Care Coordination Resources
UCare Connect + Medicare
UCare's resources are sorted by category in the following drawers and meant to help you work with our members.
Click a drawer to open it and access the resource links.
For more resources on UCare's other products, please select a plan from the drop down menu and click Change Plan to view.
Select Resources For
Connect Requirements Grid (Revised 11/1/2023)
MnCHOICES Connect Requirements Grid (Revised 11/1/2023)
Change of Care Coordination Letter (Revised 8/26/2022)
Connect/Connect + Medicare CC Appointment Letter (New 5/30/2023)
Health Resource Letter (Revised 2/28/2023)
PCP/ICT Support Plan Cover Letter (Revised 2/24/2023)
PCP/ICT Support Plan FAX Cover Sheet (Revised 7/29/2022)
Provider Engagement Letter (Revised 7/6/2022)
Refusal Letter (New 1/5/2022)
Support Plan Letter (Revised 8/31/2022)
Support Plan Signature Letter (Revised 8/31/2022)
Unable to Reach Member Letter (Updated 9/8/2022)
Welcome Letter (Revised 8/2/2022)
Welcome Letter (Waiver) (New 8/2/2022)
2023 Monthly Activity Log (Revised 8/29/2023)
Death Notification Form
Primary Care Clinic Change Request
Refusal Support Plan - PDF (Revised 10/17/2023)
Refusal Support Plan - Word (Revised 11/9/2022)
Release of Information Form (New 1/1/2022)
Support Plan Signature Sheet - MnCHOICES (New 10/2/2023)
Support Plan Member Signature Page (New 5/15/2023)
Support Plan - PDF (Revised 4/26/2023)
Support Plan - Word (Revised 4/17/2023)
Transfer Member Heath Risk Assessment - PDF (Revised 10/31/2023)
Transfer Member Heath Risk Assessment - Word (Revised 10/31/2023)
UTR Support Plan - PDF (Revised 7/10/2023)
UTR Support Plan - Word (Revised 11/9/2022)
Brief Mental Status Exam (MSE) Form
CAGE Questionnaire:
Member Version | Professional Version
Michigan Alcohol Screening Test (MAST):
Member Version | Professional Version
Patient Health Questionnaire - PHQ-9 for Depression
Transition of Care Log (Revised 12/30/2022)
TOC Log Instructions (Revised 12/27/2022)
Transition of Care (TOC) Notification to PCP
Transitions of Care Pharmacist Referral Form
Transition of Care Talking Points