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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 Dallas 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. 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 $199.00 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 Plus (HMO D-SNP) plan features an annual drug deductible of $199. Under this plan, you will pay no copay for Tier 1 preferred generic, Tier 2 generic, and Tier 6 select care drugs when filled through standard pharmacies or standard mail order. This ensures that many of your everyday prescription medications are available at no cost to you. For brand-name and specialty medications, the plan transitions to a coinsurance structure. You will pay a 20% coinsurance for Tier 3 preferred brand drugs and a 30% coinsurance for Tier 4 non-preferred drugs. Tier 5 specialty drugs require a 25% coinsurance for a one-month supply through standard pharmacies or mail order.
Additional Benefits
The Molina Medicare Complete Care Plus (HMO D-SNP) plan offers comprehensive coverage with no copays for a wide variety of essential healthcare services. You will pay no copay and no coinsurance for inpatient hospital stays, skilled nursing facility care, home health services, plan-approved transportation, and routine dental care up to a $4,000 annual limit. Additionally, preventive physicals, fitness benefits, and hearing aids are available with no copay and no coinsurance. For other medical needs, the plan generally charges no copay but requires coinsurance, such as a 20% coinsurance for outpatient services, medical equipment, diagnostic tests, and dialysis. Emergency care, specialist visits, and partial hospitalization also feature no copay but require a 30% coinsurance. Prior authorization is required for many of these benefits, and Medicare Part B insulin carries a $35 copay.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Molina Medicare Complete Care Plus (HMO D-SNP) with no copay and no coinsurance for acute and psychiatric stays, although prior authorization is required. This benefit does not cover additional hospital days, non-Medicare-covered stays, or room upgrades.
Outpatient Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers outpatient services with no copayments, though a 20% coinsurance applies to outpatient hospital, observation, ambulatory surgical center, outpatient substance abuse, and outpatient blood services. Prior authorization is required for most of these outpatient services, and there is no deductible for outpatient blood services.
Partial Hospitalization See details
Partial hospitalization is covered under Molina Medicare Complete Care Plus (HMO D-SNP) with no copay and a 30% coinsurance, although prior authorization is required.
Ambulance and Transportation Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers ambulance services with a 20% coinsurance and no copay, while plan-approved transportation is available with no copay and no coinsurance. This benefit is partially covered because transportation to any health-related location is not covered.
Emergency Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers emergency and urgently needed services with a 30% coinsurance and no copay, both of which count toward the plan's 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 Plus (HMO D-SNP) covers primary care, specialist, mental health, and therapy services with no copay and generally 30% coinsurance, although chiropractic services are not covered. Opioid treatment is covered with no copay and no coinsurance, while routine podiatry services are covered with no copay and 20% coinsurance for up to 6 visits per year.
Preventive Services See details
Preventive services are partially covered by Molina Medicare Complete Care Plus (HMO D-SNP), offering annual physicals and fitness benefits with no copay and no coinsurance, while kidney education and glaucoma screenings require a 20% coinsurance and no copay. Sub-services that are not covered under this plan include in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, readmission 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 modifications, and counseling.
Hearing Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers hearing exams with no copay, though routine annual exams require a 20% coinsurance with no deductible. OTC hearing aids are fully covered with no copay and no coinsurance, while prescription hearing aids are partially covered with no copay and no coinsurance, excluding inner ear, outer ear, and over the ear types.
Vision Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) offers partially covered vision services with no copays or deductibles, though a 20% coinsurance applies to routine eye exams and contact lenses. Covered benefits include one routine eye exam per year and up to a $250 annual combined limit for eyewear, while other eye exam services are not covered.
Dental Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) provides partial coverage for dental services, with Medicare-covered dental carrying no copay and a 20% coinsurance. Other covered preventive and comprehensive dental benefits have no copay and no coinsurance up to a $4,000 annual maximum, though implants, orthodontics, fixed prosthodontics, maxillofacial prosthetics, and other diagnostic or preventive services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under Molina Medicare Complete Care Plus (HMO D-SNP) with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and insulin, have a coinsurance ranging from no coinsurance to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
Dialysis Services are covered by Molina Medicare Complete Care Plus (HMO D-SNP) 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, medical supplies, and diabetic equipment, with no copay and a 20% coinsurance. Prior authorization is required for these services, and certain items may be restricted to preferred vendors or specified manufacturers.
Diagnostic and Radiological Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers diagnostic and radiological services, including lab services, diagnostic procedures, therapeutic radiological services, and outpatient X-rays, with a 20% coinsurance and no copay. Prior authorization is required for all of these covered services.
Home Health Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers Cardiac Rehabilitation Services with no copay and prior authorization, but some services are covered while cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered and require 30% coinsurance.
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, though prior authorization is required. This benefit does not require a three-day prior 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) covers other services with no copay and no coinsurance, including acupuncture up to 20 treatments per year, over-the-counter (OTC) items, and temporary meal benefits following surgery or for chronic illnesses. Prior authorization is required for acupuncture and meals, and certain miscellaneous services and highly integrated dual-eligible SNP services are not covered.
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