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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 $590 deductible for prescription drugs. After you meet the deductible, you will pay the costs for drugs in each tier until your total drug costs reach $2000, at which point you enter the next coverage phase. If you qualify for the low-income subsidy, the plan's premium is $15.60.
Additional Benefits
The Molina Medicare Complete Care (HMO D-SNP) plan offers a variety of benefits with a focus on outpatient and preventative care. Many services, including outpatient services, primary care, and dental services, have a 20% coinsurance. This plan also includes no copay for emergency services, preventive services like annual physical exams, and home health services. Additional benefits include coverage for hearing and vision services, with some limitations on hearing aids and eyewear. The plan also covers home infusion services, dialysis, medical equipment, and diagnostic services with varying coinsurance rates. However, it's important to note that certain services like orthodontic, and private duty nursing are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, but additional days, non-Medicare covered stays, and upgrades for Inpatient Hospital-Acute and additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered. The coinsurance for covered services is based on the Original Medicare cost share.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, are covered, with a 20% coinsurance. Outpatient substance abuse services and outpatient blood services are also covered, with a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered by Molina Medicare Complete Care (HMO D-SNP) with prior authorization. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required. Ground and air ambulance services have a 20% coinsurance, while transportation services to a plan-approved health-related location are not covered, and transportation services to any health-related location are 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. For Emergency Services and Urgently Needed Services, there is a 20% coinsurance and no copay. Worldwide Emergency Services are covered, with a maximum benefit 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, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services. Primary Care Physician Services, Physician Specialist Services, Physical Therapy and Speech-Language Pathology Services, have a 20% coinsurance. Chiropractic Services, Occupational Therapy Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, and Opioid Treatment Program Services have a 20% coinsurance. Individual and Group Sessions for Mental Health and Psychiatric Services have a 20% coinsurance.
Preventive Services See details
The Molina Medicare Complete Care (HMO D-SNP) plan covers preventive services, including annual physical exams, with no copay. The plan also covers additional preventive services such as Health Education, Personal Emergency Response System (PERS), Nutritional/Dietary Benefit (12 visits), Additional Sessions of Smoking and Tobacco Cessation Counseling (8 visits), and Fitness Benefit. The plan has a 20% coinsurance for Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit. In-Home Safety Assessment, Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline), Home and Bathroom Safety Devices and Modifications, and Counseling Services are not covered.
Hearing Services See details
Hearing Services are partially covered under the Molina Medicare Complete Care (HMO D-SNP) plan. Hearing exams have a coinsurance of at most 20%, but routine hearing exams and fitting/evaluation for hearing aids are not covered, and prescription and OTC hearing aids are not covered.
Vision Services See details
Vision services include eye exams and eyewear, and the plan covers Routine Eye Exams, Contact Lenses, Eyeglasses (lenses and frames), Eyeglass lenses, and Eyeglass frames. Eye exams have a 20% coinsurance, and the plan offers a combined maximum of $200 per year for eyewear.
Dental Services See details
Dental services are covered, with a 20% coinsurance. 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, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and coinsurance between 0-20%, and coinsurance applies for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, with a range of 0-20%.
Dialysis Services See details
Dialysis Services are covered under the Molina Medicare Complete Care (HMO D-SNP) plan. You will pay a coinsurance of 20% for these services.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance and requires prior authorization, while Durable Medical Equipment for use outside the home is not covered. Prosthetics/Medical Supplies have a 20% coinsurance for Medicare-covered items, and Diabetic Supplies and Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including all diagnostic services, lab services, and radiological services. All diagnostic services and radiological services have no copay and a coinsurance of at most 20%, while lab services have no copay and a coinsurance of at most 20%.
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 prior authorization is required. Additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but specific services including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Prior authorization is required for Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but additional days beyond Medicare-covered SNF stays and non-Medicare-covered stays are not covered. Prior authorization is required, and the copay information is available in the plan details.
Other Services See details
Under the Molina Medicare Complete Care (HMO D-SNP) plan, 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. Over-the-Counter (OTC) Items and Meal Benefit are covered, with the meal benefit requiring prior authorization.
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