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UPMC for Life’s Special Needs Plan Offers Enhanced Benefits for the 2021 Annual Election Period

Significantly expands benefits for members, including dental, vision, hearing and no cost access to numerous telehealth services

Pittsburgh (October 1, 2020) – UPMC Health Plan is pleased to announce a new plan name for its Special Needs Plans for dual eligible Medicare and Medical Assistance (Medicaid) beneficiaries. The current plan is called UPMC for Life Dual (HMO SNP) and will have a new name in 2021, UPMC for Life Complete Care (HMO SNP).

“This new name—Complete Care—reflects the whole person care and security UPMC for Life provides to all members,” said April Golenor, Chief Medicare Officer for UPMC Health Plan. “We’re here for our members and we focus on their complete health care picture, which includes more than just access to doctors and hospitals. UPMC for Life Complete Care has been enhanced for 2021 to take into account our member’s physical and emotional health, the money they spend to keep healthy, and access to programs and services in the community that allow them to live their best life. These enhanced benefits aim to expand our members’ ability to receive the highest quality health care services in the most affordable way.”

“In 2021, UPMC for Life Complete Care will continue to place the health and well-being of our members as our top priority, offering them access to the best doctors and hospitals, affordability, quality services, and protections, like no cost medical care and clinical management programs, to help members manage their health and get extra benefits and services to make healthy choices said Golenor. “We want to give our members maximum value in term of benefits and services, like over-the-counter health care products, a healthy food card for members with diabetes, and dental, vision, and hearing care. We know that offering our members easy access to getting health care products, healthy food, and preventive care can help them stay healthy.”

No-cost medical care and improved extra benefits

With UPMC for Life Complete Care, members continue to receive no-cost medical care, prescription drug coverage, and improved extra benefits:

• $0 Monthly Premium—UPMC for Life Complete Care members have a zero-dollar monthly premium and very low or zero-dollar copays for medical services, making access to great benefits and services affordable.
• Access to UPMC—UPMC for Life members have broad, in-network access to the best doctors and hospitals with UPMC’s world renowned network that includes 700 doctors’ offices, 40 hospitals and outpatient sites, as well as a large network of high-quality community doctors and hospitals.
• $0 Preventive Care Visits—UPMC for Life Complete Care members have no copays for recommended preventive care, such as an annual wellness visit, mammograms, colorectal screenings, and diabetic retinal eye exams.
• $0 Telehealth Copays—UPMC for Life Complete Care members do not have copays when accessing UPMC Health Plan’s reliable physical and emotional virtual health care services.
• Dental Services—Members can receive an improved $5,000 yearly allowance for comprehensive dental services like fillings, simple tooth extractions, root canals, bridges, crowns, dentures, and periodontal work.
• OTC Allowance—Members get an improved $350 allowance per quarter—$1,400 a year—to buy health care products with a retail card and through mail-order catalog. Members can purchase items like face masks, hand sanitizer, thermometers, and cold and flu medicines.
• Vision Care–Members have no copay for one routine vision exam per year. For 2021, members also receive an improved $400 yearly allowance for contact lenses or eyewear.
• Hearing Aids–Members have a $0 copay for one hearing exam and hearing aid fitting per year. Members can also take advantage of a $1,500 allowance of hearing aids every three years.
• SilverSneakers^®–Members can work out from the comfort of home with at-home fitness kits and online fitness classes.
• Transportation–Getting to the doctor’s office has never been easier with 50 one-way trips (25 round trips) to plan-approved locations like the doctor’s office, local pharmacies, and health care facilities at no cost.
• Home-delivered Meals–Members can get home-delivered meals after an inpatient hospital stay, observational hospital stay, or a skilled nursing facility stay. They receive a single delivery of 14 healthy meals at home at no cost.
• Health Coaches and Personal Care Managers–Members can get help and advice with improving their health. A UPMC Health Plan health coach can help members make healthy changes and reach their wellness goals at no cost. UPMC for Life also offers personal care managers who can work with the member’s doctors, pharmacists, and other health care providers to make sure the member is getting the most from their care. Personal care managers can schedule appointments, help members understand after-visit instructions and treatment plan from their doctor, and connect members with the community services.
• Support to Live Independently–UPMC for Life Complete Care offers members access to six bathroom safety products per year at no cost, one in-home safety visit per year at no cost, and support for caregiving at no cost.

Golenor concluded: “UPMC for Life Complete Care gives you the very best coverage you need to take care of you—the complete you. Everything from our 4 Star Rating from the Centers for Medicare & Medicaid Services, to the extra benefits our members can take advantage of speaks to our commitment to caring for the complete you. Plus, you get the same great benefits and access to high-quality care that you have always enjoyed.”

For members who want personal help understanding their plan, the award-winning Health Care Concierge is on-hand to answer questions and provide exceptional customer service. The UPMC Health Plan Health Care Concierge team earned 11 awards at the 2020 Stevie® Awards, including three Gold Stevie Awards. The Stevie awards are the world’s premier business awards.

Enrollment Details

For more information about UPMC’s best doctors and hospitals, go to www.upmchealthplan.com/best.

Every year, Medicare evaluates plans based on a 5-star rating system. The UPMC for Life Special Needs Plan was awarded 4 out of a possible 5 Overall Star Rating for 2020 according to ratings released by the Centers for Medicare & Medicaid Services (CMS).