UCare Customer Service Number — Practical Guide for Members

Contents

1 UCare Customer Service Number — Practical Guide for Members

Where to locate the correct customer service number

The single most reliable place for UCare customer service contact information is your UCare member ID card and the official site, https://www.ucare.org. The card typically shows a primary member services number, a separate number for pharmacy or behavioral health, and instructions for TTY/relay (for example, “TTY 711” is commonly used nationwide). If you are enrolled in a UCare plan through Medicare, Medicaid, or MNsure (the Minnesota marketplace), the exact phone number and any plan-specific hours will be printed on that card and reflected on your online account.

Because UCare operates multiple lines (general member services, claims, provider relations, pharmacy, and Medicare/Medicaid specialty teams), do not assume a single toll-free number will connect you to a specialist. Always cross-check the number on ucare.org/contact or your mailed member packet; these sources are updated when plan years change, which typically occurs in October each year for Medicare and at enrollment windows for Marketplace plans.

Phone options, expected wait times, and availability

UCare maintains separate telephone queues for routine inquiries (ID cards, eligibility), claims and billing disputes, pharmacy prior authorizations, and urgent medical or behavioral health needs. Typical business-hour hold times for routine inquiries average 3–10 minutes; specialized departments or high-volume periods such as the first two weeks of open enrollment can see hold times extend to 15–30 minutes. For Medicare members, appeals and grievances often require escalation and can take multiple business days to resolve once initiated over the phone.

Many health plans, including UCare, provide 24/7 telephonic clinical advice lines and nurse triage services; these are either reachable via the main member services number or a dedicated clinical line listed on your card. If you require TTY service, ask the operator to connect via the national relay (commonly “TTY 711”) so communications meet accessibility standards. Verify hours for non-clinical departments—member services typically operates Monday–Friday, with limited weekend hours during open enrollment.

How to prepare before calling (checklist)

Have your UCare member ID number, date of birth, and the primary name on the policy available. This speeds identity verification and routing.

Prepare claim numbers, provider names, dates of service, and any Explanation of Benefits (EOB) reference numbers to discuss billing disputes or claim denials precisely.

If calling about prescriptions, list the pharmacy name, National Drug Code (NDC) if available, prescribing clinician, and whether you need a prior authorization. Pharmacy prior authorizations often require 1–3 business days to process.

Note a clear outcome you want (e.g., “resubmit claim,” “request appeal form,” “verify PCP assignment”) so the representative can escalate appropriately without repeated calls.

What UCare customer service can and cannot do

Customer service representatives can: verify eligibility and benefits, confirm copays and coinsurance amounts, explain prior authorization and step therapy requirements, initiate appeals or grievances, and set up secure messaging or document submission channels. Representatives can also update contact details and clarify network provider status—important when traveling or changing physicians.

They cannot, in a single call, adjudicate complex claims disputes requiring medical record review, issue expedited appeals beyond stated policy timelines without documentation, or change retroactive coverage decisions made by state agencies. Complex appeals typically involve written forms and can take anywhere from 7 to 30 calendar days for standard reviews, depending on the plan and whether clinical review is required.

Alternative contact methods and escalation steps

Secure online member portal: Create or sign into your account at ucare.org to view claims, benefits, appeals forms, and secure messages. Electronic submission of documents often shortens resolution time by 1–2 business days versus mailed paperwork.

In writing: Use the postal address printed on your member materials for formal appeals and complaints. Written submissions create a paper trail required for escalations to state regulators if needed. Follow up phone calls with a secure message or mailed confirmation that references the case number given by the representative.

Escalation and external review

If you are unsatisfied with a resolution, request the representative to escalate the matter to a supervisor and obtain a reference or case number. For denied claims or coverage decisions, ask for a written explanation of benefits (EOB) and the specific code or policy citation used in the denial—this is essential for appeals. UCare members enrolled in Medicare have protections under federal Appeals processes; Medicaid and marketplace enrollees should reference state-level appeal instructions provided in the member handbook.

When internal escalation does not resolve the issue, external review options include filing a complaint with your state Department of Health or Insurance Commissioner and, for Medicare, contacting 1-800-MEDICARE or the appropriate regional office for guidance. Always retain dates, names of representatives, and case numbers; detailed documentation shortens resolution times and strengthens appeals.