Medicare Prescription Coverage

UPMC for Life Part D Prescription Drug Coverage

UPMC for Life offers many plan options that combine medical and Part D prescription drug coverage. All plans that include Part D prescription drug coverage have five levels of drug benefits. These levels are referred to in our prescription drug list (formulary) as Drug Tier Numbers.

Drug Tier Description
  1. Preferred Generic
  2. Generic
  3. Preferred Brand
  4. Non-Preferred (generic and brand drugs)
  5. Specialty

Preferred generic prescriptions are available at a $0 copay when filled at a preferred pharmacy. The preferred generic (Tier 1) $0 copay only applies during the Initial Coverage Stage.

View a complete list of HMO Premier Rx plans' preferred generic drugs.
View a complete list of all other HMO Rx and PPO Rx plans' preferred generic drugs.

New! Many UPMC for Life plans will offer lower copays for diabetic medications starting January 1, 2020. Copays are now as low as $10 at a preferred pharmacy. View a list of diabetic drugs with lower copays.

Compare and view details about our medical and prescription drug coverage plans.

Make sure your prescription drugs are covered
The UPMC for Life Part D prescription drug list includes thousands of brand-name and generic medications. These drugs have been approved for coverage by UPMC Health Plan. They are also reviewed and approved by UPMC physicians, community pharmacists, and Medicare.

You can check our prescription drug list to make sure your medications are covered:

Brand-name drugs are CAPITALIZED. Generic drugs are listed in lowercase italics. Some generic drugs may be categorized in a preferred brand or non-preferred drug tier. Make sure to check the Drug Tier Number listed next to the drug to understand the drug’s copays and costs.

Learn about how our Part D prescription drug coverage is important to UPMC for Life member Ruth:

Pharmacies in all the right places

You can fill prescriptions at your local pharmacy or through our mail-order program, making it easier to take your medications on time. Take advantage of thousands of national and regional pharmacies. You’ll pay less for prescriptions filled at one of our preferred pharmacies or through mail order. A preferred pharmacy is a pharmacy that has agreed to offer preferred cost-sharing (our lowest copays) for covered prescription drugs. Here are just some of our preferred pharmacy locations: Giant Eagle, Rite Aid, Sam’s Club, Walgreens, and Walmart. Search for a preferred pharmacy near you.

Drugs can be filled for 30-day or 90-day supplies. If you’re filling a 90-day maintenance prescription, you can save money at our mail-order pharmacy. Your out-of-pocket cost for preferred generic, generic, and preferred brand drugs will be lower than purchasing three 30-day supplies at a standard pharmacy. Our mail-order pharmacy will even mail medications directly to you.

Help for prescription drug costs
People with limited incomes may qualify for extra help to pay for their prescription drugs. Many people are eligible for these savings and don't even know it. Please select the area where you live to get information about low income subsidies.

Sign up for extra help at socialsecurity.gov for paying for your prescription drugs.
How do I ask about my LIS status or level?


 
This information is not a complete description of benefits. Call 1-866-400-5077 (TTY: 711) for more information. Out-of-network/non-contracted providers are under no obligation to treat UPMC for Life members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. Other physicians/providers are available in the UPMC for Life network.

This information is available for free in other languages. Please call our customer service number at 1-877-539-3080 (TTY: 711). We are available October 1 through March 31, seven days a week from 8 a.m. to 8 p.m. From April 1 through September 30, we are available Monday through Friday from 8 a.m. to 8 p.m. and Saturday from 8 a.m. to 3 p.m.

UPMC for Life has a contract with Medicare to provide HMO, HMO SNP, and PPO plans. The HMO SNP plans have a contract with the PA State Medical Assistance program. Enrollment in UPMC for Life depends on contract renewal. UPMC for Life is a product of and operated by UPMC Health Plan Inc., UPMC Health Network Inc., UPMC Health Benefits Inc., UPMC Health Coverage Inc., and UPMC for You Inc.

Tivity Health and SilverSneakers are registered trademarks or trademarks of Tivity Health, Inc. and/or its subsidiaries and/or affiliates in the USA and/or other countries.

UPMC for Life Members

Call us toll-free: 1-877-539-3080
TTY: 711

Oct. 1 through Mar. 31:
seven days a week from 8 a.m. to 8 p.m.

Apr. 1 through Sept. 30:
Monday through Friday: 8 a.m. to 8 p.m.
Saturday: 8 a.m. to 3 p.m.

UPMC for Life Prospective Members

Call us toll-free: 1-866-400-5077
TTY: 711

Oct. 1 through Dec. 31:
seven days a week from 8 a.m. to 8 p.m.

Jan. 1 through Sept. 30:
Monday through Friday: 8 a.m. to 8 p.m.
Saturday: 9 a.m. to 3 p.m.

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Last Updated: 10/01/2019
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