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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 $98.00. 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 $3200.00 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 type. The plan has a deductible of $235. Once you meet your deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy. After your deductible is met, you will pay $10 for preferred generic drugs at a standard pharmacy, and $47 for standard generic drugs. For preferred brand drugs, you will pay a $100 copay, and for non-preferred drugs, you will pay 30% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs.
Additional Benefits
The UCare Complete (HMO-POS) plan offers a range of benefits, including inpatient hospital stays with a $150 copay per admission. It also covers outpatient services, emergency services, primary care, preventive services, hearing, vision, dental, and home infusion services. You'll find a $0 to $30 copay for some primary care and vision services, and a $20 copay for chiropractic services. This plan includes coverage for ambulance services, skilled nursing facilities, and medical equipment with varying cost-sharing. Additional benefits include a monthly allowance for over-the-counter items. However, certain services like outpatient substance abuse, podiatry, and orthodontics are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For both Acute and Psychiatric, there is a $150 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, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include 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. Outpatient Substance Abuse Services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the UCare Complete (HMO-POS) plan. There is no further information available about the cost of this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by 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 the UCare Complete (HMO-POS) plan. Emergency Services have a $100 copay, Urgently Needed Services have a $45 copay, and Worldwide Emergency Services have a $100 copay for Worldwide Emergency Coverage and Worldwide Urgent Coverage, and a $275 copay for Worldwide Emergency Transportation. There is no coinsurance for any of these services.
Primary Care See details
The UCare Complete (HMO-POS) plan covers primary care physician services, chiropractic services with a $20 copay, occupational therapy with a $30 copay, physician specialist services with a $30 copay, other health care professional services with a copay between $0 and $30, physical therapy and speech-language pathology services with a $30 copay, and additional telehealth benefits with a coinsurance between 10% and 20% and a copay between $0 and $45. Routine chiropractic care, individual and group sessions for mental health and psychiatric services, and podiatry services are not covered.
Preventive Services See details
The UCare Complete (HMO-POS) plan covers preventive services, including annual physical exams, with no copay. Additional preventive services include support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, fitness benefits (memory fitness), remote access technologies, counseling services, kidney disease education services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit. However, health education, in-home safety assessments, personal emergency response systems, 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 benefits, home-based palliative care, in-home support services, enhanced disease management, telemonitoring services, and home and bathroom safety devices and modifications are not covered.
Hearing Services See details
Hearing services with UCare Complete (HMO-POS) include hearing exams with a $30 copay, routine hearing exams (1 per year), and fitting/evaluation for hearing aids. Prescription hearing aids (all types) are covered, with a copay between $599 and $899, but prescription hearing aids for the inner ear, outer ear, and over the ear are not covered, nor are OTC hearing aids.
Vision Services See details
The UCare Complete (HMO-POS) plan covers vision services, 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, including oral exams (2 per year), dental x-rays (1 set of bitewings, 4 periapical, and full mouth x-rays every 5 years), prophylaxis (cleaning) (2 per year), and fluoride treatment, with a $2,000 annual maximum. Restorative services have a 50-70% coinsurance, and other services like adjunctive general services, endodontics, prosthodontics, and implant services have 70% coinsurance. Periodontics has a 0-50% coinsurance, and oral and maxillofacial surgery has 50% coinsurance. Maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the UCare Complete (HMO-POS) plan, including Medicare Part B Insulin Drugs with a $35 copay. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the UCare Complete (HMO-POS) plan. You will pay 20% coinsurance for this benefit.
Medical Equipment See details
Medical Equipment is covered under the UCare Complete (HMO-POS) plan, including Durable Medical Equipment (DME) with 20% coinsurance and no copay, Prosthetics/Medical Supplies with coinsurance for Medicare-covered devices and supplies, and Diabetic Equipment with coinsurance for specific supplies and services. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the UCare Complete (HMO-POS) plan. 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. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by UCare Complete (HMO-POS). However, 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.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services 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 per day.
Other Services See details
The UCare Complete (HMO-POS) plan covers Over-the-Counter (OTC) items with a maximum benefit coverage of $45.00 per month, including Nicotine Replacement Therapy and Naloxone. Acupuncture, Meal Benefit, Dual Eligible SNPs, 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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