2025 UCare Your Choice Plan Documents and Forms
UCare Your Choice
Member guide (PDF)
Formulary (list of covered drugs)
Provider and Pharmacy Directory (PDF)
Service area map (PDF)
Plan Rating Information (PDF)
Plan Rating Information - Spanish (PDF)
Member Release of Information Form (PDF)
Statement of Representative Form (PDF)
Power of Attorney short form
Deceased Member: Affidavit for the Collection of Personal Property (mncourts.gov)
Automatic Payment Form (PDF)
Online Automatic Payment Form
Claim Reimbursement Form (PDF)
Advance Directives (PDF)
Enrollment Forms
Fillable PDF
2025 Medicare Enrollment Form - Metro (PDF)
2025 Medicare Enrollment Form - North (PDF)
2025 Medicare Enrollment Form - South (PDF)
2025 Medicare Enrollment Form - Metro - Spanish (PDF)
2025 Medicare Enrollment Form - South - Spanish (PDF)
2025 Medicare Enrollment Form - North - Spanish (PDF)
2025 Your Choice Enrollment Change Form (PDF)
Online Form
2025 Medicare Enrollment Form - Metro
2025 Medicare Enrollment Form - North
2025 Medicare Enrollment Form - South
UCare Medicare Advantage Plans Overview (PDF)
Annual Notice of Changes (PDF)
Annual Notice of Changes - Spanish (PDF)
UCare Your Choice Summary of Benefits - Metro/North (PDF)
UCare Your Choice Summary of Benefits - Metro/North - Spanish (PDF)
UCare Your Choice Summary of Benefits - South (PDF)
UCare Your Choice Summary of Benefits - South - Spanish (PDF)
Plan Comparison Chart - Metro (PDF)
Plan Comparison Chart - North (PDF)
Plan Comparison Chart - South (PDF)
UCare Medicare Advantage Plans Overview (PDF)
Annual Notice of Changes (PDF)
Annual Notice of Changes - Spanish (PDF)
UCare Your Choice Summary of Benefits - Metro/North (PDF)
UCare Your Choice Summary of Benefits - Metro/North - Spanish (PDF)
Plan Comparison Chart - Metro (PDF)
Plan Comparison Chart - North (PDF)