Network Resources
Newsletters & Alerts
Q1 2020 Update to UCare's Provider Manual
UCare’s 2020 Provider Manual contains critical information that providers need to know to effectively work with UCare and our members. It is important that providers reference the online manual regularly for up-to-date content. The Provider Manual has been updated to reflect current business practices. UCare has prepared a Provider Bulletin outlining the key updates.
Read the Provider Bulletin . Go to the 2020 Provider Manual
March 2020 Health Lines
See the March 2020 Health Lines.
UCare Pharmacy COVID-19 Updates
UCare’s Pharmacy Department has been closely monitoring the COVID-19 developments and taking appropriate action to ensure our members have access to medication.
Read the March Provider Bulletin
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Updated February 2020
Region |
UCare Product |
Eligibility |
Service Area |
Narrow network? |
| North | UCare Medicare Plans (HMO-POS) |
Must have Medicare Part A & Part B to enroll Do not have end-stage renal disease |
Aitkin, Becker, Beltrami, Carlton, Cass, Clay, Clearwater, Cook, Crow Wing, Douglas, Grant, Hubbard, Itasca, Kanabec, Kittson, Koochiching, Lake, Lake of the Woods, Mahnomen, Marshall, Morrison, Norman, Otter Tail, Pennington, Pine, Polk, Red Lake, Roseau, St. Louis, Todd, Wadena, Wilkin | All UCare network providers |
| North | UCare Medicare Plans (HMO-POS) |
Must have Medicare Part A & Part B Do not have end-stage renal disease |
Aitkin, Becker, Carlton, Cass, Clay, Cook, Crow Wing, Hubbard, Kanabec, Lake, Morrison, Pine and St. Louis | All UCare network providers |
| Metro | UCare Medicare Plans (HMO-POS) |
Must have Medicare Part A & Part B Do not have end-stage renal disease |
Anoka, Benton, Carver, Chisago, Dakota, Hennepin, Isanti, Mille Lacs, Ramsey, Scott, Sherburne, Stearns, Washington, Wright | All UCare network providers |
| South | UCare Medicare Plans (HMO-POS) |
Have Medicare Part A & Part B Do not have end-stage renal disease |
Big Stone, Blue Earth, Brown, Chippewa, Cottonwood, Dodge, Faribault, Fillmore, Freeborn, Goodhue, Houston, Jackson, Kandiyohi, Lac qui Parle, Le Sueur, Lincoln, Lyon, Martin, McLeod, Meeker, Mower, Murray, Nicollet, Nobles, Olmsted, Pipestone, Pope, Redwood, Renville, Rice, Rock, Sibley, Steele, Stevens, Swift, Traverse, Wabasha, Waseca, Watonwan, Winona, Yellow Medicine | All UCare network providers |
| South | UCare Medicare Plans (HMO-POS) |
Have Medicare Part A & Part B Do not have end-stage renal disease |
Blue Earth, Dodge, Faribault, Fillmore, Freeborn, Goodhue, Houston, Le Sueur, Mower, Nicollet, Olmsted, Rice, Steele, Wabasha, Waseca, Watonwan, Winona | All UCare network providers |
In-Network Services |
|||||||
|---|---|---|---|---|---|---|---|
| Primary Care Office Visits | $0 copay | $25 copay | $0 copay | $20 copay | $0 copay | $0 copay | $0 copay |
| Specialist Office Visits | $35 copay | $50 copay | $20 copay | $45 copay | $40 copay | $10 copay | $35 copay |
| Inpatient Hospital Care | $400 copay per stay (not per day), then 100% coverage, unlimited days per admission | $300 copay per day (days 1 - 5), then 100% coverage, unlimited days per admission | $250 copay per stay (not per day), then 100% coverage, unlimited days per admission | $300 copay per day (days 1 - 5), then 100% coverage, unlimited days per admission | $500 copay per day (days 1 - 3), then 100% coverage, unlimited days per admission | $100 copay per stay (not per day), then 100% coverage, unlimited days per admission | $150 copay per day (days 1 - 5), then 100% coverage, unlimited days per admission |
| Urgent Care | $50 copay | $45 copay | $50 copay | $50 copay | $40 copay | $0 copay | $50 copay |
| Worldwide Emergency Care | $100 copay | $90 copay | $100 copay | $100 copay | $90 copay | $100 copay | $100 copay |
| Medicare Part D Prescription Drug Coverage* | No Prescription Drug Coverage | $400 deductible | Copays based on drug tiers | $200 deductible | Copays based on drug tiers | $400 deductible | Copays based on drug tiers | $400 deductible | Copays based on drug tiers | Copays based on drug tiers | $200 deductible | Copays based on drug tiers |
| Preventive Dental Coverage | Yes | No | Yes | Yes | Yes | No | No |
| Vision Coverage-Routine | Routine Eye Exam: 1 per year, $0 Copay | Routine Eye Exam: Not Covered | Routine Eye Exam: 1 per year, $0 Copay | Routine Eye Exam: 1 per year, $0 Copay | Routine Eye Exam: 1 per year, $0 Copay | Routine Eye Exam: 1 per year, $0 Copay | Routine Eye Exam: 1 per year, $0 Copay |
| Vision Coverage-Diagnostic | Diagnostic Eye Exam: $35 copay | Diagnostic Eye Exam: $50 copay | Diagnostic Eye Exam: $20 copay | Diagnostic Eye Exam: $45 copay | Diagnostic Eye Exam: $40 copay | Diagnostic Eye Exam: $10 copay | Diagnostic Eye Exam: $35 copay |
| Hearing Services-Routine | Routine Hearing Exam: 1 per year, $0 Copay | Routine Hearing Exam: Not Covered | Routine Hearing Exam: 1 per year, $0 Copay | Routine Hearing Exam: 1 per year, $0 Copay | Routine Hearing Exam: 1 per year, $0 Copay | Routine Hearing Exam: 1 per year, $0 Copay; $500 allowed every 36 months for hearing aids | Routine Hearing Exam: 1 per year, $0 Copay |
| Hearing Services-Diagnostic | Diagnostic Hearing Exam: $35 copay | Diagnostic Hearing Exam: $50 copay | Diagnostic Hearing Exam: $20 copay | Diagnostic Hearing Exam: $45 copay | Diagnostic Hearing Exam: $40 copay | Diagnostic Hearing Exam: $10 copay | Diagnostic Hearing Exam: $35 copay |
| Out of Pocket Maximum | $3,400 | $5,000 | $3,400 | $3,400 | $4,500 | $3,000 | $3,000 |
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Benefit and cost share information for UCare Medicare Plans
* Part D deductible only applies to some drugs. See the Drug Formulary for details.