UCare Customer Care: An Expert, Step‑by‑Step Guide to Getting Answers Fast

Reach UCare customer care quickly

The fastest and most reliable way to contact UCare is to use the official channels listed on your member ID card and the Contact page at https://www.ucare.org. Phone numbers vary by plan type (for example, Medicare Advantage vs. Individual & Family Plans vs. Minnesota public programs), so use the number printed on your card to avoid transfers. If you have multiple UCare plans (e.g., medical and dental), each card can list a different service line.

When you can’t locate your card, start at UCare’s homepage and navigate to Contact Us for current plan-specific numbers and hours. Posted hours can change on holidays or during high-demand periods, so check the page the day you call. In general, health plans staff their lines on weekdays and may have extended seasonal hours during Medicare Annual Enrollment (October 15–December 7). Calling within the first two hours after lines open or mid‑afternoon often yields the shortest waits.

For non-urgent issues, consider sending a secure message through your online member account on ucare.org. Secure messages allow you to attach documents (like itemized bills or prior authorization letters) and create a written record. Expect a written response time typically measured in business days; the exact target SLA is posted in the portal.

What to have ready before you call

Having the right information at your fingertips dramatically reduces back‑and‑forth and repeat calls. Collect the items below before dialing so the representative can authenticate your identity under HIPAA and work your issue in one pass.

• Your UCare Member ID card (Member ID, plan name, and plan year)
• Issue details: dates of service (MM/DD/YYYY), provider name, location, and billed amount
• Claim identifiers: claim number or reference from your Explanation of Benefits (EOB)
• Prescription details for pharmacy questions: drug name, dosage, quantity, and pharmacy name
• Authorizations or referrals: approval number, status letter, and any clinical notes your provider gave you
• Coverage context: other insurance information (if you have Medicare, employer coverage, auto insurance, etc.)
• Permission paperwork if you are calling for someone else: a HIPAA authorization or a CMS Appointment of Representative (Form CMS‑1696) for Medicare matters
• A good callback number, email, and hours when you can be reached

If you are disputing a bill, ask your provider’s billing office for an itemized statement before calling UCare. That one document (showing CPT/HCPCS codes, units, and modifiers) often makes the difference between a same‑day fix and a prolonged investigation. Keep a blank page ready to capture the case number the representative assigns; it’s the key to smooth follow‑ups.

What to expect during a call

Calls begin with identity verification. Be ready to confirm your full name, date of birth, address, and Member ID. Representatives will typically read a brief disclosure about call recording and privacy. If someone is calling on your behalf, UCare may require a verified authorization on file or a real‑time three‑way call to obtain your consent.

Next comes issue triage and documentation. The agent will summarize your concern, open a service case, and, if necessary, conference in Provider Services, Pharmacy Benefits, or Care Management. For straightforward eligibility and benefits questions, you may receive an answer in under 10 minutes; multi‑party claim investigations can take multiple business days if coordination with providers is needed.

If a callback is needed, ask for the case number, the exact next action, and the target completion date. Health plans commonly quote ranges like “2–5 business days” for claim reviews and “24–72 hours” for urgent benefit confirmations; confirm when you should follow up and the best direct line or extension.

Billing, claims, and benefits: how customer care can help

Understand the difference between a provider bill and an Explanation of Benefits (EOB). The EOB is not a bill; it shows what UCare processed, the allowed amount, plan payment, and your share (deductible, copay, or coinsurance). A provider typically submits a claim within 30 days of your visit; most clean claims adjudicate within 30–45 days, but coordination of benefits can add time.

Network status drives your out‑of‑pocket costs. Before a visit, ask UCare member services to confirm that your clinician, facility, and anesthesiologist are in network for your specific plan and year. For HMO plans, out‑of‑network services are generally not covered except emergencies; PPO plans may cover out‑of‑network services at higher cost sharing. Customer care can verify benefits at the CPT code level if the provider supplies codes.

If you have other coverage (Medicare, employer plan, auto, or workers’ compensation), provide those details so UCare can determine primary vs. secondary payment. Incorrect coordination of benefits is a common cause of denials and can usually be fixed by updating records and reprocessing the claim.

Prior authorization and referrals

Many imaging services (CT/MRI), certain surgeries, durable medical equipment above a price threshold, and some specialty drugs require prior authorization (PA). UCare publishes PA lists by line of business on ucare.org; your provider’s office should check those lists and submit clinical documentation up front to avoid a denial.

Medicare Advantage timelines are defined by federal rules. For medical services, a standard organization determination must be made within 14 calendar days; an expedited decision is due within 72 hours when delay risks health. For Part D (prescription drug) coverage determinations, standard decisions are due within 72 hours and expedited within 24 hours when medically necessary.

