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UPMC Health Plan
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Contact: Gina Pferdehirt |
Four Medicare HMO plans will be offered, plans start as low as $0 premium per month
PITTSBURGH (Oct. 1, 2017) – For the first time, UPMC for Life – the Medicare Advantage product of UPMC Health Plan – will offer high quality plans at premium costs that are among the lowest in Susquehanna County.
UPMC for Life is offering four HMO plans in 2018 – starting as low as $0 premium per month – so that Medicare-eligible members can choose the one that best suits their needs.
All UPMC for Life Medicare Advantage members will have access to a provider network that includes over 25,000 doctors and 155 hospitals in Pennsylvania, including the doctors and hospitals of UPMC and UPMC Susquehanna. That means members get in-network access to local providers and health care facilities such as Muncy Valley Hospital, Soldiers & Sailors Memorial Hospital, Williamsport Regional Medical Center, and Divine Providence Hospital. For nearly 20 years, UPMC has been one of the top-ranked hospitals in the nation.*
All UPMC for Life HMO plans maintain an “Excellent” accreditation from the National Committee for Quality Assurance (NCQA), the highest honor a managed care plan can receive.†
UPMC for Life Medicare Advantage members can also benefit from UPMC Health Plan’s Health Care Concierge program. Concierges are customer service representatives who are knowledgeable about Medicare and are dedicated to answering members’ questions and to getting their problems solved with just one phone call.
For the second year in a row, UPMC Health Plan ranked highest in Pennsylvania in overall member satisfaction according to the J.D. Power 2017 Member Health Plan Study.SM
All of UPMC for Life's Medicare Advantage plans offer more benefits than Original Medicare alone, including low copays for primary care physician visits and complimentary membership at a participating fitness club through Silver&Fit™. Most plans will also offer preventive dental coverage.
The UPMC for Life HMO Deductible with Rx plan will have a monthly plan premium of $20. The UPMC for Life HMO Rx will have a monthly plan premium of $81 per month and the UPMC for Life HMO Rx Enhanced plan will have a $263 monthly plan premium. Both the HMO Rx and HMO Rx Enhanced have a $3,400 annual out-of-pocket maximum (the most a Medicare beneficiary will have to pay for care during the benefit year) and include Part D prescription drug coverage.
In addition, UPMC for Life HMO will have a $0 monthly plan premium plan and a $3,400 annual out-of-pocket maximum. This plan does not include Part D prescription drug coverage. This plan is considered ideal for persons who have prescription coverage through the Veterans Administration.
UPMC for Life members enrolled in a plan that includes prescription drug coverage will also have a $0 copay for preferred generic (Tier 1) prescriptions when filled at a preferred pharmacy starting on Jan. 1, 2018. Our new preferred pharmacies will also offer members our lowest copays on generic (Tier 2), preferred brand (Tier 3), and non-preferred (Tier 4) drugs. This change is designed to help members fill prescriptions as cost-effectively as possible at preferred pharmacy locations, such as Costco, Giant Eagle, Giant Food Stores, Kmart, Rite Aid, Sam’s Club, Walgreens, Walmart, and Wegmans.
All UPMC for Life HMO members will have full in-network coverage when traveling to the state of Florida. That means they maintain the same benefits and cost sharing when they see a provider in Florida as they do at home in Pennsylvania, simply by calling UPMC Health Plan to activate their travel benefit.
"UPMC for Life is excited to offer great coverage, great value and security to the Medicare beneficiaries of Pennsylvania," said John Lovelace, president of government programs at UPMC Health Plan. "Our members have the security and peace of mind with in-network access to the top-ranked hospitals as well as the concierge support of our top-quality member services."
Most UPMC for Life plans include preventive dental coverage for cleanings and exams. The UPMC Dental Advantage Medicare benefit includes a $15 copay for one oral exam and a $0 copay cleaning every six months. It also offers a $15 copay for one bitewing x-ray every year.
All UPMC for Life members can take advantage of the Silver&Fit Exercise and Healthy Aging Program. This program provides membership at participating fitness facilities at no additional cost to the member. For those who prefer to work out at home, the program provides a variety of home fitness kits including walking, Pilates, yoga, dance, and cardio strength.
Additional benefits for all UPMC for Life plans include Assist America, which provides help when travelling more than 100 miles from home or to a foreign country. Help is available 24 hours a day, 365 days a year.
† This award was not given by Medicare. For more information about UPMC for Life's CMS Star Rating, go to www.Medicare.gov.
Medicare beneficiaries must continue to pay their Medicare Part B premium when enrolled in a UPMC for Life plan. 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 Jan. 1 of each year. The provider network may change at any time. You will receive notice when necessary. Other providers are available in our network.
UPMC for Life’s pharmacy network offers limited access to pharmacies with preferred cost-sharing in our Pa. service area. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including pharmacies with preferred cost-sharing, please call Member Services at 1-877-539-3080 (TTY: 711) seven days a week from 8 a.m. to 8 p.m. or consult the online pharmacy directory at www.upmchealthplan.com/medicare. Other pharmacies are available in our network.
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.
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About UPMC Insurance Services Division
The UPMC Insurance Services Division is owned by UPMC (University of Pittsburgh Medical Center) a world-renowned health care provider and insurer based in Pittsburgh, Pa. As a provider-led organization that is part of an integrated health care delivery system, the UPMC Insurance Services Division is committed to providing its members better health, more financial security and the peace of mind they deserve. The UPMC Insurance Services Division partners with UPMC and community network providers to produce a combination of knowledge and expertise that provides the highest quality care at the most affordable price. The UPMC Insurance Services Division – which includes UPMC Health Plan, WorkPartners, UPMC for Life, UPMC for You, UPMC for Kids, and Community Care Behavioral Health — offers a full range of group health insurance, Medicare, Special Needs, CHIP, Medical Assistance, behavioral health, employee assistance and workers' compensation products and services to more than 3.2 million members. For more information, visit www.upmchealthplan.com.