1. 2018 UCare Group Medicare
NSPMEOA Retirees
U3204 (02/18)

2. UCare is not a Cost contract!
About UCare
Serve 80,000 Medicare members in Minnesota and western Wisconsin
Friendly customer service with a real person, located in Northeast Minneapolis
Members rate UCare 9 out of 10 overall
Nonprofit insurer with Medicare Advantage contract
UCare is not a Cost contract!

3. Star Ratings
Medicare Quality Program uses a 5-star rating system
Score based on five health service categories:
Keeping healthy through screenings, tests and vaccines
Managing chronic conditions
Satisfaction
Operational performance
Customer service
UCare is a 4.5 Star Plan!

4. Who can join UCare Group Medicare?
Retirees and their spouses who:
Have Medicare Part A and Part B
Continue to pay Part B premium
Live in Minnesota or within 26 counties in Wisconsin
Do not have end-stage renal disease.

5. UCare Group Medicare Premium Rates
High: $332
Core: $164
Basic: $73
Rates are per member, per month
through 12/31/18

6. Large Provider Network
Allina Health Mayo Health System
CentraCare Clinics Park Nicollet Clinics
Essentia Health Ridgeview Clinics
Fairview Clinics Stillwater Clinics
HealthEast St. Luke’s
HCMC U of M Physicians
North Memorial And many more

7. All UCare Group Medicare plans include:
Preventive Services– $0 copay
Preventive Dental – 3 cleanings/year – 100% coverage
Prescription Drug coverage – Medicare Part D
Medical Out-of-Pocket Maximum – $3400
Worldwide Emergency coverage
Coverage out of area up to 6 months – no need to notify
Out of network non-emergency coverage – 80%

8. Primary Office Visit Choose a Primary Care Clinic Just a home base
Primary Doctor Visits
Choose a Primary Care Clinic
Keep your doctor, your clinic
Find in Primary Care Clinic Listing
Change clinic anytime
Just a home base
Primary Office Visit
$15 copay on all plans
Almost every primary care clinic is in our network! Your chosen clinic is just a home base – your doctor does not have to approve, refer, or sign off on anything for you to see whoever you want. Yes, ALMOST every primary care clinic, the few primary care clinics of HealthPartners are not within our network, but the specialty and urgent care HealthPartners clinics are. For those that use the internet, it’s best to click Find a Doctor on UCVare.org to search for your doctor in the network. Choose UCare for Seniors as your plan.

9. Specialist Doctor Visits
See any Specialist
No referral needed
Simply make an appointment
Use Find a Doctor tool
Specialist Office Visit
High – $15 copay
Core – $30 copay
Basic – $40 copay
To see a specialist, like a cardiologist, the copay is $15 for High, $30 for Core and $40 for Basic.

10. Covered at 100% after copay, per admission
Inpatient Hospital
Covered at 100% after copay, per admission
High – $100 copay
Core – $200 copay
Basic – $300 per day copay, days 1 through 5
We coordinate with all providers, no paperwork

11. Outpatient Surgery and Skilled Nursing
High – $200 copay
Core – $250 copay
Basic – $250 copay
Skilled Nursing/Rehabilitation
No three-day in-patient hospital stay requirement
$0 for days 1 through 20
$100 per day for days 21 through 100

12. Worldwide Emergency Care
Emergency Services
Worldwide Emergency Care
High – $50 copay
Core – $75 copay
Basic – $75 copay
Ambulance Services 100% coverage after:
High – $100 copay
Core – $100 copay
Basic – $200 copay

13. Vision and Hearing Benefits
High and Core Plans include:
Vision exam – $0 copay
$150 eyewear credit each year
Hearing Exam – $0 copay
$500 hearing aid credit every 3 years
Basic plan includes:
Vision exam – $40 copay
Hearing exam – $40 copay

14. Additional Dental Benefits
Preventive Dental included in all plans
3 cleanings, 2 exams, annual
bitewing x-rays
Additional dental coverage for $21 per month
Coverage for fillings, crowns, dentures
Full mouth x-rays
$50 deductible
$1200 annual maximum

15. Prescription Drug Coverage – Part D
Formulary – List of Covered Drugs
Search online by name
4 tiers – Generic, Preferred Brand, Non-Preferred and Specialty
Large Pharmacy network or mail order
Includes Fairview Pharmacies
Preferred Pharmacies – 90 day supply for 2 copays .

16. Initial Coverage Stage
From $0 to $3,750 in annual prescription drug costs
High
Core
Basic
Annual deductible
Tier 1 – Generic
Tier 2 – Preferred Brand
Tier 3 – Non-preferred
Tier 4 – Specialty
$100
$10 copay
$40 copay
$90 copay
30% coinsurance
$150
$15 copay
$45 copay
$100 copay
$250
25% coinsurance

17. Coverage Gap Stage – Donut Hole
Once you have reached $3,750 in annual prescription drug costs
High
Core
Basic
Coverage in Gap
Once you reach $5000 in out of pocket costs:
Catastrophic Coverage
5% coinsurance or
$3.35 for generics and $8.35 for brand name – whichever is greater
Coverage through the gap paying co-pays.
No Donut Hole
Tier 1 Generics covered thru the gap with $15 copay
You pay 35% of brand name drugs
Smaller Donut Hole
You pay 44% of Generic drugs
Larger Donut Hole

18. UCare Group Medicare Fitness Programs
SilverSneakers® Fitness
Free membership to a fitness center
13,000 locations nationally ‒ use it anywhere!
YMCA, LA Fitness, Snap, YWCA, Curves
Health Club Savings (Lifetime and others)
$20 per month toward your membership
No minimum number of visits required.

19. How do I join UCare Group Medicare?
Retirees and Spouses
May enroll when Medicare-eligible (generally age 65)
Each fills out an application and plan choice
Enrollment Folders
Includes 2 applications and 2 plan choice forms
Mail forms in the green envelope provided

20. I joined UCare Group Medicare. Now what?
Confirmation of enrollment
Member ID card
Customer Service
UCare 24/7 Nurse Line
Disease Management Programs
Member Portal at UCare.org

21. Questions about UCare Group Medicare
Contact information
Phone:
Toll Free:
Visit our offices
500 Stinson Blvd. NE, Minneapolis, MN
Find us ucare.org

22. THANK YOU
Happy Retirement!