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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.
This summary reflects 2026 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.
Molina Medicare Complete Care (HMO D-SNP) is a HMO D-SNP plan offered by Molina Healthcare of Arizona, Inc. available for the 2026 plan year to people living in Counties: George, Hancock, Harrison, PR, Stone. CMS star rating not available for 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 $0.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.50. You must continue to pay paying your reduced Part B Premium.
Deductibles
Health deductible: information not available.
This plan has a $615.00 drug deductible that applies only to drugs in certain tiers. You pay this amount toward covered prescriptions in those tiers before the plan's cost sharing begins; drugs in the other tiers are not subject to the deductible. See the full plan details page for the tier table.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $9250.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $9250.00 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:
Sign up for Molina Medicare Complete Care (HMO D-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. Call-center hours (ET): Mon-Fri 8am-10pm; Sat 9am-8pm; Sun closed.
Drug Coverage
The Molina Medicare Complete Care (HMO D-SNP) plan features an annual drug deductible of $615. Under this plan, you will pay no copay for Tier 1 preferred generic drugs and Tier 6 select care drugs when filled at standard pharmacies or through standard mail order. This no-copay benefit applies to one-month, two-month, and three-month supplies. For other medication tiers, your costs are determined by coinsurance at standard pharmacies and standard mail order. You will 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 and are limited to a one-month supply.
Additional Benefits
Molina Medicare Complete Care (HMO D-SNP) offers comprehensive medical coverage with no copays for major services like inpatient hospital stays, primary care, outpatient services, and emergency care. While there are no copays for these services, you will typically pay a coinsurance ranging from 20% to 30% for outpatient visits, specialist care, emergency services, and diagnostic tests. Inpatient hospital stays, home health care, and skilled nursing facility services are covered fully with no copay and no coinsurance. This plan also includes valuable everyday benefits such as preventive care, dental, vision, and hearing services with no copays, though some routine exams and specialized treatments require a 20% to 30% coinsurance. Additionally, members can take advantage of no copay and no coinsurance for unlimited transportation to approved health locations, over-the-counter items, and post-hospitalization meals. Hearing aids and select preventive dental care are also covered with no copay or coinsurance, subject to annual plan limits.
Inpatient Hospital See details
Molina Medicare Complete Care (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, as upgrades, additional days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Molina Medicare Complete Care (HMO D-SNP) covers outpatient services with no copays, but a 20% coinsurance applies to outpatient hospital, observation, ambulatory surgical center, substance abuse, and blood services. Prior authorization is required for most of these outpatient services, and there is no deductible for outpatient blood services.
Partial Hospitalization See details
Molina Medicare Complete Care (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 (HMO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered, offering unlimited rides to plan-approved health-related locations with no copay and no coinsurance, while transportation to any health-related location is 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, with the emergency coinsurance waived if admitted to the hospital within 24 hours. These costs count toward the plan-level deductible, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance up to a $10,000 maximum limit.
Primary Care See details
Molina Medicare Complete Care (HMO D-SNP) covers primary care, specialist, therapy, mental health, and telehealth services with no copay and 20% to 30% coinsurance. Chiropractic services are partially covered, offering up to 12 routine visits per year while other chiropractic services are not covered, and routine podiatry is limited to 6 visits per year.
Preventive Services See details
Molina Medicare Complete Care (HMO D-SNP) provides partially covered preventive services with no copay and no coinsurance for annual physicals and fitness benefits, while kidney education and select screenings require no copay and a 20% coinsurance. Uncovered sub-services include in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, palliative care, in-home support, caregiver support, disease management, telemonitoring, home safety modifications, and counseling.
Hearing Services See details
Molina Medicare Complete Care (HMO D-SNP) covers hearing exams with no copay and no deductible, though routine exams require a 20% coinsurance. Hearing aid benefits are partially covered with no copay or coinsurance for unlimited over-the-counter and up to two prescription aids every two years, excluding inner ear, outer ear, and over-the-ear models.
Vision Services See details
Molina Medicare Complete Care (HMO D-SNP) covers vision services with no copays, but a 20% coinsurance applies to routine eye exams and contact lenses with no deductibles. Vision exams are partially covered because other eye exam services are not covered, while covered eyewear has a combined maximum benefit of $250 per year.
Dental Services See details
Dental services are partially covered by Molina Medicare Complete Care (HMO D-SNP), offering Medicare-covered dental services with no copay and a 30% coinsurance, and other covered dental services with no copay and no coinsurance. While many preventive and comprehensive services are included up to a $1,600 annual limit, some services are not covered, including other diagnostic, other preventive, maxillofacial prosthetics, implants, fixed prosthodontics, and orthodontics.
Home Infusion bundled Services See details
Home Infusion bundled services are covered by Molina Medicare Complete Care (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and insulin, require no coinsurance to 20% coinsurance, with insulin also carrying a $35 copay.
Dialysis Services See details
Dialysis Services are covered by Molina Medicare Complete Care (HMO D-SNP) with no copay and a 20% coinsurance.
Medical Equipment See details
Medical equipment is covered by Molina Medicare Complete Care (HMO D-SNP) with no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic services. Prior authorization is required for these benefits, and coverage may be limited to preferred vendors or specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Molina Medicare Complete Care (HMO D-SNP) with no copay and a 20% coinsurance, subject to prior authorization. Covered services under this benefit include diagnostic procedures, lab work, therapeutic radiological services, and outpatient X-rays.
Home Health Services See details
Home Health Services are covered by Molina Medicare Complete Care (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered under Molina Medicare Complete Care (HMO D-SNP) with no copay and no coinsurance, although in practice some services are covered while standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Molina Medicare Complete Care (HMO D-SNP) partially covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, as additional days beyond the standard Medicare-covered limit are not covered. Prior authorization is required, but the plan allows SNF admission without requiring a prior three-day inpatient hospital stay.
Other Services See details
Other services are partially covered by Molina Medicare Complete Care (HMO D-SNP), which features no copay and no coinsurance for over-the-counter (OTC) items and qualifying meal benefits, while acupuncture is not covered. The meal benefit requires prior authorization and covers meals after hospitalizations, surgeries, or for chronic illnesses.
Plan Providers
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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1-877-649-2073 / TTY 711. Call-center hours (ET): Mon-Fri 8am-10pm; Sat 9am-8pm; Sun closed.
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