A non-government entity
Molina Dual MI Coordinated Health (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Molina Dual MI Coordinated Health (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 Dual MI Coordinated Health (HMO D-SNP) in 2026, please refer to our full plan details page.
Molina Dual MI Coordinated Health (HMO D-SNP) is a HMO D-SNP plan offered by Molina Healthcare, Inc. available for enrollment in 2026 to people living in Counties: Barry, Ber, Branch, Cal, Cass, Kal, VB. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Molina Dual MI Coordinated Health (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 Dual MI Coordinated Health (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 Dual MI Coordinated Health (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 Dual MI Coordinated Health (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. Additionally, this plan comes with a Part B Premium reduction of $0.50. You must continue to pay paying your reduced 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 $600.00 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 Dual MI Coordinated Health (HMO D-SNP) plan features an annual drug deductible of $600. For prescription costs, members enjoy no copay for Tier 1 preferred generics, Tier 2 generics, and Tier 6 select care drugs when using standard retail pharmacies or standard mail order. This applies to one-month, two-month, and three-month supplies, helping you save on essential everyday medications. For brand-name and specialty prescriptions, costs are based on a percentage of the drug price rather than a flat copay. You will pay a 20% coinsurance for Tier 3 preferred brand drugs and a 30% coinsurance for Tier 4 non-preferred drugs at standard pharmacies or through mail order. Tier 5 specialty drugs require a 26% coinsurance for a one-month supply.
Additional Benefits
The Molina Dual MI Coordinated Health (HMO D-SNP) plan offers comprehensive coverage for essential medical needs with no copay for most services, including inpatient hospital stays, primary care visits, and home health care. However, members should expect to pay a coinsurance ranging from 20% to 30% for outpatient services, specialist care, emergency room visits, and durable medical equipment. This plan also includes valuable extras like fitness benefits, over-the-counter items, and home meals with no copay and no coinsurance. While the plan covers diagnostic hearing, vision, and Medicare-covered dental services with no copay, routine services such as eye exams, glasses, routine dental cleanings, and hearing aids are not covered. Prior authorization is required for many key benefits, including inpatient stays, home health, and diagnostic testing, to ensure coverage. Overall, this plan minimizes copays for core medical needs while utilizing coinsurance for specialty and outpatient care.
Inpatient Hospital See details
Molina Dual MI Coordinated Health (HMO D-SNP) covers inpatient acute and psychiatric hospital services with no copay and no coinsurance, though prior authorization is required. This benefit is partially covered, as additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by Molina Dual MI Coordinated Health (HMO D-SNP) with no copayments and a 20% coinsurance for outpatient hospital, ambulatory surgical center, substance abuse, and blood services. Prior authorization is required for most of these services, and the deductible is waived for the first three pints of blood.
Partial Hospitalization See details
Molina Dual MI Coordinated Health (HMO D-SNP) covers partial hospitalization services with no copay and a 30% coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
Molina Dual MI Coordinated Health (HMO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, with prior authorization required. For transportation, some services are covered but transportation to plan-approved health-related locations and any health-related locations are not covered.
Emergency Services See details
Molina Dual MI Coordinated Health (HMO D-SNP) covers emergency and urgently needed services with a 30% coinsurance and no copay, though the emergency coinsurance is waived if you are admitted to the hospital within 24 hours. Additionally, worldwide emergency, urgent, and transportation services are covered up to a $10,000 maximum with no copay and no coinsurance.
Primary Care See details
Primary care services offered by Molina Dual MI Coordinated Health (HMO D-SNP) feature no copay and 20% to 30% coinsurance for covered care, including PCP visits, specialist care, and physical therapy. Podiatry services are not covered, and while some chiropractic services are covered, routine and other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by Molina Dual MI Coordinated Health (HMO D-SNP), featuring an annual physical exam with no copay and no coinsurance, alongside kidney disease education and screenings with no copay and 20% coinsurance. While fitness and home safety benefits are included, several services including medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, chemotherapy wigs, weight management, alternative therapies, therapeutic massage, adult day health, home-based palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, and counseling are not covered.
Hearing Services See details
Molina Dual MI Coordinated Health (HMO D-SNP) covers diagnostic hearing exams with no copay, no coinsurance, and no deductible. Other hearing services, including routine hearing exams, fitting evaluations, prescription hearing aids, and over-the-counter hearing aids, are not covered.
Vision Services See details
Molina Dual MI Coordinated Health (HMO D-SNP) covers vision services with no copay, 20% coinsurance, and no deductible. Although some services are covered, routine eye exams, other eye exam services, contact lenses, eyeglasses, eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Molina Dual MI Coordinated Health (HMO D-SNP) partially covers dental services, offering Medicare-covered dental care with no copay and a 20% coinsurance. Routine and comprehensive dental services, including preventive cleanings, exams, x-rays, restorative treatments, and orthodontics, are not covered under this plan.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by Molina Dual MI Coordinated Health (HMO D-SNP) with no copay, though prior authorization and step therapy are required. Associated Medicare Part B drugs, including chemotherapy, insulin, and other drugs, carry a coinsurance ranging from no coinsurance to 20%, with insulin also requiring a $35.00 copay.
Dialysis Services See details
Dialysis Services are covered under the Molina Dual MI Coordinated Health (HMO D-SNP) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Molina Dual MI Coordinated Health (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with no copay and a 20% coinsurance. Prior authorization is required for these covered benefits, which may also be subject to preferred vendor or manufacturer limitations.
Diagnostic and Radiological Services See details
Molina Dual MI Coordinated Health (HMO D-SNP) covers diagnostic and radiological services, including lab work, diagnostic tests, therapeutic radiology, and X-rays, with a 20% coinsurance and no copay. Prior authorization is required for all of these covered services.
Home Health Services See details
Home Health Services are covered under the Molina Dual MI Coordinated Health (HMO D-SNP) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Molina Dual MI Coordinated Health (HMO D-SNP) covers Cardiac Rehabilitation Services with no copay, though prior authorization is required. However, some services are not covered, including standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for peripheral artery disease (PAD), which all require a 30% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is partially covered by Molina Dual MI Coordinated Health (HMO D-SNP) with no coinsurance and Medicare-defined copayments, requiring prior authorization. While the plan allows admission without a prior three-day inpatient hospital stay, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered under the Molina Dual MI Coordinated Health (HMO D-SNP), offering over-the-counter items and meal benefits with no copay and no coinsurance. Acupuncture is not covered, and prior authorization is required for the meal benefit.
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