UPMC Health Plan
Pittsburgh (October 20, 2020) – UPMC Health Plan is pleased to offer UPMC for Life, the largest individual Medicare Advantage plan in Western Pennsylvania, with significant cost savings for members with diabetes or diabetes risk factors in 2021. Building on the commitment to reduce financial barriers to life-saving medications, UPMC Health Plan is providing these members with significantly lower out-of-pocket costs for many brand name prescription medications, including insulin. These members will also have access to UPMC Health Plan's comprehensive and holistic wellness program to help them manage their health.
UPMC for Life members have low copays for all brand name non-insulin diabetes medications on the formulary. New for 2021, UPMC for Life members will also be able to save hundreds of dollars when they fill covered diabetic insulin medications. This enhancement helps UPMC for Life members affordably access insulin by capping the cost of a 30-day supply for insulins to a maximum of $35 and will not be subject to a deductible or any coverage gap increases. Whether it's January or December, our members monthly out-of-pocket cost for insulin will be $35 or less.
"Through UPMC for Life, we are directly addressing the major financial and lifestyle barriers that prevent people with diabetes from effectively managing their conditions," said Chronis Manolis, Chief Pharmacy Officer at UPMC Health Plan. "We are dramatically reducing copays on 23 covered diabetes medications in the majority of our 2021 UPMC for Life plans. In addition, we are providing our Medicare members with access to personalized, evidence-based disease management services. These efforts will help our UPMC for Life members achieve a healthier life and better manage their long-term conditions."
Additionally, UPMC for Life HMO Rx members will have coverage for generic Tier 1 and 2 drugs through the Medicare Part D Coverage Gap, or donut hole. Members of this plan will pay the same copays in the Part D Initial Coverage and donut hole stages for Tier 1 and Tier generic drugs.
Across the U.S., more than 30 million people have diabetes and 84 million have prediabetes, according to the American Diabetes Association. Manolis continued: "In order to have a vibrant community, people need to be healthy. They need to not have to choose between filling their prescription and paying a utility bill. UPMC Health Plan's low diabetes medication co-payments for Medicare members is one way we're addressing that concern. Our continued commitment to chronic condition prevention and management is another." In collaboration with the reduced copays for diabetes medications, UPMC for Life members are also able to develop personalized wellness plans with UPMC Health Plan health coaches who are specially trained in chronic condition management.
Health coaches will help members stay on track with their goals, including giving reminders to take medications as prescribed and make other lifestyle improvements, such as beginning an exercise program, losing weight, eating healthy, stopping smoking, or reducing stress.
All UPMC for Life members receive access to UPMC's top-ranked doctors, award-winning hospitals, and specialized chronic disease care programs available across Pennsylvania, as well as best-in-class concierge services and member services.For more information about UPMC’s best doctors and hospitals, visit www.upmchealthplan.com/best.
And all non-diabetic UPMC for Life members also have access to a free Diabetes Prevention Program that helps members lose weight, adopt healthy habits, and reduce the risk of developing type 2 diabetes through a series of weekly one-on-one sessions with a health coach and small group sessions to gather support from both clinical experts and peers.
The 2021 Annual Election Period is Oct. 15 through Dec. 7, 2020. Medicare beneficiaries can add or drop Part D prescription drug coverage, switch their current plan, change to a Medicare Advantage plan, or change to Original Medicare. Changes in coverage will be effective Jan. 1.Medicare beneficiaries who are interested in UPMC for Life can get information on the 2021 plans online at www.upmchealthplan.com/medicare or by calling UPMC for Life toll-free at 1-877-381-3765 seven days a week from 8 a.m. to 8 p.m. TTY users should call 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.
About the UPMC Insurance Services Division
The UPMC Insurance Services Division is owned and operated by UPMC, a world-renowned health care provider and insurer based in Pittsburgh, Pa. 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 3.9 million members. For more information, visit www.upmchealthplan.com.