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Molina Medicare Complete Care (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Molina Medicare Complete Care (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 (HMO D-SNP) in 2026, please refer to our full plan details page.
Molina Medicare Complete Care (HMO D-SNP) is a HMO D-SNP plan offered by Molina Healthcare, Inc. available for enrollment in 2025 to people living in Gila, Maricopa and Pinal Counties. 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 (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 (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 (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 (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $16.40. 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 (HMO D-SNP) plan features an annual prescription drug deductible of $615.00 and a Part D premium of $16.40, which may be reduced if you qualify for Extra Help. During the initial coverage phase, you will pay a 20% coinsurance for preferred and standard generic drugs, 30% coinsurance for preferred brand drugs, and 25% coinsurance for non-preferred drugs at standard pharmacies. Specialty tier drugs are covered with no copay at standard pharmacies and through standard mail. These cost-sharing rates apply until your total drug costs reach $2,100.00. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and will pay nothing for covered Medicare Part D prescription drugs.
Additional Benefits
Molina Medicare Complete Care (HMO D-SNP) offers comprehensive coverage where most outpatient, specialist, diagnostic, and medical equipment services require no copay and a 20% to 30% coinsurance. Preventive care and home health services are covered with no copay or coinsurance, while inpatient and skilled nursing stays utilize Medicare-defined cost-sharing. Emergency care is also covered with no copay and a 30% coinsurance, which includes worldwide emergency coverage up to a $10,000 limit. For supplemental health needs, the plan features routine dental, vision, and hearing benefits with no copay and a 20% coinsurance. This includes a $3,000 annual limit for dental services, a $200 annual allowance for eyewear, and coverage for hearing aids. Members can also access over-the-counter items and limited meal benefits with no copay or coinsurance.
Inpatient Hospital See details
Molina Medicare Complete Care (HMO D-SNP) partially covers inpatient hospital acute and psychiatric services with no copay and Medicare-defined coinsurance, though prior authorization is required. Additional days, non-Medicare-covered stays, and acute care upgrades are not covered.
Outpatient Services See details
Outpatient services under Molina Medicare Complete Care (HMO D-SNP) are covered with a 20% coinsurance, no copay, and no deductible. This includes outpatient hospital, observation, ambulatory surgical center, substance abuse, and blood services, with prior authorization required for most care.
Partial Hospitalization See details
Molina Medicare Complete Care (HMO D-SNP) covers partial hospitalization services with a 30% coinsurance and no copay. Prior authorization is required to receive these covered benefits.
Ambulance and Transportation Services See details
Molina Medicare Complete Care (HMO D-SNP) partially covers ambulance and transportation services, with ground and air ambulance services requiring a 20% coinsurance and no copay. Transportation services to plan-approved or any health-related locations are not covered.
Emergency Services See details
Molina Medicare Complete Care (HMO D-SNP) covers emergency and urgently needed services with a 30% coinsurance and no copay, subject to maximum limits of $115 and $40 per visit that count toward the plan deductible. Worldwide emergency, urgent, and transportation services are also covered up to a maximum benefit limit of $10,000.
Primary Care See details
Molina Medicare Complete Care (HMO D-SNP) partially covers primary care and professional services with no copay and a 30% coinsurance for most visits, including primary care, specialists, and therapy. Telehealth services are covered with no copay and a 20% to 30% coinsurance, while podiatry services are not covered.
Preventive Services See details
Molina Medicare Complete Care (HMO D-SNP) partially covers preventive services, offering zero-dollar Medicare preventive services with no copayments or coinsurance, while kidney disease education, glaucoma screenings, diabetes self-management, digital rectal exams, and EKGs require a 20% coinsurance. Several sub-services are not covered under this benefit, including annual physical exams, in-home safety assessments, medical nutrition therapy, and weight management programs.
Hearing Services See details
Molina Medicare Complete Care (HMO D-SNP) partially covers hearing services, including yearly routine exams and fitting evaluations with no copay and a 20% coinsurance, alongside unlimited OTC hearing aids and up to two prescription hearing aids every two years. However, prescription hearing aids for the inner ear, outer ear, and over the ear are not covered.
Vision Services See details
Molina Medicare Complete Care (HMO D-SNP) covers annual routine eye exams and eyewear—including contact lenses, eyeglasses, and upgrades—with no copay and a 20% coinsurance. There is no deductible for these services, and the plan provides a combined maximum eyewear allowance of $200 every year.
Dental Services See details
Molina Medicare Complete Care (HMO D-SNP) offers partially covered dental services, including preventive care and select comprehensive services up to a $3,000 annual limit. Medicare-covered dental services require a 20% coinsurance and no copay, while maxillofacial prosthetics, implant services, fixed prosthodontics, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Molina Medicare Complete Care (HMO D-SNP) with prior authorization, requiring a $35 copay and no coinsurance to 20% coinsurance for Medicare Part B insulin. Other covered Part B drugs, including chemotherapy and radiation, carry no copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis services are covered by Molina Medicare Complete Care (HMO D-SNP) with a 20% coinsurance and no copay.
Medical Equipment See details
Medical equipment benefits, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, are covered by Molina Medicare Complete Care (HMO D-SNP) with no copay and a 20% coinsurance. Prior authorization is required for these services, and some items may be limited to preferred vendors or specified manufacturers.
Diagnostic and Radiological Services See details
Molina Medicare Complete Care (HMO D-SNP) covers diagnostic and radiological services, including lab services, diagnostic tests, therapeutic radiology, and outpatient X-rays, with no copay and a coinsurance of at most 20%. Prior authorization is required for all of these covered diagnostic and radiological services.
Home Health Services See details
Home Health Services are covered by Molina Medicare Complete Care (HMO D-SNP) with no copay or coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Molina Medicare Complete Care (HMO D-SNP) states that some services are covered, but Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Prior authorization is required for these services, though specific copay and coinsurance cost-sharing amounts are not provided in the plan benefits.
Skilled Nursing Facility (SNF) See details
Molina Medicare Complete Care (HMO D-SNP) partially covers Skilled Nursing Facility (SNF) services with Medicare-defined copays and coinsurance, and prior authorization is required. While a prior three-day inpatient hospital stay is not required for admission, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by Molina Medicare Complete Care (HMO D-SNP), featuring over-the-counter (OTC) items and limited meal benefits with no copay or coinsurance. Acupuncture and highly integrated dual-eligible services are not covered under this plan, and the meal benefit requires prior authorization.
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