Pittsburgh (Oct. 1, 2021) – UPMC Health Plan today announced its 2022 offerings for UPMC for Life, which include Medicare Advantage (MA) plans with options to customize dental, vision or over-the-counter coverage and the debut of four new plans: one tailored to serve the needs of Medicare-eligible veterans, a plan with enhanced prescription drug coverage and two new plans for Medicare-eligible individuals in Central Pennsylvania. As the largest MA plan in Western Pennsylvania, UPMC for Life’s 2022 plans reflect UPMC Health Plan’s ongoing commitment to deliver high-quality, affordable coverage and award-winning service that meets the evolving health care needs of Medicare-eligible Pennsylvanians.
“In 2022, UPMC for Life continues to lead the way in providing great, affordable health care coverage for our members as premiums on our most popular plans remain stable and unchanged. Our most popular plan, UPMC for Life HMO Rx Choice (HMO), even had a premium decrease&emdash;the monthly plan premium is now $38,” said Angela Perri, Chief Medicare Officer for UPMC Health Plan. “All of our plans include broad access to high-quality doctors and hospitals across Pennsylvania, with many plans starting as low as $0 per month, and a new plan in 2022 that gives members the ability to customize their coverage by choosing one of these additional benefits: dental, vision, or over-the-counter health care products.”
New and Enhanced Plans for 2022
Incorporating feedback from its members has enabled UPMC for Life to offer even more robust and stronger plans for 2022.
New and enhanced in Western PA:
- New! UPMC for Life HMO Salute (HMO) is a $0 monthly premium plan that is a great new option for those who have US Department of Veterans Affairs (VA) coverage and do not need separate Part D prescription drug coverage. Members get a $50 Part B premium reduction each month along with extra benefits that help them stay healthy and independent such as allowances for comprehensive dental services, eyewear or contact lenses, hearing aids, and health care products. In addition, members have a transportation benefit to help with visits to doctors’ offices, health care facilities, and pharmacies.
- New! UPMC for Life HMO Access Rx (HMO) offers low-cost health care coverage with access to a large network of doctors and hospitals across Pennsylvania. This plan has a $25 monthly plan premium, includes prescription drug coverage, and provides allowances for comprehensive dental services, eyewear or contact lenses, hearing aids, and health care products. Members can also customize their plan by choosing one of their benefits to make even better. Members can choose dental or vision or health care products. This gives the member even more allowance dollars to use toward their health care.
- Enhanced! The UPMC for Life HMO Premier Rx (HMO) plans continue to have a low $0 monthly plan premium with first dollar coverage and prescription drug coverage. Most plans have improved dental and vision allowances and, to help members stay active, a FREE Fitbit with one-year FREE access to the Fitbit Premium app.
- Improved! UPMC for Life HMO Rx Choice (HMO) has enhanced extra benefits for 2022, including a lower $38 premium per month and an increased $3,000 maximum comprehensive dental allowance. Plus, members continue to have an annual $175 allowance for eyeglasses or contacts, a $500 allowance for hearing aids, and a $40 quarterly allowance to buy health care products.
New products in Central PA:
- New! The UPMC for Life PPO Flex Rx plans offer a $0 monthly premium, prescription drug coverage and important extra benefits with broad provider access. Members can get important extra benefits like allowances for comprehensive dental services, contact lenses or eyewear, hearing aids, and health care products. In addition, to help members stay active, members can get a FREE Fitbit with one-year FREE access to the Fitbit Premium app.
- New! The UPMC for Life PPO Rx Choice plan has a $29 monthly premium and gives members affordable medical coverage with broad provider access, a low $250 out-of-network deductible, and low-costs for out-of-network services. Plus, members also get allowances for comprehensive dental services, contact lenses or eyewear, hearing aids, and health care products.
Continuing to promote whole person care
UPMC for Life plans offer a “whole person” approach to health care with additional programs that can help members stay healthy, live independently, keep their health care costs low, and reach their health care goals. Our members have access to the following benefits and programs:
SilverSneakers®, | Fitbit | RxWell | Health Coaching | UPMC Prescription for Wellness | Travel Concierge | Assist America | UPMC AnywhereCare | UPMC MyHealth 24/7 Nurse Line | Personal Counseling | Pharmacist Counseling | Caregiver Support | Support for Serious Illness | Bathroom/Home Safety | Resources for Life® | UPMC Health Plan Mobile App | MyHealth OnLine
Helping During COVID
As the COVID-19 pandemic continues, many continue to experience stress, including financial stress. UPMC is continuing to help support our members by waiving deductibles, copays, and other cost-sharing for coronavirus testing and treatment. In addition, UPMC for Life increased member access to medications by waiving early refill limits on prescriptions. In 2022, UPMC for Life will continue that commitment to reducing the financial stress on members when accessing the health care system through the following:
- $0 Monthly Premium Plans – UPMC for Life offers plans with zero-dollar monthly premiums, making access to great benefits and services more affordable
- Access to UPMC – UPMC for Life members have broad, in-network access to the best doctors and hospitals with UPMC’s world renowned network that includes 700 doctors’ offices, and 40 hospitals and outpatient sites. Members also have access to a large network of high-quality community doctors and hospitals.
