Two important health care plans that work together to give you better coverage

UPMC Health Plan has two plans that work together to provide you with your health care coverage—UPMC for Life Dual and UPMC Community HealthChoices. You can enroll in these plans if you are eligible for Medicare and Medical Assistance (Medicaid). By being a member of both UPMC for Life Dual and UPMC Community HealthChoices, we can more effectively coordinate your health care and make it less confusing. Plus, you get extra benefits to help you stay healthy and independent.

  • UPMC for Life Dual (HMO SNP) is a Medicare Advantage plan that gives you medical and prescription drug coverage. UPMC for Life Dual acts as your primary health care coverage. You will get additional benefits, including vision and dental coverage, transportation services, a free gym membership, and an allowance to buy health and wellness items.
  • UPMC Community HealthChoices is a Medicaid plan that provides secondary coverage for most of your medical, prescription, vision, and dental services. If you are eligible for long-term services and supports (LTSS), UPMC Community HealthChoices will coordinate and pay for these services along with your medical coverage.

If your UPMC for Life Dual plan does not fully cover something you need, UPMC Community HealthChoices may help cover the cost. When you have both plans, you will have a sense of comfort in knowing that most of your health care services will be covered.

Here’s how these plans work together to help you get the most out of your health care coverage.

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Dental Coverage

UPMC for Life Dual:
  • $0 copay for two oral cleanings and exams every year.
  • A $3,000 or $3,900 yearly allowance (depending on your plan) for additional dental services.
UPMC Community HealthChoices: $500 yearly allowance for certain dental services

Vision Coverage

UPMC for Life Dual:
  • $0 copay for one routine vision exam each year.
  • A $250 or $300 yearly allowance (depending on your plan) for eyewear or contact lenses.
UPMC Community HealthChoices: Up to a $100 yearly allowance for eyewear or contacts

Gym Benefits

UPMC for Life Dual: Unlimited FREE gym memberships to participating fitness facilities plus one free personal training session each year.

Over-the-counter Allowance

UPMC for Life Dual: A $1,160 or $1300 yearly allowance (depending on your plan) to buy health and wellness items you use every day.

Transportation Benefit

UPMC for Life Dual: 50 one-way trips (25 round trips) to and from plan-approved locations, including doctor’s offices, health care facilities, pharmacies

UPMC Community HealthChoices: Nonmedical trips may be covered for those with Medicaid long-term services and supports based on your service plan

Bathroom Safety Benefits

UPMC for Life Dual: Select up to six bathroom safety products per year

UPMC Community HealthChoices: Additional bathroom safety products may be covered for those with Medicaid long-term services and supports based on your service plan.

Hearing Benefits

UPMC for Life Dual:
  • $0 copay for one hearing exam and hearing aid fitting each year
  • $1,500 allowance for hearing aids every three years
UPMC Community HealthChoices: Additional hearing services may be covered for those with Medicaid long-term services and supports based on your service plan.

Inpatient and Outpatient Medical Services

UPMC for Life Dual:
  • $0 copay for inpatient medical services
  • $0 copay for outpatient medical services
UPMC Community HealthChoices (Pays secondary to your Medicare coverage):
  • $0 copay for inpatient medical services
  • $0 copay for outpatient medical services

Part D Prescription Drug Coverage

UPMC for Life Dual:
  • $0 copay for Part D prescription drug coverage
  • Some individuals may not qualify for $0 prescription drug copays. This is based on your household income level and institutional status.

24/7 Health Care Access

UPMC for Life Dual:
  • $0 copay for medical advice over the phone from experienced, registered nurses
  • $0 copay for an online virtual visit with a UPMC provider
UPMC Community HealthChoices:
  • $0 copay for medical advice over the phone from experienced, registered nurses
  • $0 copay for an online virtual visit with a UPMC provider

Personal Assistance Services

UPMC Community HealthChoices:
  • $0 copay for assistance with daily personal care activities, such as preparing meals, eating, dressing, and using the bathroom
  • These services may be covered for people awaiting a final eligibility determination for LTSS or as part of your Medicaid long-term services and supports service plan.


View our Caring for Life eNewsletter to learn more:

Learn more about the UPMC for Life Dual plan available in your area

Learn more about UPMC Community HealthChoices
This information is not a complete description of benefits. Call 1-844-575-8241 (TTY: 711) for more information.

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 for You Inc.

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 Dual Members

Call us toll-free: 1-800-606-8648
TTY: 711

Oct. 1 through Mar. 31:
seven days a week from 8 a.m. to 8 p.m.

Apr. 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 Dual Prospective Members

Call us toll-free: 1-844-575-8241
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: 10/01/2019
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