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Enroll in UCare Connect + Medicare (HMO D-SNP)

You have three options for enrollment:

Online Enrollment Form

  • You'll need your Medical Assistance identification (ID) number, Medicare number and an email address to get a validation code.
  • If you need more time, you can save your progress and finish the application later. Access your in-progress application through a link in the original validation email.

Online enrollment form

Mail-in Form

Download and print the enrollment form. Fill it out and mail it to:

UCare
Attn: UCare Connect + Medicare
PO Box 52
Minneapolis, MN 55440

Or fax it to 612-884-2122.

Download enrollment form

Call for Assistance

Call a licensed UCare agent for assistance.

612-676-3554 or 1-800-707-1711,
(TTY: 1-800-688-2534)
8 am – 5 pm, Monday – Friday.

Information about changing plans

When can you end your membership in our plan?
You may end your membership in our plan only during certain times of the year. These are the:

  • Annual Enrollment Period
  • Medicare Advantage Open Enrollment Period

You may also be able to leave the plan during other times of the year if you meet certain requirements.

You may be able to end your membership because you have Medicare and Medicaid.
Most people with Medicare can end their membership only during certain times of the year. Because you have Medicaid, you may be able to end your membership in our plan or switch to a different plan one time during one of three Special Enrollment Periods. They occur:

  • January to March
  • April to June
  • July to September

If you joined our plan during one of these three periods, you’ll have to wait for the next period to either end your membership or switch to a different plan. You can’t use this Special Enrollment Period to end your membership in our plan between October and December. However, anyone with Medicare can make changes from October 15 – December 7 during the Annual Enrollment Period.



You must read this information before you enroll in UCare Connect + Medicare:

  • UCare Connect + Medicare (HMO D-SNP) is a health plan that contracts with both Medicare and the Minnesota Medical Assistance (Medicaid) program to provide benefits of both programs to enrollees. Enrollment in UCare Connect + Medicare depends on contract renewal
  • This plan is available to individuals who are at least age 18 and under age 65, receive Medical Assistance (Medicaid) from the state, have Medicare Parts A and B, and live in the UCare Connect + Medicare 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, copayments, 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 call1-877-486-2048, 24 hours a day/7 days a week;
    • The Social Security Office at 1-800-772-1213 (TTY 1-800-325-0778) 7 am - 7 pm, Monday - Friday; or
    • Your state Medicaid office
  • Copays and coinsurance 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 Center for Medicare and Medicaid Services (CMS) requirements for pharmacy access in your area
  • Find information about Coverage Determinations, Appeals, and Grievances

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