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UCare Value (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UCare Value (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UCare Value (HMO-POS) in 2025, please refer to our full plan details page.
UCare Value (HMO-POS) is a HMO-POS plan offered by UCare Minnesota available for enrollment in 2025 to people living in State of Minnesota. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that UCare Value (HMO-POS) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about UCare Value (HMO-POS).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For UCare Value (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $7500.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $7500.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
This plan has a Maximum Out-Of-Pocket cost of $3400.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $7500.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
Prescription drugs are not covered by UCare Value (HMO-POS).
Additional Benefits
The UCare Value (HMO-POS) plan offers a range of benefits, including inpatient hospital stays with a $200 copay per admission and outpatient services with copays ranging from $100 to $250. Emergency, urgent, and ambulance services have copays, while primary care visits have copays between $0 and $35. This plan covers preventive, hearing, vision, dental, and home infusion services. Hearing exams have a $35 copay, and prescription hearing aids are covered with a copay between $599 and $899. Vision services include routine eye exams with a copay between $0 and $35, plus eyewear coverage up to $150 per year. Dental services include no copay for exams, x-rays, cleaning, and fluoride treatment, and 30-60% coinsurance for other services.
Inpatient Hospital See details
Inpatient Hospital services are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, there is a $200 copay per admission or stay. Additional Days for Inpatient Hospital-Acute are covered with no copay, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, as well as Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, offered by UCare Value (HMO-POS), covers outpatient hospital services and observation services with a $250 copay, and ambulatory surgical center services with a $225 copay. Outpatient substance abuse services are not covered, while outpatient blood services are covered with a three-pint deductible waived.
Partial Hospitalization See details
Partial Hospitalization is covered by the UCare Value (HMO-POS) plan. There is no additional cost information available for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the UCare Value (HMO-POS) plan. Ground and Air Ambulance Services have a $100 copay, with no coinsurance, while Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the UCare Value (HMO-POS) plan. Emergency Services have a $100 copay, and Urgently Needed Services have a $45 copay, while Worldwide Emergency Services has a $100 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation. There is no coinsurance for any of these services.
Primary Care See details
The UCare Value (HMO-POS) plan covers primary care physician services, chiropractic services, occupational therapy, physician specialist services, other health care professional services, physical therapy, speech-language pathology, opioid treatment program services, and additional telehealth benefits. Chiropractic services have a $10 copay, physician specialist services and physical therapy/speech-language pathology have a $35 copay, and additional telehealth benefits have a 10-20% coinsurance and a $0-$45 copay. Occupational therapy has a copay of $35, and other health care professional services have a copay between $0 and $35. Routine chiropractic care, individual and group sessions for Mental Health, individual and group sessions for Psychiatric services, and podiatry services are not covered.
Preventive Services See details
The UCare Value (HMO-POS) plan covers preventive services, including Medicare-covered services and annual physical exams. Additional services such as Health Education, In-Home Safety Assessment, Personal Emergency Response System, Medical Nutrition Therapy, Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, and Enhanced Disease Management are not covered.
Hearing Services See details
Hearing services with the UCare Value (HMO-POS) plan include hearing exams with a $35 copay, as well as fitting/evaluation for hearing aids with no copay. Prescription hearing aids (all types) are covered with a copay between $599 and $899, but inner ear, outer ear, and over-the-ear hearing aids are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision services, including routine eye exams, are covered by the UCare Value (HMO-POS) plan. Routine eye exams have a copay of $0 - $35, while eyewear, including contact lenses, eyeglasses, lenses, frames, and upgrades, are also covered. Eyewear has a combined maximum benefit of $150 per year.
Dental Services See details
The UCare Value (HMO-POS) plan covers a variety of dental services, including oral exams (2 per year), dental x-rays (1 set of bitewing, and four periapical (PAs) once per calendar year, and full mouth X-rays every five years), prophylaxis (cleaning) (2 per year), and fluoride treatment, all with no copay. Restorative services have a coinsurance of 30% - 60%, while adjunctive general services, endodontics, and oral and maxillofacial surgery have a 30% coinsurance, and prosthodontics, removable, prosthodontics, fixed, and implant services have a 60% coinsurance, and periodontics has a coinsurance of 0% - 30%. Orthodontic services have a $75 deductible. Maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the UCare Value (HMO-POS) plan, including Medicare Part B Insulin Drugs with a $35 copay, Medicare Part B Chemotherapy/Radiation Drugs with 0-20% coinsurance, and Other Medicare Part B Drugs with 0-20% coinsurance. There is no coinsurance information for the Home Infusion bundled Services.
Dialysis Services See details
Dialysis Services are covered under the UCare Value (HMO-POS) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a 20% coinsurance and no copay, Prosthetics/Medical Supplies with a 20% coinsurance and no copay, and Diabetic Equipment with a 0-20% coinsurance depending on the service and no copay. Durable Medical Equipment for use outside the home and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
For Diagnostic and Radiological Services, Diagnostic Procedures/Tests, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services have a coinsurance of at most 10%, and lab services are not covered. There is no copay for any of these services.
Home Health Services See details
Home Health Services are covered by the UCare Value (HMO-POS) plan with no copay and no coinsurance. Additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the UCare Value (HMO-POS) plan. This plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the UCare Value (HMO-POS) plan, with no copay for days 1-20, and a $125 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Under the UCare Value (HMO-POS) plan, acupuncture, meal benefits, and several other services are not covered. Over-the-counter items are covered with a maximum benefit coverage of $75 every six months, and the plan offers Nicotine Replacement Therapy (NRT) and Naloxone as a Part C OTC benefit.
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