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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 Harris 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 $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. For prescription drug coverage, beneficiaries enjoy no copay for Tier 1 preferred generic, Tier 2 generic, and Tier 6 select care drugs filled through standard pharmacies or standard mail order. This makes essential generic and select care medications highly affordable with zero out-of-pocket copays. For brand-name and specialty medications, costs are structured as coinsurance percentages. Tier 3 preferred brand drugs require a 20% coinsurance, Tier 4 non-preferred drugs require a 30% coinsurance, and Tier 5 specialty drugs carry a 25% coinsurance for a one-month supply. These coinsurance rates apply to both standard retail pharmacies and standard mail-order services.
Additional Benefits
The Molina Medicare Complete Care Plus (HMO D-SNP) offers comprehensive healthcare coverage with many key benefits requiring no copays. Essential services such as inpatient hospital stays, skilled nursing facility care, home health services, and select preventive care are covered with no copay and no coinsurance. For other medical needs like outpatient care, specialist visits, diagnostic tests, and medical equipment, members will pay no copay but are responsible for a coinsurance typically ranging from 20% to 30%. Additionally, this plan provides valuable supplemental benefits to support daily wellness, including dental, vision, hearing, and transportation services. Dental care is covered with no copay and no coinsurance up to a 4,000 dollar annual limit, while vision benefits include annual eyewear up to a 250 dollar limit. Other helpful perks like over-the-counter items, acupuncture, and meal benefits are also available 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, although 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 under Molina Medicare Complete Care Plus (HMO D-SNP) with no copayments, though a 20% coinsurance applies to outpatient hospital, observation, ambulatory surgical center, substance abuse, and blood services. Prior authorization is required for most of these services, and there is no deductible for outpatient blood services.
Partial Hospitalization See details
Partial hospitalization is covered by Molina Medicare Complete Care Plus (HMO D-SNP) with no copay and a 30% coinsurance, and 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. Transportation services are partially covered with no copay or coinsurance up to $75 monthly for plan-approved locations, but transportation to any health-related location is not covered.
Emergency Services See details
Emergency services are covered by Molina Medicare Complete Care Plus (HMO D-SNP) with a 30% coinsurance and no copay for domestic emergency and urgent care, both of 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 limit of $10,000.
Primary Care See details
Primary care benefits under Molina Medicare Complete Care Plus (HMO D-SNP) feature no copays for covered services, including primary care, specialist visits, therapies, and mental health services, which generally carry a 30% coinsurance. Opioid treatment services are covered with no copay and no coinsurance, routine podiatry is covered for up to six visits per year with a 20% coinsurance, and chiropractic services are not covered.
Preventive Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers preventive services, including annual physical exams, fitness benefits, and personal emergency response systems with no copay and no coinsurance. While several additional preventive services like weight management and in-home support are not covered, other benefits such as kidney disease education and glaucoma screenings are covered with no copay and a 20% coinsurance.
Hearing Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers annual routine hearing exams with no copay and a 20% coinsurance, as well as fitting evaluations with no copay. Prescription hearing aids are partially covered with no copay or coinsurance for up to two aids per year (excluding inner ear, outer ear, and over the ear models), while OTC hearing aids are covered with no copay or coinsurance.
Vision Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) provides partially covered vision services, which exclude other eye exam services but include one routine eye exam per year and annual eyewear up to a $250 limit. These covered benefits feature no copays, though a 20% coinsurance applies to routine eye exams and contact lenses.
Dental Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers Medicare-covered dental services with no copay and a 20% coinsurance, and other dental services with no copay and no coinsurance up to a $4,000 yearly maximum. While preventive and comprehensive services like cleanings, exams, fillings, and oral surgery are covered, other diagnostic, other preventive, implants, fixed prosthodontics, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers home infusion bundled services with no copay and no coinsurance, though prior authorization is required. Under this benefit, chemotherapy, radiation, and other Part B drugs require no copay and no coinsurance to 20% coinsurance, while covered insulin requires a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers Dialysis Services with no copay and a 20% coinsurance.
Medical Equipment See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers durable medical equipment, prosthetics, medical supplies, and diabetic services with no copay and a 20% coinsurance. Prior authorization is required for these benefits, and some equipment and supplies are limited to preferred vendors or specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Molina Medicare Complete Care Plus (HMO D-SNP) with no copayment and a 20% coinsurance for all diagnostic procedures, lab services, X-rays, and therapeutic radiological services. Prior authorization is required for these covered diagnostic and radiological services.
Home Health Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers home health services with no copay and no coinsurance, although prior authorization is required for these services.
Cardiac Rehabilitation Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) offers Cardiac Rehabilitation Services with no copay and a 30% coinsurance, though prior authorization is required. While some services are covered, key programs such as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered in practice.
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 is partially covered because additional days beyond the Medicare-covered limit are not covered, but the plan does allow for admission without a prior three-day inpatient hospital stay.
Other Services See details
Other services are partially covered by Molina Medicare Complete Care Plus (HMO D-SNP), providing acupuncture, over-the-counter items, and meal benefits with no copay and no coinsurance. Highly integrated services for dual-eligible SNPs and other auxiliary services are not covered under this plan.
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