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Plan Benefit Comparison                            

Find the plan that's right for you. We offer four flexible levels of coverage to fit a variety of needs. Take a moment to compare the different plans below and learn what more than 90,000 members across Minnesota already know – UCare for Seniors gives you more from your Medicare plan.

Classic and Value Plus are only available in certain counties in Minnesota.

Classic

Value Plus

Value

Essentials Rx

Monthly premium*

$181 

$135

$39

$52

Primary care doctor office visits

$0 copay

$0 copay

$0 copay

$15 copay

Specialist office visits

$20 copay

$30 copay

$30 copay

$40 copay

Inpatient hospital care

$200 per stay (not per day), then 100%

$400 per stay (not per day), then 100%

$400 per stay (not per day), then 100%

$300 per day (days 1-5), then 100%

Emergency care

$75 copay

$75 copay

$75 copay

$75 copay

Medicare Part D prescription drug coverage

Deductible: $0

Copays based on drug tiers

Coverage for many generics while in gap

Deductible: $50

Copays based on drug tiers

Not covered

Deductible: $100

Copays based on drug tiers

Preventive dental coverage

Included:

Preventive coverage

Optional:

UCare Comprehensive Dental Coverage ($24 additional)

Included:

Preventive coverage

Included:

Preventive coverage

Included:

Preventive coverage

Vision coverage

$0 copay for annual routine eye exam.

$0 copay for Medicare-covered glaucoma screening.

$20 copay for diagnostic eye exams.

$75 annual plan benefit maximum for eyeglasses or contacts at any provider.

$0 copay for annual routine eye exam.

$0 copay for Medicare-covered glaucoma screening.

$30 copay for diagnostic eye exams.

$0 copay for annual routine eye exam.

$0 copay for Medicare-covered glaucoma screening.

$30 copay for diagnostic eye exams.

$0 copay for annual routine eye exam.

$0 copay for Medicare-covered glaucoma screening.

$40 copay for diagnostic eye exams.

Hearing coverage
EPIC Hearing Health Care Network/EPIC hearing discount

$0 copay for annual routine hearing test.

$20 copay for diagnostic hearing exams.

$500 benefit allowance every 36 months for hearing aids (does not accrue).

$0 copay for annual routine hearing test.

$30 copay for diagnostic hearing exams.

 

$0 copay for annual routine hearing test.

$30 copay for diagnostic hearing exams.

$0 copay for annual routine hearing test.

$40 copay for diagnostic hearing exams.

Fitness programs

SilverSneakers®
OR
Health Club Savings

SilverSneakers®
OR
Health Club Savings

SilverSneakers®
OR
Health Club Savings

SilverSneakers®
OR
Health Club Savings

Out-of-pocket maximum

$3,400 per year**

$3,400 per year**

$3,400 per year**

$3,400 per year**

 

For more plan comparison information, check out A Guide to Comparing Your Options (PDF).

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or copayments/coinsurance may change on January 1 of each year.

*You must continue to pay your Medicare Part B premium.

**Out-of-pocket maximum refers to the out-of-pocket limit for in-network, Medicare-covered services.