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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) plan features an annual drug deductible of $615. Under this plan, members enjoy no copay for Tier 1 preferred generic drugs and Tier 6 select care drugs filled at standard retail pharmacies or through standard mail order. These no-copay benefits apply to one-month, two-month, and three-month supplies, helping you save on essential daily medications. For other medication tiers, the plan utilizes coinsurance for standard pharmacy and mail-order fills. Members pay a 20% coinsurance for Tier 2 generic and 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 at standard locations.
Additional Benefits
The Molina Medicare Complete Care Plus (HMO D-SNP) plan offers comprehensive coverage with no copays for many essential healthcare services. Beneficiaries enjoy inpatient hospital stays, skilled nursing facility care, and home health services with no copay and no coinsurance. For outpatient care, doctor visits, and emergency services, you will also pay no copay, though standard coinsurance rates ranging from 20% to 30% will apply. Additionally, this plan provides robust coverage for daily wellness and supplemental needs at little to no out-of-pocket cost. Preventive dental care, routine vision exams with a $200 annual eyewear allowance, and hearing aids are all covered with no copays. Members also benefit from unlimited transportation to plan-approved medical locations and allowances for over-the-counter items with no copays or coinsurance.
Inpatient Hospital See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers inpatient acute and psychiatric hospital services with no copay and no coinsurance, though prior authorization is required. This benefit is partially covered because 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 copay, but a 20% coinsurance applies to outpatient hospital, ambulatory surgical center, outpatient substance abuse, and outpatient 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 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, with prior authorization required. Transportation services are partially covered, offering unlimited rides to plan-approved health-related locations with no copay or coinsurance, while 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, and the emergency coinsurance is waived if you are admitted to the hospital within 24 hours. Worldwide emergency, urgent care, and emergency transportation are also covered with no copay or coinsurance up to a maximum benefit of $10,000.
Primary Care See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers primary care, specialist, and therapy services with no copay and generally 30% coinsurance, while opioid treatment has no copay and no coinsurance. Routine chiropractic care (up to 20 visits yearly) and podiatry (up to 12 visits yearly) are covered, but other chiropractic services are not covered.
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 disease education and select screenings have no copay and a 20% coinsurance. Uncovered sub-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, home-based palliative care, in-home support, caregiver support, tobacco cessation, disease management, telemonitoring, home safety modifications, and counseling.
Hearing Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers hearing services with no copays for exams and hearing aids, though routine exams require a 20% coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance, but inner ear, outer ear, and over the ear types are not covered. Unlimited over-the-counter (OTC) hearing aids are also covered with no copay or coinsurance.
Vision Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) offers vision services with no copay, no coinsurance, and no deductible, though other eye exam services are not covered. This benefit includes one routine eye exam per year and up to a $200 annual allowance for eyewear, including eyeglasses, contact lenses, and upgrades.
Dental Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) partially covers dental services, offering key preventive and comprehensive care with no copay and no coinsurance. While essential treatments like exams, cleanings, and fillings are covered at no cost, specific services such as implants, fixed prosthodontics, orthodontics, and maxillofacial prosthetics 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, though prior authorization is required. Covered Medicare Part B drugs, including chemotherapy, radiation, and insulin, carry a coinsurance ranging from no coinsurance to 20% coinsurance, with insulin also requiring a $35 copay.
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, and diabetic supplies with no copay and 20% coinsurance. Prior authorization is required for these services, and coverage may be limited to preferred manufacturers or vendors.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are partially covered by Molina Medicare Complete Care Plus (HMO D-SNP) with no copay, but a 20% coinsurance and prior authorization are required for covered services. While diagnostic procedures, radiological services, and outpatient X-rays are covered, lab services are not covered.
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
Cardiac Rehabilitation Services are offered by Molina Medicare Complete Care Plus (HMO D-SNP) with no copay and require prior authorization, though only some services are covered in practice. Specifically, Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) services are not covered and require 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. The plan allows for admission without a prior three-day inpatient 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, offering over-the-counter (OTC) items and limited meal benefits with no copay and no coinsurance, while acupuncture is not covered. Prior authorization is required for the meal benefit, which is available for chronic illnesses or immediately following a hospital stay.
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