Be sure to read this important information before you enroll.

Find the Plan That’s Right for You

We offer three levels of coverage to fit a variety of needs. Take a moment to compare the different plans below and learn what more than 60,000 members across Minnesota and western Wisconsin already know. UCare for Seniors gives you more from your Medicare plan.

	Classic	Value Plus	Value
2010 Monthly premium +	Minnesota Metro: $110 Greater: $129 Wisconsin: $128	Minnesota Metro: $64 Greater: $62.50 Wisconsin: $61.50	Minnesota Metro: $35 Greater: $44 Wisconsin: $51
No co-pay for primary care doctor office visits
Specialist office visits	$15 co-pay per visit.	$30 co-pay per visit.	$30 co-pay per visit.
Inpatient hospital care	100% after $150, co-pay per inpatient admission.	100% after $300, co-pay per inpatient admission.	100% after $300, co-pay per inpatient admission.
Worldwide emergency care	$50 co-pay; co-pay is waived if admitted to the hospital within 24 hours for the same condition.	$50 co-pay; co-pay is waived if admitted to the hospital within 24 hours for the same condition.	$50 co-pay; co-pay is waived if admitted to the hospital within 24 hours for the same condition.
Prescription drug coverage	On drug costs between $0 and $2,830 with co-pays. Once $2,830 in actual prescription drug costs is reached, prescription coverage on generic drugs with co-pays. After total out-of-pocket costs of $4,550, $2.50-$6.30 co-pay or 5% co-insurance (whichever is greater) on all covered drugs.	On drug costs between $0 and $2,830 with co-pays. After total out-of-pocket costs of $4,550, $2.50-$6.30 co-pay or 5% co-insurance (whichever is greater) on all covered drugs.	N/A
Dental coverage	Preventive dental paid in full. Two oral exams, three cleanings (one must be a gum cleaning) per year. X-rays once per year. Additional Comprehensive Dental coverage available for $20/month.	N/A	N/A
Vision Coverage	$75 annual plan benefit maximum for eyeglasses or contacts at any provider.	N/A	N/A
Hearing aid benefit	$500 plan benefit maximum every 36 months.	N/A	N/A

For more plan comparison information, check out The Guide to Comparing Your Options.

Minnesota

Wisconsin

^†You must continue to pay your Medicare Part B premium if not paid for under Medicaid or by another third-party.

December 2009

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