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Molina Complete Care for MyCare Ohio (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Molina Complete Care for MyCare Ohio (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 Complete Care for MyCare Ohio (HMO D-SNP) in 2026, please refer to our full plan details page.
Molina Complete Care for MyCare Ohio (HMO D-SNP) is a HMO D-SNP plan offered by Molina Healthcare, Inc. available for enrollment in 2026 to people living in Ohio State. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Molina Complete Care for MyCare Ohio (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 Complete Care for MyCare Ohio (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 Complete Care for MyCare Ohio (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 Complete Care for MyCare Ohio (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $19.60. 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 $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 Complete Care for MyCare Ohio (HMO D-SNP) plan has an annual prescription drug deductible of $615. You will pay no copay for Tier 1 preferred generic drugs and Tier 6 select care drugs when filled through standard pharmacies or standard mail order. This $0 cost-sharing applies to one-, two-, and three-month supplies. For other medication tiers, cost-sharing is structured as a percentage of the drug cost. Tier 2 generic and Tier 3 preferred brand drugs both carry a 20% coinsurance, while Tier 4 non-preferred drugs require a 30% coinsurance. Tier 5 specialty drugs are subject to a 25% coinsurance for a one-month supply through standard pharmacies or standard mail order.
Additional Benefits
The Molina Complete Care for MyCare Ohio (HMO D-SNP) offers comprehensive medical coverage featuring no copayments for most services, though coinsurance rates apply in several areas. For instance, inpatient hospital stays, skilled nursing facility care, and home health services are covered with no copay and no coinsurance. However, outpatient services, primary care, emergency care, and specialist visits require no copay but carry coinsurance rates ranging from 20% to 30%. Diagnostic testing, dialysis, and medical equipment are also available with no copay and a 20% coinsurance. While preventive care, diagnostic hearing exams, and Medicare-covered dental care feature no copay and no coinsurance, routine vision, routine dental, and routine hearing services are generally not covered under this plan. Additionally, members can access select extra benefits like acupuncture and post-hospitalization meals with no copay and no coinsurance.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Molina Complete Care for MyCare Ohio (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required. This benefit does not cover additional days, upgrades, or non-Medicare-covered stays.
Outpatient Services See details
Molina Complete Care for MyCare Ohio (HMO D-SNP) covers outpatient services, including outpatient hospital, ambulatory surgical center, substance abuse, and blood services, with no copay and a 20% coinsurance. Prior authorization is required for most of these outpatient services, and there is no deductible for blood services.
Partial Hospitalization See details
Partial hospitalization is covered by Molina Complete Care for MyCare Ohio (HMO D-SNP) with no copay and a 30% coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Molina Complete Care for MyCare Ohio (HMO D-SNP) covers Medicare-approved ground and air ambulance services with a 20% coinsurance and no copay, though prior authorization is required. Routine transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Molina Complete Care for MyCare Ohio (HMO D-SNP) covers emergency and urgently needed services with a 30% coinsurance and no copay, with the emergency coinsurance waived if you are admitted to the hospital within 24 hours. Worldwide emergency, urgent, and transportation services are also covered up to a $10,000 limit with no copay and no coinsurance.
Primary Care See details
Molina Complete Care for MyCare Ohio (HMO D-SNP) covers primary care, specialist, mental health, and therapy services with no copay and a 30% coinsurance. Chiropractic care is partially covered with no copay and no coinsurance for up to 12 routine visits per year (other chiropractic services are not covered), while podiatry services are not covered.
Preventive Services See details
Molina Complete Care for MyCare Ohio (HMO D-SNP) partially covers preventive services, offering annual physicals and select wellness benefits with no copay and no coinsurance, while other services like glaucoma screenings and kidney disease education have no copay and a 20% coinsurance. Excluded services that are not covered under this benefit include medical nutrition therapy, weight management, alternative therapies, therapeutic massage, adult day health, home-based palliative care, in-home support, caregiver support, and counseling.
Hearing Services See details
Hearing services are partially covered by Molina Complete Care for MyCare Ohio (HMO D-SNP), offering covered diagnostic hearing exams with no copay, no deductible, and no coinsurance. However, routine hearing exams, hearing aid fitting evaluations, over-the-counter (OTC) hearing aids, and prescription hearing aids are not covered under this plan.
Vision Services See details
Molina Complete Care for MyCare Ohio (HMO D-SNP) covers vision services with no copay, no coinsurance, and no deductible, but only some services are covered in practice. Routine eye exams, other eye exam services, contact lenses, and eyeglasses, including lenses, frames, and upgrades, are not covered.
Dental Services See details
Molina Complete Care for MyCare Ohio (HMO D-SNP) partially covers dental services, offering Medicare-covered dental care with no copay and no coinsurance. Other dental services, including preventive care like cleanings, oral exams, and x-rays, as well as restorative, prosthetic, and orthodontic services, are not covered.
Home Infusion bundled Services See details
Molina Complete Care for MyCare Ohio (HMO D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs carry a $35 copay and coinsurance ranging from no coinsurance to 20%, while chemotherapy and other Part B drugs have no copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered by Molina Complete Care for MyCare Ohio (HMO D-SNP) with no copay and a 20% coinsurance.
Medical Equipment See details
Molina Complete Care for MyCare Ohio (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with no copay and a 20% coinsurance. Prior authorization is required for these benefits, and certain supplies may be limited to preferred vendors or manufacturers.
Diagnostic and Radiological Services See details
Molina Complete Care for MyCare Ohio (HMO D-SNP) covers diagnostic and radiological services with no copay, subject to a minimum 20% coinsurance and prior authorization. This coverage includes outpatient diagnostic tests, lab services, diagnostic and therapeutic radiological services, and outpatient x-rays.
Home Health Services See details
Molina Complete Care for MyCare Ohio (HMO D-SNP) covers home health services with no copay and no coinsurance. Prior authorization is required before receiving these services.
Cardiac Rehabilitation Services See details
Molina Complete Care for MyCare Ohio (HMO D-SNP) covers cardiac rehabilitation services with no copay and prior authorization, although only some services are covered. Specifically, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy for peripheral artery disease are not covered and require a 30% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by Molina Complete Care for MyCare Ohio (HMO D-SNP) with no copay and no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. While standard Medicare-covered days are fully included, additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by Molina Complete Care for MyCare Ohio (HMO D-SNP), offering acupuncture, over-the-counter items, and meal benefits with no copay and no coinsurance, though some specific other services are not covered. Covered benefits include up to 12 acupuncture treatments per year and prior-authorized meals following a hospitalization or for chronic illness.
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