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FEHB and Medicare Part B

UPMC Health Plan has designed the Standard Option HMO to assist you with your Part B payment.

Coinsurance does not apply after you meet your plan deductible.

Fill out the reimbursement form if your plan is the Standard HMO option.

Here's how it works:

  1. Choose to enroll in the Standard Option.
  2. Choose to enroll in Medicare Part B along with Medicare Part A.*
  3. Your coinsurance is reduced to zero.
  4. You’ll receive up to $700 in premium reimbursement through a health reimbursement arrangement (HRA).
  5. Set up a reimbursement by using these forms:

Remember, all plan options include a health incentive account (HIA) that enables you to earn up to $250 for Individual coverage.

Annual Plan Deductible Member Coinsurance** Medicare Part B premium reimbursement
Standard Option with Medicare Part A $850 individual coverage 20% after deductible N/A
Medicare Part B premium reimbursement $700 individual coverage 0% after deductible Up to $600 per member

This is a summary of the features of the UPMC Health Plan options. Before making a final decision, please read the Health Plan’s Federal Employees Health Benefits Program and 2021 Plan Brochure RI 73-797. All benefits are subject to the definitions, limitations, and exclusions set forth in the plan brochure. The scenarios depicted in this document only apply when Medicare is the primary payer.

*Go to Medicare.gov for information on how to purchase Medicare Part B.

**Office visit and prescription drug copayments apply for the Standard Option HMO plan, including when it is paired with Medicare Parts A and B.

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Attention

It is important to know that when you enroll in this plan, services are provided through UPMC Health Plan's participating providers as described in UPMC Health Plan's federal brochure — but the continued participation of any one doctor, hospital, or other provider cannot be guaranteed.

Continue to UPMC Health Plan online provider search
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