Ask the Expert: What to know about provider networks

Answers provided by Keith Asmussen, Medicare Product Manager at UCare.

Do provider networks differ from plan to plan?

Yes. Provider networks can vary from one health care company to another, and also from plan to plan within the same company.

Networks can also vary by type. There are focused networks and broad networks. Usually, the broader the network, the more choice and flexibility you’ll have when selecting a provider.

For example, UCare covers 96 percent of all Minnesota providers in its broad network offerings. UCare also has Partner Plans with focused networks that include only certain provider partners.

What should I look for in a provider network?

If you have a favorite doctor, hospital or care system that you want to continue to visit, check to make sure they are in the provider network before you enroll in the plan. In Minnesota and bordering states, large care systems are common. So, if your doctor is part of a care system that your health plan has a contract with, your doctor is considered in network.

UCare contracts with most major care systems in Minnesota. Allina, Fairview, University of Minnesota and Park Nicollet are just some of the care systems in our Medicare plan networks.

UCare covers 96 percent of all Minnesota providers in its broad network offerings. Contributed photo

What happens when I go out of network?

Before you decide to seek services outside of your plan network, find out if your plan offers out-of-network coverage. Most Medicare plans include some out-of-network benefits for covered services you receive from providers who accept Medicare. But you may pay more for covered services you receive outside your plan network.

Many UCare Medicare Plans include an enhanced out-of-network benefit called UCare Anywhere. With this convenient travel benefit, you can get care anywhere you travel in the U.S. from any provider that accepts Medicare. Your copay will be the same amount you pay for covered services you receive in network. UCare Anywhere provides great peace of mind.

How do I find out what providers are in or out of network?

Check the plan website. Most have a network search tool you can use to find in-network doctors, hospitals and clinics. Or you can call the plan to find out.

What advantages do focused networks offer?

Plans with more limited networks can be a great option if you’re looking to save costs on premium or copays. If your doctors are part of the network and you have no reason to seek care outside of it, even better.

UCare has partner plans that feature the Fairview and North Memorial Health network. You can get all your health needs met through this collaborative partnership.

To Learn More

To learn more about UCare Medicare Plans, call 612-676-3500 or 1-877-523-1518 (TTY: 612-676-6810) 8 a.m. – 8 p.m., seven days a week, or visit

UCare Minnesota is an HMO-POS plan with a Medicare contract. Enrollment in UCare Minnesota depends on contract renewal. EssentiaCare is a PPO plan with a Medicare contract. Enrollment in EssentiaCare depends on contract renewal. H8783_Y0120_2459_11318_M CMS Accepted (11172018) 

#Healthcare #medicare #ProviderNetworks #UCare

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