- $0 Preventive Care Visits &endash; UPMC for Life members will have no copays for recommended preventive care, such as an annual wellness visit, mammograms, colorectal screenings, and diabetic retinal eye exams.
- 0 Telehealth Copays – Most UPMC for Life members will not have copays when seeing their in-network PCP through a video visit. Members also have a reduced copay when seeing in-network specialists through telehealth.
- $0 Preferred Generic Prescriptions – Medications on Tier 1 of the UPMC for Life formulary have a $0 copay when filled at preferred pharmacies or through our mail-order pharmacy.
- Cost-Savings for Diabetic Prescriptions — All brand diabetes medications on Tier 2 of the UPMC for Life formulary continue to have copays as low as $10 for a 30-day supply when they are filled at a preferred pharmacy. Plus, in 2022, UPMC for Life members will be able to save hundreds of dollars when they fill covered diabetic insulin medications in the Part D Coverage Gap, otherwise known as the “donut hole.” Members pay the same copays ($35 for a 30-day supply when filled at either a preferred or standard pharmacy, and $87.50 for a 90-day supply at a preferred pharmacy, or $105 at a standard pharmacy) in the Part D Initial Coverage and Coverage Gap donut hole stages. This applies to covered insulins filled at standard, preferred, or mail-order pharmacies.
- Additional “Donut Hole” Coverage for HMO Rx Members – Members of the UPMC for Life HMO Rx (HMO) plan will have additional donut hole coverage for generic Tier 1 and 2 drugs through the Medicare Part D Coverage Gap, otherwise known as the “donut hole.” Members pay the same copays in the Part D Initial Coverage and Coverage Gap donut hole stages. When filled at a preferred pharmacy, Tier 1 generic medications will have copays as low as $0 for a 30-day or 90-day supply and Tier 2 generic medications will have copays as low as $10 for a 30-day supply or $20 for a 90-day supply.
- Dental Services – Members of UPMC for Life’s most popular plans can receive an increased allowance of up to $3,000 per year for comprehensive dental services like fillings, simple tooth extractions, root canals, bridges, crowns, dentures, and periodontal work.
- OTC Allowance – Members of some plans will receive an allowance of up to $50 per quarter to buy approved health care products through our mail-order catalog.
Virtual Enrollment Help and Support
Medicare beneficiaries interested in UPMC for Life can enroll by phone or online from the comfort and safety of home.
For members who want personal help understanding their plan benefits, the award-winning Health Care Concierge team is on-hand to answer questions and provide exceptional customer service. The UPMC Health Plan Health Care Concierge team earned eight awards at the 2021 Steve® Awards, including five Gold Stevie Awards. The Stevie Awards are the world’s premier business awards.
Medicare beneficiaries who are interested in UPMC for Life can get information on the 2022 plans online at 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. For more information about UPMC’s best doctors and hospitals, go to upmchealthplan.com/best.
The 2022 Annual Election Period is Oct. 15 through Dec. 7, 2021. Medicare beneficiaries can add or drop Part D prescription coverage, switch their current plan, or change to a Medicare Advantage plan, or change to Original Medicare. Changes in coverage will be effective Jan. 1, 2022.
About UPMC Insurance Services
Serving 4 million members, UPMC Insurance Services is owned and operated by UPMC, a world-renowned health care provider and insurer based in Pittsburgh, Pa. UPMC Insurance Services includes commercial products from UPMC Health Plan for groups as well as individuals. Commercial products also include workers' compensation and employee assistance from nationally known Workpartners®. Government products include Medicare Advantage (UPMC for Life); special needs plans for those eligible for Medicare and Medical Assistance (UPMC for Life Complete Care and UPMC Community HealthChoices); Medical Assistance (UPMC for You); and Children's Health Insurance Program (UPMC for Kids). Community Care Behavioral Health, one of the nation's largest nonprofit managed care behavioral health organizations, offers a full range of services to Commercial and Medical Assistance members. For more information, visit upmchealthplan.com.