Need help, or have questions? We’re here to help.

By Phone: UPMC Medicare Special Needs Plans Sales Call Center

Toll-free: 1-866-405-8762

TTY 1-866-407-8762

Licensed sales agents are available to take your call. Our hours of operation change twice a year. We are available to take your call October 1 – February 14 from 8 a.m. to 8 p.m., seven days a week; February 15 – September 30 from 8 a.m. to 8 p.m., Monday through Friday.

In Person: Schedule a home visit.

You can meet with one of our authorized representatives face-to-face at your home, office, or another place in the community.

Toll-free: 1-866-405-8762

TTY 1-866-407-8762

Licensed sales agents are available to take your call. Our hours of operation change twice a year. We are available to take your call October 1 – February 14 from 8 a.m. to 8 p.m., seven days a week; February 15 – September 30 from 8 a.m. to 8 p.m., Monday through Friday.

Find the Right Plan

You or the person for whom you’re applying must have Medicare Part A and Part B in order to apply for UPMC for Life Dual or UPMC for Life Options.

If you would like to explore other plans that may meet your needs, or if you would like to continue to learn about Medicare Special Needs Plans, see the options below. If you would like to learn more about how to sign up for Medicare Parts A and B, visit www.medicare.gov for information.

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UPMC Health Plan offers plans and services for every need. Look here to learn more.

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Continue to learn more about UPMC Medicare Special Needs Plans even though you may not be eligible.

  • UPMC for Life Dual
  • UPMC for Life Options

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Together We Can Find the Right Plan for You

Here at UPMC Health Plan, health is our #1 priority. That’s why we offer coverage to meet and exceed our members’ needs. Take a closer look at our Special Needs Plans. We offer compassionate care, customer service excellence, and much more for every member.

Compare All Available Plans

UPMC for Life Dual

This plan is for you if you are eligible for Medicare and Medical Assistance. With UPMC for Life Dual, you don’t have to worry about questions like, “Is my doctor in the network?” or “Am I allowed to go to my neighborhood hospital?” You have access to 8,700 UPMC doctors and 87 hospitals, as well as urgent care centers, community hospitals, and specialty care centers. No referrals required. UPMC for Life Dual offers enhanced dental and vision benefits for dual eligible beneficiaries, along with extra benefits and services that help you manage your overall health and wellness. This plan can also help coordinate your Medicare and Medical Assistance services.

Enroll today

Apply online using our secure enrollment website.

Supplemental Benefits: What You Get Compared to Original Medicare

Benefits UPMC for Life Dual Original Medicare
Outpatient Medical Services $0 copay for surgery, rehabilitation services, mental health, and substance abuse You pay 20% of Medicare-approved amounts for doctor or provider's services, and the Part B deductible applies. For all other services, you also pay a copayment for each service.
Inpatient Medical Services $0 copay per stay Per benefit period, you pay:
$1,288 deductible
$0 coinsurance days 1-60
$322 coinsurance per day days 61-90
$644 coinsurance per each “lifetime reserve day" after day 90 (up to 60 days over your lifetime).
Beyond lifetime reserve days: all costs.
Prescription Drug Coverage $0 or low copays for generic and brand medications depending on your level of Extra Help Not covered
Routine Dental Benefits and Allowance for Additional Services $0 copay for one oral exam and cleaning every six months
$0 copay for one bitewing x-ray every six months
A $2,500 yearly allowance for additional services like dentures, bridges, root canals, crowns, fillings and simple tooth extractions.
Not covered
Routine Vision Benefits and Eyewear Allowance $0 for one routine vision exam every year
$250 allowance every year for contact lenses and eyewear, including lenses and frames
Not covered
Over the Counter Medications NEW for 2018 – Receive a $125
allowance per quarter towards over-the-counter medications and wellness items.
Not covered
Routine Hearing Benefits and Hearing Aid Allowance $0 copay for one hearing exam every year
$0 copay for one hearing aid fitting every year
$1,500 allowance for hearing aids every 3 years
Not covered
Fitness Benefits Join a local participating fitness facility at no additional cost or work out a home with fitness kits and DVDs Not covered
Transportation Benefits Get a ride at no cost.
We cover 50 one-way trips to plan-approved locations.
Not covered
Meal Services (after an inpatient, observational, or skilled nursing facility hospital stay) Receive home-delivered meals after discharge from an inpatient or observational hospital stay at no additional cost to you. Get 14 meals delivered to your home. Not covered
Bathroom Safety Products Choose up to six different bathroom safety products from a menu of items. Not covered
24/7 Nursing Advice Line Call the UPMC MyHealth 24/7 Nurse Line to get health advice from experienced, registered nurses. Not covered
E-Visit a UPMC Provider with AnywhereCare E-visit a UPMC provider straight from your computer, anytime, day or night for a $0 copay. Get access to care for common medical conditions such as colds and flu, sinus infections, coughs and sore throats, urinary symptoms, back pain, sunburn, pink eye, and poison ivy. Not covered
A Customized Care Plan for Every Member Our Care Managers work with you to develop a care plan that helps you meet your personal health goals Not covered

Benefits listed for individuals with Original Medicare do not include any benefits available through the state Medical Assistance (Medicaid) program.

UPMC for Life Options

For those with long-term care needs, UPMC for Life Options uses a network of specialized providers and facilities to provide excellent care in the setting you choose. This plan offers extra services and benefits to give you and your loved ones the peace of mind you deserve. To qualify, you must live in a nursing home or in the community and require the same level of care.

You must reside in one of the following counties to enroll in UPMC for Life Options: Allegheny, Erie, and Washington.

View UPMC for Life Options Details
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Premium, copays, and coinsurance may vary based on the level of Extra Help you receive. Please contact the plan for further details. 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 January 1 of each year. The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.

UPMC for Life Dual is available to anyone who has both Medical Assistance (Medicaid) from the state and Medicare. UPMC for Life Dual is an HMO SNP plan with a Medicare contract and a contract with the Pennsylvania Medical Assistance (Medicaid) program. Enrollment in UPMC for Life Dual depends on contract renewal. UPMC for Life Dual is a product of and operated by UPMC for You Inc.

UPMC for Life Options is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and/or resides in a nursing home. Premiums, copayments, coinsurance, and deductibles may vary based on the level of Extra Help you receive. UPMC for Life Options is an HMO SNP plan with a Medicare contract. Enrollment in UPMC for Life Options depends on contract renewal. UPMC for Life Options is a product of and operated by UPMC Health Plan Inc.


We are available to take your call:
Toll-free: 1-866-405-8762
TTY: 1-866-407-8762
seven days a week 8 a.m. to 8 p.m.*

*Our hours of operation change twice a year.

Oct. 1 – Feb. 14:
seven days a week 8 a.m. to 8 p.m.

Feb. 15 – Sept. 30:
Monday through Friday 8 a.m. to 8 p.m.


Y0069_18_1123 Approved

Last Updated: 10/01/2017
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