Applying for enrollment in UPMC for Life is easy

This online enrollment application can be used to apply for enrollment in a UPMC for Life plan. If you have any questions during the enrollment process please call us toll-free at 1-866-400-5077 from 8 a.m. to 8 p.m., seven days a week.* TTY/TDD users should call 1-800-361-2629.

Before you start your online enrollment, make sure you:

  • Meet the eligibility requirements for enrolling in a UPMC for Life Medicare Advantage plan.
  • Have your Medicare card or letter from the Social Security Administration or Railroad Retirement Board handy.
  • Disable pop-up blockers on your computer.
  • Have Windows/Internet Explorer 6.0 or 7.0

Choose the state in which you live: 

 

Choose the UPMC for Life plan you would like to enroll in below.

Click here to compare your 2011 plan options. If you get extra help in paying for your Medicare prescription drug coverage, your plan premium will differ. Review the list below for actual plan premiums.

Plan Name
Monthly Plan Premium
  
UPMC for Life PPO High Deductible with Rx (PPO)
Our most popular PPO option with a deductible of $1,200, in- and out-of-network medical coverage, and brand-name and generic prescription drug coverage.
$10

You must continue to pay your Medicare Part B premium.

Already a UPMC for Life member?

If you are already a UPMC for Life member and would like to change plans, please contact us at 1-877-539-3080 from 8 a.m. to 8 p.m.,* seven days a week. TTY/TDD users should call 1-800-361-2629.

Choose the UPMC for Life plan you would like to enroll in below.

Click here to compare your 2011 plan options. If you get extra help in paying for your Medicare prescription drug coverage, your plan premium will differ. Review the list below for actual plan premiums.

Plan Name
Monthly Plan Premium
  
UPMC for Life HMO
A medical-only plan that is ideal for individuals who already have prescription drug coverage through the VA or PACE.
$0
UPMC for Life HMO Rx (HMO)
Our most popular plan option with brand-name and generic prescription drug coverage.
69.50
UPMC for Life HMO Rx Enhanced (HMO)
This plan includes brand-name and generic prescription drug coverage along with enhanced medical benefits.
$196.50
UPMC for Life PPO High Deductible with Rx (PPO)
Our most popular PPO option with a deductible of $1,200, in- and out-of-network medical coverage, and brand-name and generic prescription drug coverage.
$0
UPMC for Life PPO Rx (PPO)
This plan includes in- and out-of-network medical benefits along with brand-name and generic prescription drug coverage.
$81.50

You must continue to pay your Medicare Part B premium.

Already a UPMC for Life member?

If you are already a UPMC for Life member and would like to change plans, please contact us at 1-877-539-3080 from 8 a.m. to 8 p.m.,* seven days a week. TTY/TDD users should call 1-800-361-2629.

Choose the UPMC for Life plan you would like to enroll in below.

Click here to compare your 2011 plan options. If you get extra help in paying for your Medicare prescription drug coverage, your plan premium will differ. Review the list below for actual plan premiums.

Plan Name
Monthly Plan Premium
  
UPMC for Life PPO High Deductible with Rx (PPO)
Our most popular PPO option with a deductible of $1,200, in- and out-of-network medical coverage, and brand-name and generic prescription drug coverage.
$32.50

You must continue to pay your Medicare Part B premium.

Already a UPMC for Life member?

If you are already a UPMC for Life member and would like to change plans, please contact us at 1-877-539-3080 from 8 a.m. to 8 p.m.,* seven days a week. TTY/TDD users should call 1-800-361-2629.

image of lockSecure Enrollment is provided by Digicert, Inc. Any information provided is strictly confidential and is only viewable by you and UPMC for Life.

Click here for a list of additional plan documents and forms.

 
Questions?

Call us toll-free: 1-866-400-5077
TTY/TDD: 1-800-361-2629

Hours: 8 a.m. to 8 p.m.,*
seven days a week

 
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