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2014 Plan Information

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UPMC for You Advantage (HMO SNP)
A Medicare Special Needs Plan that provides medical and prescription drug benefits for beneficiaries eligible for both Medicare Part A and B, and full Medical Assistance. UPMC for You Advantage offers enhanced dental and vision benefits for dual eligible beneficiaries, along with extra benefits and services that help you manage your overall health and wellness. UPMC for You Advantage can also help coordinate your Medicare and Medicare Assistance services.

UPMC for Life Options (HMO SNP)
A Medicare Special Needs Plan that provides medical and prescription drug benefits for older beneficiaries that demostrate long-term care needs. UPMC for Life Options uses a small network of specialized providers and facilities to help you age in place in a setting you choose, and offers extra services and benefits to give you and your loved ones the peace of mind you deserve.

UPMC Community Care (HMO SNP)
UPMC Community Care is a Special Needs Plan designed specifically to coordinate physical and complex behavioral health care needs through a designated medical home. The purpose of the medical home is to improve provider communication in addition to supporting member wellness and recovery. To be eligible to join, you must reside in the plan's service area and meet specific criteria.


Download Medicare, a booklet written by the Social Security Administration.

Below is information for those interested in enrolling in one of our plans.

Please read the important information in the box below before clicking on an enrollment application.

UPMC Medicare Special Needs Plans Program Eligibility Statements:

To qualify for UPMC for You Advantage, individuals must meet the following criteria at the time of enrollment:

To qualify for UPMC for Life Options, individuals must meet the following criteria at the time of enrollment:

To qualify for UPMC Community Care, individuals must meet the following criteria at the time of enrollment:

Enrollment Limitations:

UPMC for You Advantage,, and UPMC Community Care eligible beneficiaries can enroll at any time.

Alternative Formats:

You have the right to get your questions answered. Our plan has individuals and translation services available to answer questions from non-English speaking beneficiaries, and must provide information about our benefits that is accessible and appropriate for persons eligible for Medicare because of disability. If you need plan documents in other formats, please contact us at the number below.

For full information on UPMC Medicare Special Needs Plan benefits, call our Medicare Special Needs Plan Sales Hotline at 1-866-405-8762 from 8 a.m. to 8 p.m., Monday through Friday. TTY users should call 1-866-407-8762.

Plan Rating Information
Plan performance Star Ratings are assessed each year and may change from one year to the next.

Multi-Language Interpreter Information
Free interpreter services are available to answer any questions you might have about our plans.
Learn more »

Enrollment Application

Participating Providers and Pharmacies
(This also includes available dental and vision providers.)

Covered Drugs


Other helpful information on Medicare:

Other individual health insurance options from UPMC Health Plan:

 

Y0069_15_3025 Approved

Last updated: 11/13/2014

*Hours of Operation:
You may call our Member Services Department toll-free at 1-800-606-8648 from 8 a.m. to 8 p.m., seven days a week. TTY users should call 1-866-407-8762.

Our hours of operation change twice a year. You can call us October 1 through February 14, from 8 a.m. to 8 p.m., seven days a week. From February 15 through September 30, you can call us from 8 a.m. to 8 p.m., Monday through Friday, and from 8 a.m. to 3 p.m., Saturday.

Federal Contracting Statements:
UPMC for You Advantage is an HMO SNP plan with a Medicare contract and a contract with the Pennsylvania Medical Assistance (Medicaid) program. Enrollment in UPMC for You Advantage depends on contract renewal.

UPMC for Life Options and UPMC Community Care are HMO SNP plans with a Medicare contract. Enrollment in UPMC for Life Options and UPMC Community Care depends on contract renewal.

Benefits Disclaimer:
The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or copayments/coinsurance may change on January 1 of each year. Premiums, copayment, coinsurance and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.