Medical Services Authorizations
UCare Individual & Family Plans and UCare Individual & Family Plans with M Health Fairview
Authorization and Notification Requirements - Medical Services
Review UCare Individual & Family Plans Requirements:
Forms & Information
Durable Medical Equipment/Supply Prior Authorization Form
General Prior Authorization Request Form (Not used for Behavioral Health services)
Genetic Testing Prior Authorization Form
Hospice Election Form
Transplant Notification Form
Universal Health Plan/Home Health Agency Prior Authorization Request Form
For SNF Medically Necessary Private Room Requests, UCare will accept either the DHS Private Room Request Form found in the DHS Nursing Home portal or the necessary details added to the Nursing Home/Swing Bed Admission/Update Form.
Nursing Home/Swing Bed Admission/Update Form
UCare has partnered with Magellan to manage the utilization and quality of its members’ outpatient and in-home rehabilitative and habilitative therapy services. You must register to access functionality that will help you with your UCare Therapy Authorizations.
Direct all authorization questions to Magellan Healthcare | 952-225-5700 or 1-888-660-4705, Fax: 1-888-656-1952
The forms below may be used when referring members to the UCare Individual & Family Plans Restricted Member Program:
UCare Individual & Family Plans Medical Referral for UCare Restricted Member Enrollee
UCare Individual & Family Plans Prescribing Privileges for PCP Partners
UCare Individual & Family Plans Restricted Member Program Intake Form
All Products
This form is intended to communicate patient referrals between medical and behavioral health providers.
Authorization Contact Information
UCare Clinical Services
Phone (local): 612-676-6705
Phone (toll free): 1-877-447-4384
Fax: 612-884-2499
Provider Resources
View Authorization Requirements & Forms For Another Plan
*UCare Medicare Plans include Aware, Classic, Complete, Essentials Rx, Prime, Standard, Value and Value Plus,
Advocate Choice, Advocate Choice Plus and UCare Medicare Supplement.
UCare Individual & Family Plans include Core, Bronze, Bronze HSA, Silver, Silver HSA and Gold; and
UCare Individual & Family Plans with M Health Fairview Bronze, Bronze HSA, Silver, Silver HSA and Gold.