2025 UCare Your Choice Plan Documents and Forms
UCare Your Choice
Formulary (list of covered drugs)
Provider and Pharmacy Directory (PDF)
Service area map (PDF)
Plan Rating Information (PDF)
Plan Rating Information - Spanish (PDF)
Member Release of Information Form (PDF)
Statement of Representative Form (PDF)
Power of Attorney short form
Deceased Member: Affidavit for the Collection of Personal Property (mncourts.gov)
Automatic Payment Form (PDF)
Online Automatic Payment Form
Claim Reimbursement Form (PDF)
Advance Directives (PDF)
UCare Medicare Advantage Plans Overview (PDF)
Annual Notice of Changes (PDF)
UCare Your Choice Summary of Benefits - Metro/North (PDF)
UCare Your Choice Summary of Benefits - South (PDF)
UCare Your Choice Summary of Benefits - South - Spanish (PDF)
Plan Comparison Chart - Metro (PDF)
Plan Comparison Chart - North (PDF)
Plan Comparison Chart - South (PDF)