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2025 UCare Medicare Supplement Plan Documents and Forms

UCare Medicare Supplement

Benefits and perks overview (PDF)
TruHearing Hearing Aid Benefit (PDF)

Enrollment Forms

Fillable PDF

Enrollment Form (PDF)

DocuSign online form

Online Enrollment Form

Basic

Policy (PDF)
Outline of Coverage (PDF)
Part A Deductible Rider (PDF)
Part B Deductible (PDF)
Part B Excess Charges Rider (PDF)
Preventive Care Rider (PDF)
2024 UCare Medicare Supplement Plans comparison chart (PDF)
2024 Rates (PDF)

Extended Basic

Policy (PDF)
Outline of Coverage (PDF)
2024 UCare Medicare Supplement Plans comparison chart (PDF)
2024 Rates (PDF)

$20/$50 Copay

Policy (PDF)
Outline of Coverage (PDF)
2024 UCare Medicare Supplement Plans comparison chart (PDF)
2024 Rates (PDF)