Medicare Options
New for 2023! UPMC for Life FEHB Retirees – Medicare Advantage Plan
Get a complete Medicare Advantage plan without suspending your FEHB coverage!
UPMC Health Plan is adding a Medicare Advantage Plan—UPMC for Life FEHB Retiree—for FEHB annuitants who are enrolled in our Standard Option HMO Plan and Medicare Part B.
UPMC Health Plan offers Medicare Advantage plans that can give you high-quality medical and prescription benefits at an affordable price. Our Medicare Advantage plans have some of our largest provider networks. That means you can choose from more doctors and hospitals in your community than ever before.
Signing up for UPMC for Life FEHB Retirees is simple, you can enroll online or by calling 1-844-383-1819 (TTY: 711).
Enroll online
Medicare Parts A and B for Annuitants
UPMC Health Plan has designed the Standard Option HMO to assist you with your Medicare Part B payment.
Here are two options:
Option #1
- Choose to enroll in the Standard Option HMO.
- Choose to enroll in UPMC for Life FEHB Retirees by submitting the enrollment form online or by calling 1-844-383-1819 (TTY: 711).
- Most services will have a $0 copay or lower out-of-pocket costs with $0 deductible.
Option #2
- Choose to enroll in the Medicare Parts A and B.
- Choose to enroll in Medicare Part B along with Medicare Part A.*
- Your deductible will be reduced to $700 for Self Only coverage.
- Your coinsurance will be reduced to 0 percent.
- PCP visits will have a $20 copay and specialist visits will have a $50 copay.
With both options, you are eligible to receive up to $800 in premium reimbursement through a health reimbursement arrangement (HRA).
Set up your reimbursement by mail or online using these forms:
Remember, all plan options include a health incentive account (HIA) that enables you to earn up to $250 for Self Only coverage.
Our members also enjoy extra benefits that provide significantly more coverage than what your current plan may offer. When you pair UPMC for Life FEHB Retirees with our FEHB Standard Option HMO plan and Medicare Part B, you will get:
| Self Only Deductible |
$0 |
| Annual Out-of-Pocket Max (Embedded) Individual |
$3,400 per retired member enrolled with MC Part A and B |
| PCP Office Visit |
$0 |
| Specialist Office Visit |
$25 |
| Virtual Urgent Care Visit |
$0 |
| Urgent Care Visit |
$0 |
| Emergency Room Visit |
$0 |
| Preventive Care |
$0 |
UPMC for Life Retiree Plan FAQ
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It’s a plan that combines the benefits of a Medicare Advantage Plan and the Standard Option HMO Plan for annuitants (retirees), providing a high-value option exclusively for FEHB retirees.
You are eligible to enroll if you are:
- Are retired.
- Are enrolled or are enrolling in UPMC Health Plan's Standard Option HMO (UW4-6).
- Have Medicare Part A and Part B.
- FEHB retirees with Medicare Parts A and B continue to pay Part B premiums with the UPMC for Life FEHB Retiree plan. You receive additional benefits, such as a $0 deductible, many services that have a $0 copay, and excellent prescription benefits.
- It offers a premium reimbursement opportunity of up to $800 per year.
- You must use providers who participate with UPMC for Life.
- The premium rates with FEHB remain the same as the Standard Option HMO.
Enrollment is easy for retirees with Medicare Parts A and B.
- Enroll as you normally would through the OPM Retirement website, retireefehb.opm.gov, or by calling 1-888-767-6738 (TTY: 1-800-878-5707).
- Enroll in UPMC Health Plan’s Standard Option HMO using enrollment code UW4, UW5, or UW6. OPM will transfer your enrollment to UPMC within 10 business days.
- Enroll in the UPMC for Life FEHB Retirees plan through our online form, or by calling 1-844-383-1819 (TTY: 711).
- Call UPMC Health Plan at 1-844-383-1819 (TTY: 711) to opt in to the UPMC for Life FEHB Retirees plan.
- Have your original Medicare effective date for Parts A and Part B, along with your Medicare beneficiary ID.
The FEHB premiums for the Standard Option HMO will be as follows for 2023:
| Monthly Rates |
Enrollment Code |
Premium |
| Standard Self |
UW4 |
$183.08 |
| Standard Self & Family |
UW5 |
$431.40 |
| Standard Self Plus One |
UW6 |
$432.12 |
No, this plan is only available through FEHB.
Yes. You will receive an ID card from UPMC Health Plan for your Standard Option HMO.
Then, after you enroll in the UPMC for Life FEHB Retirees plan, you will receive an ID card for the Medicare Advantage HMO plan.
When a provider asks you for your ID card, please provide both cards.
Coverage and 2023 benefit changes for current members and annuitants will begin on Jan. 1, 2023.
Coverage for new UPMC Health Plan members who are actively employed during Open Season will begin on the first day of the first pay period in January 2023.
If you are a new federal employee, you have 60 days to enroll in an FEHB plan. Your enrollment will begin at the start of the pay period after your enrollment is received.
Our network includes standard pharmacies and preferred pharmacies. You can go to either type of pharmacy to pick up your prescriptions. Preferred pharmacies have agreed to offer our lowest copays for covered prescription drugs. Standard pharmacies do not offer our lowest copays. That means you can save money when using pharmacies in our preferred pharmacy network. You will have a $0 copay when you fill a preferred generic prescription (Tier 1) at a preferred pharmacy during the initial coverage phase. Here are some of our preferred pharmacy locations: Giant, Giant Eagle, Rite Aid, Sam’s Club, Walgreens, Walmart, and Weis.
|
30-day supply |
90-day supply |
|
Retail |
Retail |
Mail order |
| Tier |
Preferred pharmacy |
Standard pharmacy |
Preferred pharmacy |
Standard pharmacy |
Preferred pharmacy |
Standard pharmacy |
| Tier 1 Preferred Generic |
$0 copay |
$15 copay |
$0 copay |
$30 copay |
$0 copay |
$30 copay |
| Tier 2 Generic |
$10 copay |
$20 copay |
$20 copay |
$40 copay |
$20 copay |
$40 copay |
| Tier 3 Preferred Brand |
$47 copay |
$47 copay |
$129.50 copay |
$141 copay |
$117.50 copay |
$141 copay |
| Tier 4 Non-Preferred |
$100 copay |
$100 copay |
$300 copay |
$300 copay |
$300 copay |
$300 copay |
Tier 5 Specialty
| 33% coinsurance |
33% coinsurance |
Not offered |
Not offered |
33% coinsurance limited to a 30-day supply |
33% coinsurance limited to a 30-day supply |
|
| If you receive Extra Help (Low Income Subsidy) from Medicare for prescription drug costs, you may have a lower copay or coinsurance than what is listed above. You may not receive cost savings from using a preferred pharmacy. |
*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.
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