UPMC for Life Plans

Florida Travel Benefits

UPMC for Life members enrolled in an HMO plan have full in-network coverage when traveling to the state of Florida. That means HMO members pay the same cost-sharing when seeing a provider in Florida as they do in-network at home.

Make sure you call Member Services at the number on the back of your member ID card to activate this benefit before you travel to Florida. Our Member Services team will:
  • Activate your Florida travel benefits.
  • Locate a provider or pharmacy for you.
  • Schedule a medical appointment for you.
  • Help you obtain prior authorization for services as needed.
UPMC for Life HMO members must call Member Services to activate the travel benefit. Claims for non-emergent and non-urgent care may be denied if the HMO member does not call Member Services prior to seeking medical care in Florida. This benefit is only applicable in the state of Florida.

Members will be charged in-network cost sharing for covered services received from any provider that accepts Medicare. PPO plan members will be charged out-of-network cost sharing as applicable for covered services received from non-participating providers. All members are charged the applicable cost sharing for emergent and urgent care as listed in the Evidence of Coverage. Members with coverage through their employer group do not have the Florida travel benefit. Some in-network services require prior authorization. Make sure you receive prior authorization for services as listed in the Evidence of Coverage when traveling to Florida.

Global Emergency Medical Assistance When You Travel

Assist America provides emergency medical assistance when you travel more than 100 miles from home or even to another country. Help is available 24 hours a day, 365 days a year, anywhere in the world.

What benefits and services does Assist America provide?
  • Emergency medical evacuation
  • Hospital admission assistance
  • Medical monitoring
  • Round-trip transportation for a family member or friend (if traveling alone)
  • Help replacing forgotten prescriptions (additional costs may apply)
  • Assistance with local language communications
  • Member transportation if medically necessary
  • Arranging for transport of mortal remains
Assist America does not replace your UPMC for Life emergency benefits. If you have an emergency, go to the nearest hospital or urgent care facility. You will be covered under your UPMC for Life medical coverage.
This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premium, and/or copayments/coinsurance may change on January 1 of each year. The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. Out-of-network/non-contracted providers are under no obligation to treat UPMC for Life members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. 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.

The UPMC for Life Medicare Advantage HMO and PPO plans are available to persons entitled to Medicare Part A and enrolled in Part B. You must continue to pay your Medicare Part B premium, reside in the service area, and not have end-stage renal disease (ESRD).

This information is available for free in other languages. Please call our customer service number at 1-877-381-3765 (TTY: 1-800-361-2629). We are available October 1 through February 14, seven days a week from 8 a.m. to 8 p.m. From February 15 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 and PPO plans. 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., and UPMC Health Benefits Inc.

The Silver&Fit program is a product of American Specialty Health Fitness, Inc., (ASH Fitness), a subsidiary of American Specialty Health Incorporated (ASH). All programs and services are not available in all areas. Silver&Fit® is a federally registered trademark of ASH and used with permission herein.

*Our hours of operation change twice a year.

You can call us:

October 1 through February 14:
seven days a week from 8 a.m. to 8 p.m.

February 15 through September 30:
Monday through Friday: 8 a.m. to 8 p.m.
Saturday: 8 a.m. to 3 p.m.

Y0069_17_1193 Approved

Last Updated: 10/01/2016
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