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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 October 15 through December 7, during the Annual Election Period. Outside of the Annual Election Period, you must qualify for a Special Enrollment Period.

When switching plans outside of the Annual Election Period (October 15 – December 7), 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 Mar. 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.

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 March 31:
seven days a week from 8 a.m. to 8 p.m.

April 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: 10/01/2020
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