To speed things up, ensure your provider includes diagnosis codes, chart notes demonstrating medical necessity, prior treatment failures, and any imaging or lab results. Ask customer care for the best fax or portal address for your provider’s submissions and request a confirmation number upon receipt.

Grievances and appeals: timelines and escalation

A grievance is a complaint about service or quality (for example, long wait times or discourtesy). An appeal challenges a coverage decision (for example, denial of a claim or authorization). For Medicare Advantage plans, you generally have 60 days from the date of the denial notice to file an appeal; deadlines are printed on your decision letter. File as soon as possible and keep copies of everything you send.

For Medicare Advantage medical service appeals, plans must issue standard decisions within 30 calendar days (services) or 60 days (payment) and expedited decisions within 72 hours. For Part D appeals, standard redeterminations are due within 7 calendar days, and expedited redeterminations within 72 hours. If you disagree with the plan’s appeal outcome, you may request an independent review. You can also call 1‑800‑MEDICARE (1‑800‑633‑4227; TTY 1‑877‑486‑2048) for help with Medicare rights and next steps.

For Medicaid/CHIP and Individual & Family plans, state rules apply. As a general guide, you often have at least 60 days to appeal an adverse benefit determination, with standard decisions due in about 30 days and expedited decisions within 72 hours when delay could jeopardize health. Check your plan’s Evidence of Coverage and ucare.org for state‑specific instructions and addresses.

Accessibility and language help

Language assistance services are available at no cost. Ask for an interpreter at the start of your call; UCare can conference a qualified interpreter for over 200 languages. You can also request large‑print, braille, or audio formats for plan materials under Section 1557 of the Affordable Care Act.

Members who are deaf, hard of hearing, or speech disabled can connect via TTY or preferred relay service by dialing 711. Tell the relay agent you are calling your UCare Member Services number, and have your Member ID ready. If you need accommodations beyond interpretation—such as extended appointment time or auxiliary aids—customer care can document your preferences on your account.

Secure communication and privacy

UCare must comply with HIPAA privacy and security rules. Representatives will discuss protected health information (PHI) only with the member or an authorized representative. For Medicare-related matters, a CMS Appointment of Representative (Form CMS‑1696) is commonly used; for other plans, a plan‑specific HIPAA release may suffice. Authorizations can often be uploaded via your secure member portal.

Avoid sending PHI over regular email. Use the secure portal, encrypted email if offered, or fax numbers provided by customer care. Keep a record of each interaction: date and time, representative’s first name or ID, case number, promised action, and the follow‑up date. This documentation is invaluable if you need to escalate.

Useful links and verified contacts

Use official sources for the most current numbers, forms, and rules. The links below are maintained by UCare or federal agencies and are appropriate for verifying benefits, filing appeals, and appointing a representative.

• UCare homepage and member resources: https://www.ucare.org
• Medicare information and plan rights: https://www.medicare.gov
• Medicare appeals overview (Centers for Medicare & Medicaid Services): https://www.cms.gov/medicare/appeals-and-grievances/medicareappeals/
• CMS Appointment of Representative form (CMS‑1696): https://www.cms.gov/cms-forms/cms-forms/downloads/cms1696.pdf
• 1‑800‑MEDICARE for 24/7 assistance: 1‑800‑633‑4227 (TTY 1‑877‑486‑2048)

If you need a plan‑specific phone number or mailing address for UCare, check the back of your Member ID card or the Contact page on ucare.org for the most accurate, up‑to‑date details by line of business and plan year.

How much is UCare in Minnesota?

Cheapest Health Insurance Plans by County in Minnesota

County	Cheapest Insurer	Cheapest Plan Rate
Hennepin	UCare Minnesota	$302
Hubbard	UCare Minnesota	$338
Isanti	UCare Minnesota	$338
Itasca	UCare Minnesota	$338

Does UCare cover implants?

Prosthetics — removable and fixed: A prosthetic appliance (denture or bridge) for the purpose of replacing an existing appliance will be covered only after 60 months. Implant services: Replacing a single missing tooth. Coverage for implants is limited to once per tooth per lifetime (also see Exclusion #18).

What is the phone number for UCare Minnesota care?

Contact the Care Management team to learn more or enroll. Medicare and Individual & Family Plan members call 612-676-6538. PMAP and MinnesotaCare members, call 612-676-6512. You can reach us 9 am – 5 pm, Monday through Friday.

Is UCare a good health insurance in Minnesota?

UCARE IS A STAR TRIBUNE TOP WORKPLACE 16 STRAIGHT YEARS
We ranked in the top 20 large employers for the 16th straight year by the Minnesota Star Tribune. We also earned national recognition as the highest placed health plan in the USA Today Top Workplaces.