Individual & Family Plans
Documents and Information

For 2018 documents click here.

View the documents below for benefit and coverage information, including deductibles, copays and emergency services. To request a hard copy mailed to you, send us a message through your acccount in the Member Portal or call Customer Services.

UCare Individual & Family Plans

New Member Booklet (PDF)

Formulary
Provider and Pharmacy Directory (PDF)
Service Area Map (PDF)

Automatic Payment Form (PDF)
Claim Reimbursement Form (PDF)
Prescription Drug Reimbursement Form (PDF)

UCare Individual & Family Plans with Fairview

New Member Booklet (PDF)

Formulary
Provider and Pharmacy Directories (PDF)
Service Area Map (PDF)

Automatic Payment Form (PDF)
Claim Reimbursement Form (PDF)
Prescription Drug Reimbursement Form (PDF)

Cost sharing reduction (CSR) plans

CSR plans help reduce your out-of-pocket costs by lowering your deductibles and coinsurance. You must meet certain income levels (determined by MNsure) to enroll in a CSR plan.

“A” plans have 100% cost sharing reductions; “B” plans have limited cost sharing variations; Silver “2” plans have 73% cost sharing reduction; Silver “3” plans have 87% cost sharing reduction; and Silver “4” plans have 94% cost sharing reduction. If you are unsure which plan you qualify for, please call us at 1-855-307-6985.