2022 UCare Value (HMO-POS)

UCare Value (HMO-POS) H2459-001 is a 2022 Medicare Advantage Plan or Part-C by UCare available to residents in Minnesota. This plan does not provide additional prescription drug (Part-D) coverage. The UCare Value (HMO-POS) has a monthly premium of $29.00 and has an in-network maximum out-of-pocket limit of $3,400 (MOOP). This means that if you get sick or need a high cost procedure the co-pays are capped once you pay $3,400 out-of-pocket. This can be a extremely nice safety net.

UCare Value (HMO-POS) is a Local HMO *. With a health maintenance organization (HMO) you will be required to receive most of your health care from an in-network provider. Health maintenance organizations require that you select a primary care physician (PCP). Your PCP will serve as your personal doctor to provide all of your basic healthcare services. If you require specialized care or a physician specialist, your primary care physician will make the arrangements and inform you where you can go in the network. You will need your PCPs okay, called a referral. Services received from an out-of-network provider are not typically covered.

UCare works with Medicare to provide significant coverage beyond Part A and Part B benefits. If you decide to sign up for UCare Value (HMO-POS) you still retain Original Medicare. But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from UCare and not Original Medicare. With Medicare Advantage you are always covered for urgently needed and emergency care. Plus you receive all the benefits of Original Medicare from UCare except hospice care. Original Medicare still provides you with hospice care even if you sign up for Medicare Advantage.

Ready to Enroll?

Click Here

Or Call
1-855-778-4180
Mon-Fri 8am-8pm EST
Sat 8am-8pm EST

2022 UCare Medicare Advantage Plan Costs

2021 UCare Value (HMO-POS) Summary of Benefits

*This will be updated with 2022 data when available.

---

Additional Benefits

No

---

Comprehensive Dental

Diagnostic services	Not covered
Endodontics	Not covered
Extractions	Not covered
Non-routine services	Not covered
Periodontics	$0 copay (Out-of-Network)
Periodontics	$0 copay
Prosthodontics, other oral/maxillofacial surgery, other services	Not covered
Restorative services	Not covered

---

Deductible

$0

---

Diagnostic Tests and Procedures

Diagnostic radiology services (e.g., MRI)	20% coinsurance (Out-of-Network)
Diagnostic radiology services (e.g., MRI)	10% coinsurance
Diagnostic tests and procedures	10% coinsurance
Diagnostic tests and procedures	20% coinsurance (Out-of-Network)
Lab services	$0 copay
Lab services	$0 copay (Out-of-Network)
Outpatient x-rays	10% coinsurance
Outpatient x-rays	20% coinsurance (Out-of-Network)

---

Doctor Visits

Primary	$0 copay
Primary	$0 copay (Out-of-Network)
Specialist	$35 copay per visit
Specialist	$35 copay per visit (Out-of-Network)

---

Emergency care/Urgent Care

Emergency	$100 copay per visit (always covered)
Urgent care	$50 copay per visit (always covered)

---

Foot Care (podiatry services)

Foot exams and treatment	$35 copay
Foot exams and treatment	$35 copay (Out-of-Network)
Routine foot care	Not covered

---

Ground Ambulance

$100 copay (Out-of-Network)
$100 copay

---

Hearing

Fitting/evaluation	$0 copay
Hearing aids	$599-899 copay
Hearing exam	$35 copay
Hearing exam	20% coinsurance (Out-of-Network)

---

Inpatient Hospital Coverage

20% per stay (Out-of-Network)
$200 per stay

---

Medical Equipment/Supplies

Diabetes supplies	20% coinsurance per item (Out-of-Network)
Diabetes supplies	0-20% coinsurance per item
Durable medical equipment (e.g., wheelchairs, oxygen)	20% coinsurance per item
Prosthetics (e.g., braces, artificial limbs)	20% coinsurance per item (Out-of-Network)
Prosthetics (e.g., braces, artificial limbs)	20% coinsurance per item

---

Medicare Part B Drugs

Chemotherapy	20% coinsurance (Out-of-Network)
Chemotherapy	20% coinsurance
Other Part B drugs	20% coinsurance (Out-of-Network)
Other Part B drugs	20% coinsurance

---

Mental Health Services

Inpatient hospital - psychiatric	$200 per stay
Inpatient hospital - psychiatric	20% per stay (Out-of-Network)
Outpatient group therapy visit	$35 copay
Outpatient group therapy visit	$35 copay (Out-of-Network)
Outpatient group therapy visit with a psychiatrist	$35 copay (Out-of-Network)
Outpatient group therapy visit with a psychiatrist	$35 copay
Outpatient individual therapy visit	$35 copay (Out-of-Network)
Outpatient individual therapy visit	$35 copay
Outpatient individual therapy visit with a psychiatrist	$35 copay (Out-of-Network)
Outpatient individual therapy visit with a psychiatrist	$35 copay

---

MOOP

$3,400 In-network $7,500 Out-of-network

---

Option

No

---

Optional supplemental benefits

Yes

---

Outpatient Hospital Coverage

$250 copay per visit
20% coinsurance per visit (Out-of-Network)

---

Package #1

Deductible	$75.00
Monthly Premium	$25.00

---

Preventive Care

$0 copay
$0 copay (Out-of-Network)

---

Preventive Dental

Cleaning	$0 copay (Out-of-Network)
Cleaning	$0 copay
Dental x-ray(s)	$0 copay (Out-of-Network)
Dental x-ray(s)	$0 copay
Fluoride treatment	$0 copay
Fluoride treatment	$0 copay (Out-of-Network)
Oral exam	$0 copay
Oral exam	$0 copay (Out-of-Network)

---

Rehabilitation Services

Occupational therapy visit	$35 copay
Occupational therapy visit	$35 copay (Out-of-Network)
Physical therapy and speech and language therapy visit	$35 copay
Physical therapy and speech and language therapy visit	$35 copay (Out-of-Network)

---

Skilled Nursing Facility

$0 per day for days 1 through 20 $125 per day for days 21 through 100
20% per stay (Out-of-Network)

---

Transportation

Not covered

---

Vision

Contact lenses	$0 copay
Eyeglass frames	$0 copay
Eyeglass lenses	$0 copay
Eyeglasses (frames and lenses)	Not covered
Other	Not covered
Routine eye exam	$0 copay
Upgrades	$0 copay

---

Wellness Programs (e.g. fitness nursing hotline)

Covered

CMS Star Ratings for UCare Value (HMO-POS) H2459

Staying Healthy, Screening, Testing, & Vaccines

Managing Chronic And Long Term Care for Older Adults

Member Experience with Health Plan

Member Complaints and Changes in UCare Value (HMO-POS) Plans Performance

Health Plan Customer Service Rating for UCare Value (HMO-POS)

UCare Value (HMO-POS) Drug Plan Customer Service Ratings

Ratings For Member Complaints and Changes in the Drug Plans Performance

Member Experience with the Drug Plan

Drug Safety and Accuracy of Drug Pricing

Ready to Enroll?

Click Here

Or Call
1-855-778-4180
Mon-Fri 8am-8pm EST
Sat 8am-8pm EST

Coverage Area for UCare Value (HMO-POS)

(Click county to compare all available Advantage plans)

Go to top

Source: CMS.
Data as of September 1, 2021.
Notes: Data are subject to change as contracts are finalized. For 2022, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part-D benefit. Includes 2022 approved contracts. Employer sponsored 800 series and plans under sanction are excluded.