Sample Medical Insurance Warning Letter Template Page 3

Attention. If you want free help translating this information, call UCare at 612-676-3200 or

toll free at 1-800-203-7225.

This information is available in other forms to people with disabilities by calling: 612-676-3200

(voice) or toll free at 1-800-203-7225 (voice), 612-676-6810 (TTY) or toll free at 1-800-688-2534

(TTY); or through the Minnesota Relay at 711 or toll free direct access at 1-800-627-3529 (TTY,

Voice, ASCII, Hearing Carry Over), or 1-877-627-3848 (speech to speech relay service).

American Indians can continue or begin to use tribal and Indian Health Services (IHS) clinics. We will

not require prior approval or impose any conditions for you to get services at these clinics. For enrollees

age 65 years and older this includes Elderly Waiver (EW) services accessed through the tribe. If a doctor

or other provider in a tribal or IHS clinic refers you to a provider in our network, we will not require you

to see your primary care provider prior to the referral.

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Parent category: Letters