UPMC for Life Complete Care (HMO SNP) Extra Benefits

Prescription drug coverage

Making sure your clients know their prescriptions are covered and what they can expect to pay is an important part of the sales process. We want to make it as easy as possible for you to be their best resource for prescription drug options.

2024 Prescription drug formularies

• UPMC for Life Complete Care (HMO SNP) Formulary

You can also find PDFs of our formularies by following these instructions:

1. Go to our Find a Medication page. 
2. Choose the type of health insurance from the dropdown menu.
3. Select View the Directory.
4. The formulary will open in a new internet tab.
5. All covered prescription drugs on the plan you selected will be included and categorized by drug type then alphabetized.
   
    

Check a prescription via our Online Searchable Formulary.

2024 Additional prescription drug materials

Top 200 Drug List

Diabetic medications and insulins flier

Additional benefits

• SilverSneakers flier
• Over-the-counter and shop healthy card (OTC) catalog
• Shop healthy food card flier
• Extra benefits flier

Community HealthChoices (CHC)

Community HealthChoices (CHC) is the Department of Human Services’ (DHS) Medical Assistance (Medicaid) program that allows managed care organizations (MCOs) to coordinate medical care and long-term services and supports (LTSS) for individuals who qualify for Medical Assistance (Medicaid) and also qualify for Medicare or require a nursing facility level of care.

View the Community HealthChoices handbook.

Additional assistance

• Prior authorization and step therapy
  Help your clients find information about our prior authorization and step therapy requirements.
  • Prior authorization requirements UPMC for Life Complete Care (HMO SNP)
  • Step therapy requirements UPMC for Life Complete Care (HMO SNP)
• Low income subsidy (LIS) premium summary table—People with low incomes may apply for Extra Help to pay their prescription drug costs. Many people are eligible for these savings and don’t even know it. Find out if your clients are eligible by contacting the Broker Resource Center at 1-855-289-3197 or contact your designated broker manager. View the Low income subsidy (LIS) premium summary table (PDF) for more information. 

To sign up for Extra Help or to inquire about low income subsidy status:

• Visit the Social Security Administration online.
• You can also call 1-800-722-1213 Monday through Friday from 7 a.m. to 7 p.m. TTY users should call 1-800-325-0778. 
• You can also call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day, 7 days a week.
• Call the state Medical Assistance office.