Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026

Molina Medicare Complete Care, 2027

H5628Contract013Plan

HMO D-SNP · special needs plan, dual-eligible · 43 counties in Idaho

Run by Molina Healthcare of Utah, Inc. (contract H5628), sold as Molina Healthcare of Utah & Idaho, owned by Molina Healthcare, Inc.

Renews for 2027

2026 star rating, contract H5628: 3 of 5

Molina Medicare Complete Care (H5628-013) costs $45.50 a month in 2027, up $7.90 from 2026, with an in-network out-of-pocket limit of $9,850 ($9,250 in 2026).

What changes from 2026 to 2027?

The changed lines are marked and come first. In-network amounts; members keep paying the Part B premium unless the plan reduces it. The plan files its benefits in parts for different counties, so lines marked ◆ show the most generous part of its area and some counties get less: the plan's Evidence of Coverage gives your county's amounts.
What you pay or get	2026	2027	Change
Monthly premium	$37.60	$45.50	up $7.90
In-network out-of-pocket limit	$9,250	$9,850	up $600
Drug deductible	$615	$700	up $85
Hospital stay, in network (best in its area)	not filed	$2,241 a stay	changed
Drug tier 2, generic	20% of the cost	25% of the cost	up 5 points
Drug tier 3, preferred brand	20% of the cost	25% of the cost	up 5 points
Drug tier 4, non-preferred drug	30% of the cost	26% of the cost	down 4 points
15 lines do not change
Part B premium reduction, monthly (best in its area)	none	none	no change
Primary care visit (best in its area)	30% of the cost	30% of the cost	no change
Specialist visit (best in its area)	30% of the cost	30% of the cost	no change
Emergency room (best in its area)	30% of the cost	30% of the cost	no change
Medical deductible, in network (best in its area)	none	none	no change
Skilled nursing facility, in network (best in its area)	not filed	not filed	no change
Ground ambulance, in network (best in its area)	20% of the cost	20% of the cost	no change
Comprehensive dental, yearly limit (best in its area)	not offered	not offered	no change
Eyewear, yearly limit (best in its area)	$250 a year	$250 a year	no change
Hearing aids, yearly limit for both ears (best in its area)	not offered	not offered	no change
Over-the-counter items, yearly (best in its area)	not offered	not offered	no change
Counties served	43	43	no change
Drug tier 1, preferred generic	$0	$0	no change
Drug tier 5, specialty tier	25% of the cost	25% of the cost	no change
Drug tier 6, select care drugs	$0	$0	no change

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS plan benefit package files, 2027 and 2026; CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026). Plan details can change during the year; confirm on Medicare Plan Finder.

What will prescriptions cost?

Your share for a 30-day supply at a retail pharmacy, as filed with CMS; tiers whose share changes are marked
Tier	What the tier holds	2026	2027
Tier 1	Preferred Generic	$0	$0
Tier 2	Generic	20% of the cost	25% of the cost
Tier 3	Preferred Brand	20% of the cost	25% of the cost
Tier 4	Non-Preferred Drug	30% of the cost	26% of the cost
Tier 5	Specialty Tier	25% of the cost	25% of the cost
Tier 6	Select Care Drugs	$0	$0

Source: CMS plan benefit package files, 2027 and 2026. Insulin is capped at $35 a month by law. A drug's tier is set by the plan's formulary.

How does it compare with plans sold where it is?

In the counties it serves, 4 dual-eligible special needs plans are sold for 2027, this one included. Against the others, 3 the same. On the premium, 3 plans have a lower premium.

Out-of-pocket limits of the 4 dual-eligible special needs plans

$0 to under $2,0000 plans

$2,000 to under $4,0000 plans

$4,000 to under $6,0000 plans

$6,000 to under $8,0000 plans

$8,000 to $10,000 (this plan)4 plans

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).

Where is it sold, and what does it cost there?

The premium and the out-of-pocket limit are the same in all 43 counties: $45.50 a month and $9,850.

Idaho

Ada Adams Bannock Bear Lake Benewah Bingham Blaine Boise Bonner Bonneville Boundary Butte Camas Canyon Caribou Cassia Clark Clearwater Custer Elmore Franklin Fremont Gem Gooding Idaho Jefferson Jerome Kootenai Latah Lewis Lincoln Madison Minidoka Nez Perce Oneida Owyhee Payette Power Shoshone Teton Twin Falls Valley Washington

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).

Who runs this plan?

Plan ID: H5628-013
Legal name of the contract: Molina Healthcare of Utah, Inc.
Sold as: Molina Healthcare of Utah & Idaho
Parent company: Molina Healthcare, Inc.
Plan type: HMO D-SNP
2026 star rating of the contract: 3 of 5 overall; health plan 3 of 5, drug plan 3.5 of 5
Members, September 2026: 10,162
Plan website, as filed with CMS: https://www.molinahealthcare.com/members/id/en-us/

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS 2026 Star Ratings (October 2025); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11). CMS publishes the 2027 Star Ratings in October 2026.

What else should you check?

Other 2027 plans in Ada, IDWhere most of its members live; premiums and limits side by side
Every Molina Healthcare of Utah & Idaho plan for 2027Its contracts, counties and plans that end
The other 1 plan of contract H5628Same company, same contract
Is your prescription covered?Coverage share and tier for 2,259 drugs

Data, not advice. These are the plan's filed amounts, not a quote for you; confirm on Medicare Plan Finder or call the plan before you enroll.