Ways to Enroll

Applying for enrollment in UPMC for Life is easy

Follow the steps below to apply for enrollment in a UPMC for Life plan. If you are a UPMC for Life member and would like to change your plan, please visit our Member Plan Change Form.

  1. Choose the UPMC for Life plan to which you would like to apply for enrollment.
    Compare plan options and benefits    .

  2. Apply for enrollment. We offer three ways to apply:
    • By phone: Call us at 1-866-400-5077 (TTY: 711) to apply for enrollment over the phone.
    • Online: Apply online using our secure enrollment website.
    • Print: Complete, sign, and date the enrollment application and mail or fax it to us.

         
    2025 Enrollment Application

    2026 Enrollment Application

    Mail: UPMC for Life
    PO Box 2967
    Pittsburgh, PA 15230

    Fax: 412-454-7766

     

  3. We will contact you once your enrollment application has been processed.

You can also enroll online via the Medicare website at medicare.gov.

Medicare resources

View More
Additional Documents and Forms
Medicare Complaint Form
Eligible for Medicare and Medicaid
Request a Provider Directory or Plan Materials
Medication Therapy Management
Language Assistance
UPMC for Life Coverage Criteria

This information is not a complete description of benefits. Call 1-866-400-5077 (TTY: 711) for more information. Out-of-network/Noncontracted providers are under no obligation to treat UPMC for Life members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost sharing that applies to out-of-network services. Other physicians/providers are available in the UPMC for Life network.

This information is available for free in other languages. Please call our customer service number at 1-877-539-3080 (TTY: 711).

UPMC for Life has a contract with Medicare to provide HMO, HMO D-SNP, and PPO plans. The HMO D-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., UPMC for You Inc., and UPMC Health Coverage Inc.

SilverSneakers is a registered trademark of Tivity Health Inc. SilverSneakers GO is a trademark of Tivity Health Inc. © 2025 Tivity Health Inc. All rights reserved.

UPMC for Life Members
Call us: 1-877-539-3080
TTY: 711

Oct. 1 – March 31:
Seven days a week from 8 a.m. to 8 p.m.

April 1 – Sept. 30:
Monday through Friday from 8 a.m. to 8 p.m.

UPMC for Life Prospective Members
Call us: 1-866-400-5077
TTY: 711

Oct. 1 – March 31:
Seven days a week from 8 a.m. to 8 p.m.
 
April 1 – July 31:
Monday through Friday from 8 a.m. to 8 p.m. 
 
Aug. 1 – Sept. 30:
Monday through Friday from 8 a.m. to 8 p.m. Saturday from 9 a.m. to 3 p.m. 

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Last Updated: 10/1/2025