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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 $142.00. 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 $5300.00 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. The plan has a deductible of $235. Once you meet your deductible, you will pay a copay or coinsurance for your prescriptions depending on the drug tier and where you fill your prescription. In the initial coverage phase, you will pay a copay of $10 for preferred generic drugs and $47 for standard generic drugs at standard pharmacies. For preferred brand drugs, you will pay a copay of $100 at standard pharmacies. For non-preferred drugs, you will pay 30% coinsurance. After your total drug costs reach $2000, you enter the catastrophic coverage phase and pay nothing for covered Part D drugs.
Additional Benefits
The UCare Complete (HMO-POS) plan offers a variety of benefits, including coverage for inpatient and outpatient services with copays ranging from $0 to $300. You'll find coverage for emergency services, primary care, preventive services, hearing, vision, and dental care, with specific copays and coinsurance amounts for each. The plan also includes coverage for home infusion, dialysis, medical equipment, diagnostic services, home health, cardiac rehabilitation, and skilled nursing facility services, with varying cost-sharing structures.
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 $300 copay per admission or stay, while Additional Days for Inpatient Hospital-Acute are covered with no copay. 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, including all outpatient hospital services and observation services, are covered by UCare Complete (HMO-POS), with a $250 copay per service, and ambulatory surgical center (ASC) services have a $225 copay. Outpatient substance abuse services are not covered, and outpatient blood services are 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 service.
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, 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 Complete (HMO-POS) plan. Emergency Services have a $100 copay and no coinsurance, while Urgently Needed Services have a $45 copay and no coinsurance. Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $100 copay, while Worldwide Emergency Transportation has a $275 copay.
Primary Care See details
The UCare Complete (HMO-POS) plan covers primary care physician services, chiropractic services with a $20 copay, occupational therapy services with a $30 copay, physician specialist services with a $30 copay, other health care professionals with a copay between $0 and $30, physical therapy and speech-language pathology services with a $30 copay, and additional telehealth benefits with a copay between $0 and $45 and a coinsurance between 10% and 20%. However, 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 Medicare-covered services with no copay, annual physical exams, and additional preventive services. Health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, readmission 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, and in-home support services are not covered. The plan covers support for caregivers, additional sessions of smoking and tobacco cessation counseling, a fitness benefit, remote access technologies, and counseling services.
Hearing Services See details
Hearing Services, including hearing exams and prescription hearing aids, are covered by the UCare Complete (HMO-POS) plan. Routine hearing exams have a $30 copay, and prescription hearing aids have a copay between $599 and $899.
Vision Services See details
Vision services under the UCare Complete (HMO-POS) plan include eye exams with a copay of $0-$30, and eyewear benefits like contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames. The plan provides a combined maximum of $200 per year for eyewear.
Dental Services See details
The UCare Complete (HMO-POS) plan covers various dental services, including oral exams (limited to 2 per year), dental x-rays (limited to one set of bitewings, four periapical (PAs) per year, and full mouth x-rays every five years), prophylaxis (cleaning) (limited to 2 per year), and fluoride treatment, all with no copay. Other covered services include restorative services with 50% to 70% coinsurance, adjunctive general services with 70% coinsurance, endodontics with 50% coinsurance, periodontics with 0% to 50% coinsurance, prosthodontics (removable) with 70% coinsurance, implant services with 70% coinsurance, prosthodontics (fixed) with 70% coinsurance, and oral and maxillofacial surgery with 50% coinsurance. Maxillofacial prosthetics and orthodontics are not covered. There is a $2,000 annual maximum benefit for dental services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the UCare Complete (HMO-POS) plan. Medicare Part B Insulin Drugs have a $35 copay, while 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 these services.
Medical Equipment See details
The UCare Complete (HMO-POS) plan covers Durable Medical Equipment (DME) with a 20% coinsurance, Prosthetic Devices with a 20% coinsurance, and Medical Supplies with a 20% coinsurance. Diabetic Supplies have a coinsurance between 10% and 20%, and Diabetic Therapeutic Shoes/Inserts have a 10% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including Diagnostic Procedures/Tests, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services, are covered with a coinsurance of at most 10%, while Lab Services are not covered. There is no copay for these services.
Home Health Services See details
Home Health Services are covered by the UCare Complete (HMO-POS) plan, with no copay or coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but specific services including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. There is a copay for some Cardiac and Pulmonary Rehabilitation Services, but the specific amount is not listed.
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, while days 21-100 have a copay of $214.
Other Services See details
The UCare Complete (HMO-POS) plan covers over-the-counter items, with a maximum benefit of $45.00 every month, including nicotine replacement therapy and Naloxone. Acupuncture, meal benefits, and other services are not covered.
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