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Provider FAQs: UCare to Suspend Certain Medicare Advantage Products Beginning in 2026

Page last updated: Sept. 8, 2025

GENERAL QUESTIONS

Why did UCare make these changes?
Rising medical and pharmacy costs have made it increasingly difficult to sustain Medicare Advantage products while protecting UCare’s overall stability and mission and financial stability. As a nonprofit focused on government programs, this decision protects our ability to continue serving Minnesotans through Medical Assistance (Medicaid), MinnesotaCare, Special Needs BasicCare and other programs.

Which UCare plans are impacted, and which plans will remain?

Ending after Dec. 31, 2025:

  • UCare Medicare Plans
  • UCare Your Choice
  • EssentiaCare
  • UCare Advocate
  • UCare Medicare Group plans

Continuing to offer in 2026:

  • UCare Medicare Supplement
  • UCare Individual & Family Plans
  • UCare Individual & Family Plans with M Health Fairview
  • Medical Assistance (Medicaid)
  • MinnesotaCare
  • Special Needs Basic Care (Connect)
  • Minnesota Senior Care Plus (MSC+) (Medicaid only for seniors) 
  • Medical Assistance + Medicare (includes UCare’s Minnesota Senior Health Options and UCare Connect + Medicare) plans

What happens for impacted members now?
No immediate changes in 2025. Members can continue to use their UCare ID cards, providers and benefits as usual through Dec. 31, 2025.

Impacted members will receive Centers for Medicare & Medicaid (CMS)-approved notices after Oct. 1, 2025, explaining their next steps. Right now, there is nothing they need to do.

They will need to choose new coverage beginning Jan. 1, 2026. Members can choose a new Medicare Advantage plan during the annual enrollment period, which typically runs from Oct. 15 to Dec. 7.

Again, right now members do not need to take any action. They should watch for a letter from UCare that will provide all the details needed to get ready for 2026. That letter will arrive around Oct. 1.

What should providers do today?
Continue serving UCare members as you do today. There are no changes to contracts or network status.

How should we address UCare members who are canceling appointments because they are worried they won’t be covered?

  • For appointments prior to Jan. 1, 2026, reply with: “Because you are still a UCare member at this time, your visit will be covered, based on the terms of your member contract. Are you sure you want to cancel? If you have any questions about your coverage, please call the UCare Customer Service number listed on the back of your UCare member ID card.”
  • For appointments Jan. 1, 2026, or later, reply with: “Before you cancel, you may want to check with your new health plan to see if the appointment is covered.”

Will there be any changes to UCare’s provider network as a result of the change to Medicare Advantage product offerings?
Not at this time. Contracted providers should continue to serve impacted UCare members as they do today.

Will UCare be re-contracting with providers as a result of these changes?
If your current Provider Participation Agreement (PPA) with UCare includes Medicare Advantage products, those products will remain part of your contract. 

UCare seems to be making some changes to its authorizations, policies, billing requirements and processes. How can providers stay updated on the latest information?
For the latest news and information, providers should sign up to receive Provider Bulletins and newsletters. Visit http://www.ucare.org/providers, scroll to the “News & Alerts” section of the page, then click the blue “Sign Up” button under “Newsletter Sign Up.” All news items are available by clicking “Provider News” on the top navigation bar and scrolling down that page to the News Archive.

Additionally, the provider website offers a host of information, including the Provider Manual, policies, authorization grids, claims and billing information, forms, training and education, and much more.

OTHER RELATED QUESTIONS

Will existing authorizations for our patients be honored by their new health plan?
Yes. Authorizations approved by UCare should be honored by the new health plan. To ensure continuity of care and appropriate transition of care, federal rules require health plans to ensure at least a 90-day transition period for any active course(s) of treatment when a member switches to a new plan. The new health plan must not disrupt or require reauthorization during this period.  

How will inpatient hospital stays for a Medicare Advantage member be handled when they start prior to Jan. 1, 2026, and end after that date?
Per 42 CFR 422.318 -- Special rules for coverage that begins or ends during an inpatient hospital stay:

Coverage that begins during an inpatient stay. If coverage under a Medicare Advantage (MA) plan offered by an MA organization begins while the beneficiary is an inpatient in one of the facilities described in paragraph (a) of this section—

  1. Payment for inpatient services until the date of the beneficiary's discharge is made by the previous MA organization or original Medicare, as appropriate;
  2. The MA organization offering the newly-elected MA plan is not responsible for the inpatient services until the date after the beneficiary's discharge; and
  3. The MA organization offering the newly-elected MA plan is paid the full amount otherwise payable under this subpart.

Coverage that ends during an inpatient stay. If coverage under an MA plan offered by an MA organization ends while the beneficiary is an inpatient in one of the facilities described in paragraph (a) of this section—

  1. The MA organization is responsible for the inpatient services until the date of the beneficiary's discharge;
  2. Payment for those services during the remainder of the stay is not made by original Medicare or by any succeeding MA organization offering a newly-elected MA plan; and
  3. The MA organization that no longer provides coverage receives no payment for the beneficiary for the period after coverage ends.

UCare announced it will be launching a new provider portal with Availity. Will this still be occurring even with the Medicare Advantage changes?
Yes. UCare remains committed to supporting our providers and enhancing operational effectiveness. Earlier this year we partnered with Availity to develop our new provider portal. This work is moving forward as planned and is expected to roll out to providers in phases starting this fall.