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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 South Carolina State. This plan received an overall rating of 3.5 out of 5 stars in 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 $12.80. 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:
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Drug Coverage
The Molina Medicare Complete Care Plus (HMO D-SNP) prescription drug plan has an annual drug deductible of $615. Beneficiaries will pay no copay for Tier 1 preferred generic drugs and Tier 6 select care drugs when using standard pharmacies or standard mail order services. This zero-cost coverage applies to one-month, two-month, and three-month supply options. For other medication categories, costs are determined by coinsurance percentages at standard pharmacies and standard mail order. You will pay a 20% coinsurance for Tier 2 generic and Tier 3 preferred brand drugs, 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) plan offers comprehensive coverage with no copays for nearly all covered services, making healthcare highly affordable. Essential medical needs like inpatient hospital stays, skilled nursing facility care, home health services, and preventive care are fully covered with no copay and no coinsurance. Additionally, members can access preventive and comprehensive dental care, routine vision exams with a $250 annual eyewear allowance, and hearing aids with no copay and no coinsurance. For other medical needs, such as outpatient services, diagnostic tests, and durable medical equipment, members will pay no copay and a 20% coinsurance. Specialist visits, mental health services, and emergency care also feature no copay, though they carry a 30% coinsurance. The plan also includes valuable extra benefits like unlimited transportation to approved health locations and over-the-counter items 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. The benefit is partially covered, as additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers outpatient services with no copays, 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 the deductible is waived for the first three pints of blood.
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 before you can receive these services.
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, subject to prior authorization. Transportation services are partially covered, offering unlimited rides to plan-approved health-related locations with no copay and no coinsurance, though 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, with cost sharing counting toward the plan's deductible. Worldwide emergency coverage, including urgent care and emergency transportation, is also provided with no copay and no coinsurance up to a $10,000 maximum limit.
Primary Care See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers primary care, specialist, and mental health services with no copay and generally 30% coinsurance, while opioid treatment has no copay and no coinsurance. Chiropractic services are partially covered, offering up to 20 routine visits per year with no copay and 30% coinsurance, while other chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered by Molina Medicare Complete Care Plus (HMO D-SNP), featuring an annual physical, health education, and fitness benefits with no copay and no coinsurance. Kidney disease education and screenings like glaucoma, diabetes self-management, digital rectal exams, and post-welcome-visit EKGs have no copay and a 20% coinsurance. Excluded sub-services include in-home safety assessments, medical nutrition therapy, weight management, alternative therapies, caregiver support, and home-based palliative care.
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. Prescription hearing aids are partially covered with no copay and no coinsurance, but 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
Vision services are partially covered by Molina Medicare Complete Care Plus (HMO D-SNP), offering covered services with no copay, no coinsurance, and no deductible. The plan includes one routine eye exam per year and up to a $250 annual allowance for eyewear like contacts and eyeglasses, while other eye exam services are not covered.
Dental Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) provides partially covered dental services with no copay and no coinsurance for covered preventive and comprehensive care. Sub-services that are not covered include other diagnostic dental services, other preventive dental 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, although prior authorization is required. Covered Medicare Part B chemotherapy, radiation, and other drugs have a coinsurance of 0% to 20%, 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
Medical equipment is covered by Molina Medicare Complete Care Plus (HMO D-SNP) with no copay and a 20% coinsurance for durable medical equipment, prosthetics, and diabetic supplies. Prior authorization is required for these benefits, and certain brand or vendor limitations may apply.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are partially covered under Molina Medicare Complete Care Plus (HMO D-SNP) with no copay and a 20% coinsurance for diagnostic procedures, X-rays, and radiological services, though lab services are not covered and prior authorization is required.
Home Health Services See details
Home Health Services are covered under the Molina Medicare Complete Care Plus (HMO D-SNP) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Molina Medicare Complete Care Plus (HMO D-SNP) with no copay, though prior authorization is required. Only some services are covered, as cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered and carry a 30% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Molina Medicare Complete Care Plus (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required. This benefit is partially covered because, while it allows for admission without a prior three-day inpatient hospital stay, it does not cover additional days beyond the standard Medicare-covered limit.
Other Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) partially covers other services, providing over-the-counter (OTC) items and meal benefits with no copay and no coinsurance. Acupuncture is not covered, and the meal benefit requires prior authorization.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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