access technologies, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a welcome visit. However, 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, therapeutic massage, adult day health services, home-based palliative care, in-home support services, support for caregivers of enrollees, enhanced disease management, home and bathroom safety devices, 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 prescription hearing aids (all types) with a limit of 2 every two years. OTC hearing aids are also covered. Prescription hearing aids - inner ear, prescription hearing aids - outer ear, and prescription hearing aids - over the ear are not covered.
Vision Services See details
Vision services include coverage for routine eye exams, with one exam covered every year, and eyewear, with a 20% coinsurance for contact lenses, and a combined maximum plan benefit of $200 per year. Eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered.
Dental Services See details
Dental services are covered, including oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, orthodontic services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable), and oral and maxillofacial surgery; however, maxillofacial prosthetics, implant services, prosthodontics (fixed), and orthodontics are not covered. Oral exams are limited to 2 visits, and prophylaxis (cleaning), fluoride treatment are limited to 2 visits per year, while restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable), and oral and maxillofacial surgery are limited to 1 visit. Orthodontic services have a maximum benefit of $500 per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required for this benefit.
Dialysis Services See details
Dialysis Services are covered under the Molina Medicare Complete Care Select (HMO D-SNP) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a 20% coinsurance and Prosthetics/Medical Supplies with a 20% coinsurance. Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts are not covered, and Durable Medical Equipment for use outside the home is also not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, and Therapeutic Radiological Services, are covered with no copay, and a coinsurance of at most 20%. 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. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but specific services like Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, Additional Cardiac Rehabilitation Services, and Medicare-covered Pulmonary Rehabilitation Services are not covered. 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, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $200.
Other Services See details
Other Services includes coverage for over-the-counter items, and meal benefits, but acupuncture, Dual Eligible SNPs, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered. Over-the-counter items include nicotine replacement therapy and Naloxone, and meal benefits require prior authorization.
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