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UCare Advocate Plus (HMO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UCare Advocate Plus (HMO I-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UCare Advocate Plus (HMO I-SNP) in 2025, please refer to our full plan details page.
UCare Advocate Plus (HMO I-SNP) is a HMO I-SNP plan offered by UCare Minnesota available for enrollment in 2025 to people living in Twin Cities and Greater MN 22 counties. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that UCare Advocate Plus (HMO I-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
UCare Advocate Plus (HMO I-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about UCare Advocate Plus (HMO I-SNP).
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 Advocate Plus (HMO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $15.00. 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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $3850.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 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 Advocate Plus (HMO I-SNP) plan has a $0 deductible for prescription drugs. During the initial coverage phase, you'll pay a copay for your prescriptions depending on the drug tier and the pharmacy you use. For example, standard generic drugs have a $12 copay, while preferred brand drugs have a $100 copay. Once your total drug costs reach $2000, you enter the catastrophic coverage phase and pay nothing for your Part D covered drugs. If you qualify for the low-income subsidy, you may have reduced premiums.
Additional Benefits
The UCare Advocate Plus (HMO I-SNP) plan offers a variety of benefits, including inpatient hospital stays with a copay for days 6-10, and outpatient services with a $250 copay. The plan also provides coverage for ambulance and transportation services, with a $250 copay for ambulance and no-cost transportation to health-related locations. This plan includes primary care physician services, with copays for specialist visits, chiropractic, occupational, physical therapy, and speech-language pathology services. It also offers preventive services, hearing and vision services with coinsurance, and a wide range of dental services with no copay. Additionally, it covers home infusion, dialysis, and medical equipment with varying copays and coinsurance, along with home health services and skilled nursing facility care.
Inpatient Hospital See details
Inpatient Hospital benefits include coverage for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, there is no copay for days 1-5 and 11-90, but a $250 copay for days 6-10. For Inpatient Hospital Psychiatric, there is no copay for days 1-5 and 11-90, but a $250 copay for days 6-10. Additional days for Inpatient Hospital-Acute are covered with no copay, but Non-Medicare-covered stay and Upgrades for Inpatient Hospital-Acute are not covered, as well as Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric.
Outpatient Services See details
Outpatient Services, including outpatient hospital services, observation services, ambulatory surgical center services, and outpatient blood services, are covered by the UCare Advocate Plus (HMO I-SNP) plan. Outpatient Hospital Services, Observation Services, and Ambulatory Surgical Center Services have a copay of $250.00, while Outpatient Substance Abuse Services, including individual and group sessions, are not covered.
Partial Hospitalization See details
Partial Hospitalization benefits are covered under the UCare Advocate Plus (HMO I-SNP) plan. There is no information provided about the cost of this service.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the UCare Advocate Plus (HMO I-SNP) plan. Ground and Air Ambulance Services have a $250 copay, and Transportation Services to a plan-approved health-related location are covered without limits.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the UCare Advocate Plus (HMO I-SNP) plan. Emergency Services have a $90 copay, and Urgently Needed Services have a $45 copay, and there is no coinsurance for either. Worldwide Emergency Services, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are not covered.
Primary Care See details
The UCare Advocate Plus (HMO I-SNP) plan covers primary care physician services, chiropractic services with a $20 copay, occupational therapy services with a $20 copay, physician specialist services with a copay between $0 and $40, podiatry services with a copay between $0 and $40, other health care professional services with a copay between $0 and $40, physical therapy and speech-language pathology services with a $20 copay, additional telehealth benefits with a 20% coinsurance and a copay between $0 and $40, and opioid treatment program services with a coinsurance between 10% and 20%. Mental health and psychiatric services are not covered.
Preventive Services See details
The UCare Advocate Plus (HMO I-SNP) plan covers preventive services, including no copay for Medicare-covered preventive services, and covers additional preventive services, but does not cover annual physical exams. The plan also covers support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, remote access technologies, kidney disease education services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit. However, the plan does not cover 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, fitness benefit, enhanced disease management, telemonitoring services, home and bathroom safety devices and modifications, or counseling services.
Hearing Services See details
Hearing Services include coverage for hearing exams, with a coinsurance of at most 20% for routine hearing exams, and fitting/evaluation for hearing aids. Prescription hearing aids (all types) are covered, with a maximum benefit of $550 every year, but prescription hearing aids for the inner, outer, and over-the-ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision services with the UCare Advocate Plus (HMO I-SNP) plan include coverage for eye exams and eyewear, with a 20% coinsurance for both. Eyewear has a combined maximum plan benefit coverage of $225 every year.
Dental Services See details
The UCare Advocate Plus (HMO I-SNP) plan covers a range of dental services, including oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), implant services, and oral and maxillofacial surgery, all with no copay and no coinsurance. This plan also covers orthodontic services, with a maximum benefit of $1125 every year. Maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the UCare Advocate Plus (HMO I-SNP) 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 by the UCare Advocate Plus (HMO I-SNP) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered by UCare Advocate Plus (HMO I-SNP), including Durable Medical Equipment with 20% coinsurance and no copay. Prosthetic devices have a 10% coinsurance, and medical supplies have a 10% coinsurance with no copay, while diabetic supplies have between 0% and 20% coinsurance with no copay. Durable medical equipment for use outside the home and diabetic therapeutic shoes/inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the UCare Advocate Plus (HMO I-SNP) plan. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of at most 20%, while Therapeutic Radiological Services and Outpatient X-Ray Services have a coinsurance of at most 20%. Lab Services are not covered.
Home Health Services See details
Home Health Services are covered by the UCare Advocate Plus (HMO I-SNP) 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 by the UCare Advocate Plus (HMO I-SNP), but the plan does not cover any of the sub-services. The plan has a copay for some cardiac and pulmonary rehabilitation services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the UCare Advocate Plus (HMO I-SNP) plan, with no copay for days 1-20, and a $170 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The UCare Advocate Plus (HMO I-SNP) plan covers Over-the-Counter (OTC) Items, with a maximum benefit coverage amount of $75.00 every six months, and includes Nicotine Replacement Therapy (NRT) and Naloxone coverage. Other services like 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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