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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 OH. This plan received an overall rating of 3 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 $29.70. 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 your deductible, you will pay the costs for your prescriptions, but the exact amount is not provided. This plan may offer a reduced premium if you qualify for the low-income subsidy, with a monthly Part D premium of $29.70. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you will pay nothing for covered Part D drugs. However, the exact cost-sharing details for each drug tier are not provided in this summary.
Additional Benefits
The Molina Medicare Complete Care (HMO D-SNP) plan offers a wide range of benefits with varying cost-sharing. Many services, such as vision exams, transportation to health-related locations, and home health services, have no copay. Other services, including outpatient, partial hospitalization, emergency, and primary care services, have a coinsurance of up to 20%. The plan also covers hearing and dental services, with specific details on coverage for hearing aids and a range of dental procedures. Additionally, it includes benefits for home infusion, dialysis, medical equipment, diagnostic and radiological services, and other services like acupuncture and over-the-counter items. Prior authorization may be required for some services.
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 for inpatient hospital, non-Medicare-covered stays, and upgrades for inpatient hospital acute, and additional days for inpatient hospital psychiatric, and non-Medicare-covered stay for inpatient hospital psychiatric are not covered. Copays apply for covered services.
Outpatient Services See details
Outpatient services, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services, are covered. Outpatient hospital services, observation services, and outpatient blood services have a 20% coinsurance, while individual and group sessions for outpatient substance abuse have a coinsurance of 20%.
Partial Hospitalization See details
Partial Hospitalization is covered by the Molina Medicare Complete Care (HMO D-SNP) plan, but requires prior authorization. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including both ground and air ambulance services, as well as transportation to any health-related location. Both ground and air ambulance services have a 20% coinsurance, while transportation services to any health-related location have no copay or coinsurance.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by Molina Medicare Complete Care (HMO D-SNP). Emergency Services and Urgently Needed Services have a 20% coinsurance, and 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 (up to 12 visits per year), occupational therapy services with 20% coinsurance, physician specialist services with 20% coinsurance, and physical therapy and speech-language pathology services with 20% coinsurance. The plan does not cover mental health specialty services individual and group sessions, Podiatry Services.
Preventive Services See details
Preventive Services, including Medicare-covered preventive services, annual physical exams, and additional preventive services, are covered. Kidney Disease Education Services, Glaucoma Screenings, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visits are covered with a 20% coinsurance.
Hearing Services See details
The Molina Medicare Complete Care (HMO D-SNP) plan covers hearing exams with a coinsurance of at most 20% and routine hearing exams, including fitting/evaluation for hearing aids, once per year. Prescription hearing aids are partially covered, while OTC hearing aids are covered with a quantity of 2 every two years.
Vision Services See details
Vision services include eye exams, with no deductible and no copay, and routine eye exams are covered once per year. Eyewear is covered with a combined maximum of $200 per year, and contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered.
Dental Services See details
The Molina Medicare Complete Care (HMO D-SNP) plan covers a range of dental services, including oral exams, dental X-rays, prophylaxis (cleaning), fluoride treatment, orthodontics, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable), and oral and maxillofacial surgery. Maxillofacial prosthetics, implant services, prosthodontics (fixed), and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under 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), Prosthetics/Medical Supplies, and Diabetic Equipment. DME and Diabetic Supplies have a 20% coinsurance, while Prosthetic Devices and Medical Supplies have a 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with no copay. For Diagnostic Procedures/Tests and Lab Services, you pay a coinsurance of at most 20%, and for Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services, you also pay 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 Additional Hours of Care and Personal Care Services are not covered. Prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but none of the sub-services are covered. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but additional days beyond Medicare-covered and non-Medicare-covered stays are not covered. This plan requires prior authorization for SNF services, and the copay information is available within the plan details.
Other Services See details
Other Services include acupuncture, over-the-counter (OTC) items, and a meal benefit. Acupuncture has a limit of 12 treatments per year. The plan provides OTC items as a supplemental benefit and covers nicotine replacement therapy (NRT) and Naloxone. The meal benefit requires prior authorization. The plan does not cover 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.
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