Important Information

You must read this information before you enroll in UCare’s MSHO.

• UCare's MSHO is a coordinated care plan with a Medicare Advantage contract and a contract with the Minnesota Medicaid program.
• This plan is available to individuals who are age 65 or over, receive Medicaid (Medical Assistance) from the state, have Medicare Parts A and B, and live in the service area.
• You must use network providers except in emergency or urgent care situations, open access services, out-of-network dialysis services, or any other services previously authorized. If you obtain routine care from out-of-network providers, neither Medicare nor UCare will be responsible for the costs.
• Eligible beneficiaries can enroll at any time, effective the first of the following month.
• You must pay your Medicare Part B premium unless it is paid for by the State. 
• Limitations, co-payments, and restrictions may apply.
• Because you have Medical Assistance, you qualify for and are getting Extra Help to pay for your prescription drug premiums and costs. If you have questions about Extra Help, call:
  • 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/7 days a week;
  • The Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call 1-800-325-0778; or
  • Your State Medicaid office.
• Co-pays and co-insurance may vary based on the level of Extra Help received. Contact the plan for further details.
• Eligible beneficiaries must use network pharmacies to access their prescription drug benefit, except under non-routine circumstances. Quantity limitations and restrictions may apply.
• UCare has contracts with pharmacies that equal or exceed CMS requirements for pharmacy access in your area.
• The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information, contact the plan.
• Benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change on January 1, 2013.
• For information about Coverage Determinations, Appeals, and Grievances, click here.
• Sales kit materials:
• Cover Letter (PDF) (coming soon) 
• Formulary (PDF)
• Summary of Benefits (PDF)
• Plan Rating Information (PDF)
• Primary Care Network Listing (PCNL) (PDF)

• UCare’s MSHO has been approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) until December 31, 2014. NCQA’s approval is based on a review of UCare’s MSHO’s Model of Care and is an indicator of compliance with CMS requirements. NCQA’s approval is not an endorsement by CMS and/or NCQA of UCare’s MSHO or the quality of service provided by UCare’s MSHO. UCare’s MSHO will still need to be approved each year by CMS in order to operate. If you have questions regarding our approval by the NCQA, please contact us at 612‑676‑6868 or 1‑866‑280‑7202 (toll free), 8 a.m. to 8 p.m., daily. TTY: 612‑676‑6810 or 1‑800‑688‑2534 (toll free).

• This information is available in alternate formats or languages. Please call 1-800-707-1711 toll free (TTY: 1-800-688-2534 toll free) to request this information in other formats or languages.