UCare's Coverage Policies
These coverage policies describe UCare’s application of coverage rules and methodologies for claims submitted under UCare’s health benefit plans. This information is offered as a helpful resource regarding UCare coverage policies. UCare cannot address every possible aspect of a reimbursement scenario.
View the Annual Review of 2022 Coverage Policies.
Coverage Policies
| Name | Product | Policy Number | Effective Date |
|---|---|---|---|
| Allergy Injections | Individual and Family Plans | CP-IFP21-0021A | 2022-01-01 |
| Bone Mineral Density Studies | Individual and Family Plans | CP-IFP22-032A | 2022-10-01 |
| Category III Codes | Individual and Family Plans | CP-IFP22-026A | 2022-07-01 |
| Coverage for Routine Costs for Members Participating in Clinical Trialstine | Individual and Family Plans | CP-IFP20-001A | 2021-01-01 |
| Colorectal Cancer Tests (Preventative & Diagnostic) | Individual and Family Plans | CP-IFP21-012A | 2021-10-01 |
| Cosmetic Services | Individual and Family Plans | CP-IFP22-027A | 2022-07-01 |
| Coverage Related to Diabetes | Individual and Family Plans | CP-IFP21-015A | 2021-12-01 |
| DME Compression Stockings & Wraps | Individual and Family Plans | CP-IFP21-014A | 2021-12-01 |
| Durable Medical Equipment (DME) | Individual and Family Plans | CP-IFP21-006A | 2021-05-01 |
| Enteral/Total Parental Nutrition (TPN) | Individual and Family Plans | CP-IFP20-002A | 2021-01-01 |
| Eyewear for Children | Individual and Family Plans | CP-IFP20-003A | 2021-01-01 |
| Fetal Aneuploidy | Individual and Family Plans | CP-IFP21-017A | 2022-01-01 |
| Gender-Affirming Treatment | Individual and Family Plans | CP-IFP23-0033A | 2023-01-01 |
| Home Health Services | Individual and Family Plans | CP-IFP20-004B | 2021-01-01 |
| Home Hospice Services | Individual and Family Plans | CP-IFP20-005A | 2021-01-01 |
| Infertility Diagnosis | Individual and Family Plans | CP-IFP21-011A | 2021-10-01 |
| DME: Mastectomy Bras and External Breast Prosthesis | Individual and Family Plans | CP-IFP22-023A | 2022-04-01 |
| Maternity Services | Individual and Family Plans | CP-IFP23-034A | 2023-05-01 |
| Medical Dental | Individual and Family Plans | CP-IFP21-009A | 2021-05-01 |
| Member Reimbursement | Individual and Family Plans | CP-IFP23-035A | 2023-05-01 |
| Online Care/E-Care/Telemedicine (Including Retail/Convenience Clinic Visits) | Individual and Family Plans | CP-IFP21-008A | 2021-05-01 |
| Palliative Care | Individual and Family Plans | CP-IFP21-010A | 2021-10-01 |
| DME Pneumatic Compression and Lymphedema Pumps | Individual and Family Plans | CP-IFP21-020A | 2021-12-01 |
| Preventive Services Adults/Female/Children | Individual and Family Plans | CP-IFP21-013B | 2021-10-01 |
| Rabies Vaccine | Individual and Family Plans | CP-IFP22-029A | 2022-07-01 |
| Eye Exams for Adults | Individual and Family Plans | CP-IFP21-022A | 2022-01-01 |
| Septoplasty | Individual and Family Plans | CP-IFP21-019B | 2021-12-01 |
| Telemonitoring | Individual and Family Plans | CP-IFP22-024A | 2022-04-01 |
| Travel Vaccines | Individual and Family Plans | CP-IFP22-028A | 2022-07-01 |
| DME: Scalp Hair Prosthesis (Wigs) | Individual and Family Plans | CP-IFP22-025A | 2022-04-01 |
| Bone Mineral Density Studies | Medicaid | CP-MCD22-004A | 2022-10-01 |
| Male Circumcision | Medicaid | CP-MCD20-001B | 2021-01-01 |
| Enhanced Asthma Care Services for Children | Medicaid | CP-MCD22-003A | 2022-01-01 |
| Septoplasty | Medicaid | CP-MCD22-004A | 2022-07-01 |
| Telemonitoring Remote Physiological Monitoring Services | Medicaid | CP-MCD22-002A | 2022-04-01 |
| Bone Mineral Density Studies | Medicare | CP-MCR22-006A | 2022-10-01 |
| Category III Codes | Medicare | CP-MCR22-003A | 2022-07-01 |
| Member Reimbursement | Medicare | CP-MCR23-007A | 2023-05-01 |
| Medicare Exams | Medicare | 2022-12-19 | |
| Medicare Physical Exam Coverage | Medicare | CP-MCR22-005A | 2022-07-01 |
| Post Stabilization Care-Medicare | Medicare | CP-MCR21-001A | 2022-01-01 |
| Septoplasty | Medicare | CP-MCR22-004A | 2022-07-01 |
| Medicare Transplants Lodging and Transportation Related Expenses Member Reimbursement | Medicare | CP-MCR22-002A | 2022-04-01 |
| Travel and Lodging Reimbursement Form for Transplant Related Expenses | Medicare | ||
| Worldwide Supplemental Benefit | Medicare | CP-MCR23-008A | 2023-05-01 |