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UCare Complete (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UCare Complete (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UCare Complete (HMO-POS) in 2025, please refer to our full plan details page.
UCare Complete (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 Complete (HMO-POS) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about UCare Complete (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 Complete (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $93.00. 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.
This plan has a $235.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
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 $3000.00 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
The UCare Complete (HMO-POS) plan has an enhanced alternative drug benefit, with a $235 deductible. After the deductible is met, you will pay a copay or coinsurance for your prescriptions. For preferred generic drugs, the copay is $10 at standard and mail-order pharmacies. For standard generic drugs, the copay is $47. For preferred brand drugs, the copay is $100. Non-preferred drugs have a 30% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you will pay nothing for your prescriptions.
Additional Benefits
The UCare Complete (HMO-POS) plan offers coverage for a wide range of services with varying costs. This plan includes inpatient hospital stays with a $150 copay per admission and outpatient services with copays ranging from $225 to $250. Additionally, it provides coverage for ambulance services, emergency services, primary care, preventive services, hearing, vision, and dental services. Other key benefits include home health services with no copay, skilled nursing facility care with a copay after 20 days, and home infusion services. The plan also covers medical equipment, diagnostic and radiological services, and offers an allowance for over-the-counter items. However, it's important to note that certain services like some outpatient substance abuse sessions, specific hearing aids, maxillofacial prosthetics, and orthodontics are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, there is a $150 copay per admission or stay for Medicare-covered stays. Additional days for Inpatient Hospital-Acute are covered, but Non-Medicare-covered Stay for Inpatient Hospital-Acute, Upgrades for Inpatient Hospital-Acute, Additional Days for Inpatient Hospital Psychiatric, and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services includes coverage for Outpatient Hospital Services and Observation Services with a $250 copay, Ambulatory Surgical Center (ASC) Services with a $225 copay, and Outpatient Blood Services with a waived three-pint deductible; however, Individual and Group Sessions for Outpatient Substance Abuse are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered by UCare Complete (HMO-POS). This plan covers partial hospitalization services.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the UCare Complete (HMO-POS) plan. Ground and Air Ambulance Services have a $275 copay, 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 UCare Complete (HMO-POS). For Emergency Services, the copay is $100, and there is no coinsurance. For Urgently Needed Services, the copay is $45, and there is no coinsurance. For Worldwide Emergency Services, the copay for Worldwide Emergency Coverage and Worldwide Urgent Coverage is $100, and the copay for Worldwide Emergency Transportation is $275; there is no coinsurance for any of these services.
Primary Care See details
The UCare Complete (HMO-POS) plan covers primary care physician services, occupational therapy services, physician specialist services, other health care professional services, physical therapy, speech-language pathology services, and opioid treatment program services. Chiropractic services have a $20 copay, while occupational therapy services have a $30 copay. Physician specialist services and physical therapy, speech-language pathology services have a $30 copay. Other health care professional services have a copay between $0 and $30. Additional telehealth benefits have a 10%-20% coinsurance and a copay between $0 and $45. Psychiatric and mental health services are not covered.
Preventive Services See details
The UCare Complete (HMO-POS) plan covers preventive services, including annual physical exams, with no copay or coinsurance. Some additional services, such as Health Education, In-Home Safety Assessment, and Personal Emergency Response System (PERS), are not covered. Other covered services include support for caregivers, smoking cessation counseling, fitness benefits, remote access technologies, counseling services, kidney disease education services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKGs.
Hearing Services See details
Hearing services with the UCare Complete (HMO-POS) plan include hearing exams with a $30 copay, and prescription hearing aids with a copay between $599 and $899, while routine hearing exams and fitting/evaluation for hearing aids are also covered. Prescription hearing aids for the inner ear, outer ear, and over the ear, as well as OTC hearing aids, are not covered.
Vision Services See details
Vision services are covered, including eye exams with a copay between $0 and $30, and eyewear with a combined maximum benefit of $200 every year. Contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered.
Dental Services See details
The UCare Complete (HMO-POS) plan covers dental services with a $2,000 annual maximum. Oral exams, dental x-rays, prophylaxis (cleaning), and fluoride treatments are covered; Oral exams are limited to 2 per year, and dental x-rays are limited to one set of bitewings, four periapical (PAs) once per year, and full mouth x-rays every five years. Restorative services, endodontics, and oral and maxillofacial surgery are covered with 50% to 70% coinsurance, adjunctive general services, prosthodontics (removable, fixed), and implant services are covered with 70% coinsurance, and periodontics has 0% to 50% coinsurance. Maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including insulin and other Medicare Part B drugs. For Medicare Part B insulin drugs, there is a $35 copay. For Medicare Part B Chemotherapy/Radiation Drugs and other Medicare Part B drugs, the coinsurance is between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by UCare Complete (HMO-POS), with a coinsurance of 20%.
Medical Equipment See details
Medical Equipment is covered by UCare Complete (HMO-POS), with Durable Medical Equipment (DME) subject to a 20% coinsurance and no copay, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies also have coverage, with a 20% coinsurance and no copay. Diabetic Equipment is covered, and is subject to a 10-20% coinsurance.
Diagnostic and Radiological Services See details
The UCare Complete (HMO-POS) plan covers diagnostic and radiological services, with no copay for any services. Diagnostic Procedures/Tests, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services have a coinsurance of at most 10%, while Lab Services are not covered.
Home Health Services See details
Home Health Services are covered by the UCare Complete (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 covered by the UCare Complete (HMO-POS) plan, but the specific services of Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services are not covered. There is a copay for these services, but the exact amount is not specified.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered by the UCare Complete (HMO-POS) plan. For days 1-20, there is no copay, and for days 21-100, the copay is $214.
Other Services See details
The UCare Complete (HMO-POS) plan covers Over-the-Counter (OTC) Items with a maximum benefit coverage amount of $45.00 every month, and offers Nicotine Replacement Therapy (NRT) and Naloxone as a Part C OTC benefit. Acupuncture, Meal Benefit, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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