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Need to make a change to your UPMC for Life Medicare Advantage plan? We can help!

You can change your Medicare Advantage plan for any reason from Oct. 15 through Dec. 7 during the Annual Enrollment Period. When switching plans outside of the Annual Enrollment Period, you must qualify for a Special Enrollment Period.

This plan change form can be used when switching from an HMO plan to another HMO plan. If you wish to change from an HMO plan to a PPO plan, or a PPO plan to an HMO plan, you must complete a new enrollment application.

You can apply to change your Medicare Advantage plan online, over the phone, or by mail

Online
Quickly and safely apply to change your plan online. Fill out the form completely, then click submit.

Plan change form

Over the phone
Change your plan over the phone with help from your dedicated Health Care Concierge team. Just call 1-877-539-3080 (TTY: 711). You can call us Oct. 1 through March 31 seven days a week from 8 a.m. to 8 p.m. From Apr. 1 through Sept. 30, you can call us Monday through Friday from 8 a.m. to 8 p.m. and Saturday from 8 a.m. to 3 p.m.

By mail
A Health Care Concierge can mail you a plan change form upon request. Please allow 7-10 business days for your plan change form to arrive. Once you receive your form, fill it out completely and return it using the postage-paid envelope provided.

Once your plan change application has been approved, you will receive a letter in the mail confirming enrollment in your new plan.

This information is not a complete description of benefits. Call 1-866-400-5077 (TTY: 711) for more information. Out-of-network/Noncontracted 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).

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., and UPMC Health Coverage Inc.

SilverSneakers is a registered trademark of Tivity Health Inc. SilverSneakers GO is a trademark of Tivity Health Inc. © 2021 Tivity Health Inc. All rights reserved.
UPMC for Life Members
Call us toll-free: 1-877-539-3080
TTY: 711

Oct. 1 – March 31:
Seven days a week from 8 a.m. to 8 p.m.

April 1 – Sept. 30:
Monday through Friday from 8 a.m. to 8 p.m., Saturday from 8 a.m. to 3 p.m.

UPMC for Life Prospective Members
Call us toll-free: 1-866-400-5077
TTY: 711

Jan. 1 – Sept. 30:
Seven days a week from 8 a.m. to 8 p.m.

Oct. 1 – Dec. 31:
Seven days a week from 7 a.m. to 9 p.m.

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Last Updated: 10/01/2022