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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 2025, 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 Select counties in MS. This plan received an overall rating of 3.5 out of 5 stars in 2025.
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 $15.60. 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 $590.00 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 $9350.00 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 has a defined standard for drug coverage. The plan has a deductible of $590.00. If you qualify for the low-income subsidy (LIS), the plan's premium is $15.60. Once you meet your deductible, you will pay costs for drugs in each tier until your total drug costs reach $2000. After your yearly out-of-pocket drug costs reach $2000, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Molina Medicare Complete Care (HMO D-SNP) plan provides comprehensive coverage with various benefits. This plan includes coverage for inpatient and outpatient services, as well as services for emergency care, primary care, preventive care, and home health services. Many services have a 20% coinsurance, while some services may have no copay. Additional benefits include hearing, vision, and dental services, with varying levels of coverage and cost-sharing. The plan also offers coverage for medical equipment, diagnostic and radiological services, and home infusion services. However, services such as cardiac rehabilitation, additional home health hours, and certain other services are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including Acute and Psychiatric care, are covered under the Molina Medicare Complete Care (HMO D-SNP) plan, but additional days and non-Medicare-covered stays are not covered. The plan uses the Medicare-defined cost share for tier 1, with coinsurance details available.
Outpatient Services See details
Outpatient services are covered, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital and observation services have a 20% coinsurance, while outpatient blood services have a 20% coinsurance. Individual and group sessions for outpatient substance abuse have a coinsurance between 20% and 20%, and ambulatory surgical center services have a coinsurance between 20% and 20%.
Partial Hospitalization See details
Partial Hospitalization is covered with a 20% coinsurance, and requires prior authorization.
Ambulance and Transportation Services See details
Ambulance Services are covered with a 20% coinsurance for both ground and air ambulance services, and Transportation Services are partially covered. Transportation Services to any health-related location are covered, while Transportation Services to a plan-approved health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Molina Medicare Complete Care (HMO D-SNP) plan. Emergency Services and Urgently Needed Services have a 20% coinsurance and no copay, while Worldwide Emergency Services has a maximum benefit coverage of $10,000.
Primary Care See details
The Molina Medicare Complete Care (HMO D-SNP) plan covers primary care physician services, chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Primary care physician services, chiropractic services, physician specialist services, physical therapy and speech-language pathology services, mental health specialty services, podiatry services, other health care professional services, psychiatric services, and opioid treatment program services have a 20% coinsurance.
Preventive Services See details
The Molina Medicare Complete Care (HMO D-SNP) plan covers various preventive services, including Medicare-covered services with no copay, an annual physical exam, and additional preventive services with prior authorization. The plan also covers kidney disease education services, as well as other preventive services such as Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, all with a 20% coinsurance.
Hearing Services See details
Hearing Services are partially covered by the Molina Medicare Complete Care (HMO D-SNP) plan, with Routine Hearing Exams, Fitting/Evaluation for Hearing Aid, and all types of Prescription Hearing Aids not covered. Hearing Exams have a coinsurance of at most 20%, with no deductible.
Vision Services See details
Vision services include coverage for eye exams and eyewear. Eye exams have a 20% coinsurance, while eyewear, including contact lenses, eyeglasses (lenses and frames), and eyeglass lenses and frames, also have a 20% coinsurance with a combined maximum benefit of $200 per year for eyewear.
Dental Services See details
Dental Services are partially covered by the Molina Medicare Complete Care (HMO D-SNP) plan, with a 20% coinsurance for some services. Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics, removable, Maxillofacial Prosthetics, Implant Services, Prosthodontics, fixed, Oral and Maxillofacial Surgery, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, Medicare Part B Chemotherapy/Radiation Drugs with 0-20% coinsurance, and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required for this benefit.
Dialysis Services See details
Dialysis Services are covered by the Molina Medicare Complete Care (HMO D-SNP) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment with 20% coinsurance for Medicare-covered Diabetic Supplies and Therapeutic Shoes/Inserts; Durable Medical Equipment for use outside the home is not covered. There is no copay for any of these services.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Molina Medicare Complete Care (HMO D-SNP) plan. You will pay a coinsurance of at most 20% for Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services.
Home Health Services See details
Home Health Services are covered by the Molina Medicare Complete Care (HMO D-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. This benefit requires authorization.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Molina Medicare Complete Care (HMO D-SNP) plan. Prior authorization is required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Molina Medicare Complete Care (HMO D-SNP) plan, but require prior authorization. The plan does not cover additional days beyond Medicare-covered SNF services, nor does it cover non-Medicare-covered SNF stays.
Other Services See details
Other services include coverage for Over-the-Counter (OTC) Items and meal benefits; acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered. The plan offers OTC items and meal benefits, with the meal benefit requiring prior authorization.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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