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Molina Medicare Complete Care Plus (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Molina Medicare Complete Care Plus (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 Plus (HMO D-SNP) in 2026, please refer to our full plan details page.
Molina Medicare Complete Care Plus (HMO D-SNP) is a HMO D-SNP plan offered by Molina Healthcare, Inc. available for enrollment in 2026 to people living in Bexar County. The overall rating for this plan is not yet available for 2026.
It's important to know that Molina Medicare Complete Care Plus (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 Plus (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 Plus (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 Plus (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 $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:
Sign up for Molina Medicare Complete Care Plus (HMO D-SNP)
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Drug Coverage
The Molina Medicare Complete Care Plus (HMO D-SNP) plan features an annual drug deductible of $615. Beneficiaries enjoy no copay for Tier 1 preferred generic drugs and Tier 6 select care drugs for one-month, two-month, or three-month supplies filled at standard pharmacies and standard mail order. This makes managing everyday prescriptions highly affordable. For other medication tiers, costs are based on coinsurance at standard pharmacies and standard mail order. Tier 2 generic 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 are subject to a 25% coinsurance for a one-month supply.
Additional Benefits
The Molina Medicare Complete Care Plus (HMO D-SNP) offers comprehensive healthcare coverage featuring no copays for most primary care, specialist, outpatient, and inpatient hospital services. While there are no copays for these essential medical visits, members are typically responsible for a coinsurance ranging from 20% to 30% on outpatient care, diagnostics, and specialist services. Major services like home health care, skilled nursing facility stays, and inpatient hospital stays are fully covered with no copay and no coinsurance. Additionally, this plan provides valuable supplemental benefits including dental, vision, hearing, and transportation services with no copays. Members benefit from no copay and no coinsurance for preventive and comprehensive dental up to a $4,000 annual limit, as well as no copay and no coinsurance for unlimited over-the-counter hearing aids. Vision exams, medical equipment, and dialysis are also accessible with no copay and a standard 20% coinsurance.
Inpatient Hospital See details
Molina Medicare Complete Care Plus (HMO D-SNP) partially covers inpatient hospital services with no copay and no coinsurance for acute and psychiatric stays, though prior authorization is required. Additional days, upgrades, and non-Medicare-covered stays are not covered under this benefit.
Outpatient Services See details
Outpatient services are covered by Molina Medicare Complete Care Plus (HMO D-SNP) with no copays, but a 20% coinsurance and prior authorization requirements apply to outpatient hospital, observation, ambulatory surgical center, and substance abuse services. Outpatient blood services are also covered with no copay and a 20% coinsurance, with no deductible for the first three pints.
Partial Hospitalization See details
Partial hospitalization is covered under the Molina Medicare Complete Care Plus (HMO D-SNP) plan with no copay and a 30% coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay. Unlimited transportation to plan-approved health locations is provided with no copay and no coinsurance, though transportation to any health-related location is not covered.
Emergency Services See details
Emergency and urgently needed services are covered by Molina Medicare Complete Care Plus (HMO D-SNP) with a 30% coinsurance and no copay, which count toward the plan-level deductible. Worldwide emergency, urgent, and transportation services are also covered with no copay and no coinsurance, up to a maximum benefit of $10,000.
Primary Care See details
Primary care and specialist services under Molina Medicare Complete Care Plus (HMO D-SNP) are covered with no copays, with coinsurance ranging from 20% to 30% for most medical, therapy, and mental health visits. While routine chiropractic care is not covered, opioid treatment features no copay and no coinsurance, and other services like podiatry and telehealth are covered with no copays and up to 30% coinsurance.
Preventive Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) partially covers preventive services, featuring annual physicals and select wellness benefits with no copay and no coinsurance, while kidney education and specific screenings carry no copay and a 20% coinsurance. Non-covered services include in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, chemotherapy wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home safety devices, and counseling.
Hearing Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers hearing services, offering hearing exams with no copay and a 20% coinsurance for routine visits, and 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 per year, 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 Plus (HMO D-SNP), featuring no copay and a 20% coinsurance for routine eye exams (limited to one yearly) while other eye exam services are not covered. Eyewear is covered with no copay, no deductible, and a 20% coinsurance for contact lenses, providing up to a $250 annual maximum for contacts, eyeglasses, frames, lenses, and upgrades.
Dental Services See details
Dental services are partially covered by Molina Medicare Complete Care Plus (HMO D-SNP), featuring no copay and a 20% coinsurance for Medicare-covered dental, and no copay or coinsurance for covered preventive and comprehensive services up to a $4,000 annual limit. Non-covered services include other diagnostic and preventive services, maxillofacial prosthetics, implant services, fixed prosthodontics, and orthodontics.
Home Infusion bundled Services See details
Molina Medicare Complete Care Plus (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 carry a 0% to 20% coinsurance, while Part B insulin has a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Molina Medicare Complete Care Plus (HMO D-SNP) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Molina Medicare Complete Care Plus (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, and some items may be restricted to preferred manufacturers or vendors.
Diagnostic and Radiological Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers diagnostic and radiological services, including lab work, diagnostic tests, therapeutic radiology, and outpatient X-rays, with prior authorization required. These covered services feature no copay and are subject to a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered by Molina Medicare Complete Care Plus (HMO D-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered with no copay under the Molina Medicare Complete Care Plus (HMO D-SNP) plan, though some services are covered while cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require a 30% coinsurance. Prior authorization is required for these services.
Skilled Nursing Facility (SNF) See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, subject to prior authorization. The plan allows SNF admission without a prior three-day hospital stay, but additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) partially covers other services with no copay and no coinsurance, including over-the-counter (OTC) items, up to 20 acupuncture treatments per year, and temporary meal benefits following a hospitalization or for chronic illness. Prior authorization is required for acupuncture and meal benefits, and highly integrated services for dual-eligible SNPs are not covered.
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