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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 El Paso 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. Under this plan, you will pay no copay for Tier 1 preferred generic drugs and Tier 6 select care drugs at standard pharmacies or through standard mail order. This no-copay benefit applies to one-month, two-month, and three-month drug supplies. For other medication categories, your cost-sharing is based on coinsurance percentages at standard pharmacies and standard mail order. You will pay 20% coinsurance for Tier 2 generic and Tier 3 preferred brand drugs, and 30% coinsurance for Tier 4 non-preferred drugs. Additionally, Tier 5 specialty drugs require a 25% coinsurance for a one-month supply.
Additional Benefits
The Molina Medicare Complete Care Plus (HMO D-SNP) plan offers comprehensive medical coverage with no copay and no coinsurance for inpatient hospital stays, skilled nursing facility care, and home health services. For outpatient hospital services, doctor visits, and emergency care, members pay no copay but are responsible for a coinsurance ranging from 20% to 30%. Preventive care and annual physicals are fully covered with no copay and no coinsurance. Additional benefits like dental, vision, and hearing care are partially covered with no copays, although routine exams and select services may carry a 20% coinsurance. The plan also provides diagnostic testing, diabetic supplies, and durable medical equipment with no copay and a 20% coinsurance. Furthermore, members can access acupuncture, over-the-counter items, and meal benefits with no copay and no coinsurance.
Inpatient Hospital See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers inpatient acute and psychiatric hospital stays with no copay and no coinsurance, though prior authorization is required. This coverage does not include additional 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 copay, but a 20% coinsurance applies to outpatient hospital, ambulatory surgical center, outpatient substance abuse, and blood services. Prior authorization is required for most of these outpatient services.
Partial Hospitalization See details
Molina Medicare Complete Care Plus (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 Medicare Complete Care Plus (HMO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered with no copay and no coinsurance up to $100 monthly for plan-approved locations, but 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, which count 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 Plus (HMO D-SNP) covers primary care, specialist, psychiatric, and therapy services with no copay and a 30% coinsurance, while chiropractic services are not covered. Podiatry and other healthcare professional services are covered with no copay and a 20% to 30% coinsurance, and opioid treatment is available with no copay and no coinsurance.
Preventive Services See details
Preventive services are covered by Molina Medicare Complete Care Plus (HMO D-SNP) with no copay and no coinsurance for annual physicals, while kidney education and other screenings have no copay and a 20% coinsurance. Additional preventive benefits are partially covered with no copay or coinsurance, but do not cover in-home safety assessments, medical nutrition therapy, medication reconciliation, re-admission prevention, 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 modifications, and counseling.
Hearing Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers hearing exams with no copay, though routine exams require a 20% coinsurance with no deductible. Prescription hearing aids are partially covered with no copay and no coinsurance, though inner ear, outer ear, and over the ear types are not covered. Unlimited OTC hearing aids are also covered with no copay and no coinsurance.
Vision Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) offers partially covered vision services, which exclude other eye exam services but cover one routine eye exam per year with no copay and a 20% coinsurance. Covered eyewear—including contact lenses, eyeglasses, and upgrades—features no copay, no coinsurance (except for a 20% coinsurance on contact lenses), and a combined maximum plan benefit of $350 per year.
Dental Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) partially covers dental services, offering Medicare-covered dental with no copay and 20% coinsurance, and other dental services with no copay and no coinsurance. Uncovered services include other diagnostic dental services, other preventive dental services, maxillofacial prosthetics, implant services, fixed prosthodontics, and orthodontics.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Molina Medicare Complete Care Plus (HMO D-SNP) with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs carry no coinsurance to 20% coinsurance, while Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance.
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 durable medical equipment, prosthetics, and diabetic supplies with no copay and a 20% coinsurance. Prior authorization is required for these benefits, and some equipment may be limited to preferred vendors or manufacturers.
Diagnostic and Radiological Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers diagnostic and radiological services, including lab tests, diagnostic procedures, therapeutic radiology, and outpatient X-rays, with no copay and a 20% coinsurance. Prior authorization is required for all of these covered diagnostic and radiological services.
Home Health Services See details
Home Health Services are covered under Molina Medicare Complete Care Plus (HMO D-SNP) with no copay and no coinsurance. Prior authorization is required to access this benefit.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by Molina Medicare Complete Care Plus (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required. While some services are covered, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered and require a 30% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by Molina Medicare Complete Care Plus (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required. This benefit does not require a prior three-day inpatient hospital stay, but additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services under Molina Medicare Complete Care Plus (HMO D-SNP) are partially covered, providing acupuncture, over-the-counter (OTC) items, and meal benefits with no copay and no coinsurance. Prior authorization is required for acupuncture (limited to 20 treatments per year) and meals, while highly integrated services for dual eligible SNPs and other miscellaneous services are not covered.
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