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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
Medical Dental Individual and Family Plans CP-IFP21-009A 2021-05-01
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
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