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Minnesota 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 nearly 100,000 members across Minnesota and western Wisconsin 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†

$168 

$115 

$44

$48

Primary care doctor office visits

$0

$0 

 $0

$15

Specialist office visits

$20

$30

$30

$40

Inpatient hospital care

$200 per admission

$400 per admission

$400 per admission

$300 per day (days 1-5)

Emergency care

$65 co-pay

$65 co-pay

$65 co-pay

$65 co-pay

 

Medicare Part D prescription drug coverage 

Deductible: $0

 

Copays based on drug tiers 

 

Deductible: $0

Copays based on drug tiers 

 

Not covered

Deductible: $75

Copays based on drug tiers 

Preventive dental coverage

 

UCare Comprehensive Dental 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

$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
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 - Minnesota (PDF).

The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.

Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January of each year.

Limitations, co-payments, and restrictions may apply.

†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.