2026 benefits

UPMC for Life Complete Care: Western and Central PA plans

UPMC for Life Complete Care: Northeastern and Southeastern PA plans

Original Medicare Parts A and B

Inpatient and outpatient medical services

$0 copay

$0 copay

$0 copay

Prescription drug coverage

$0 copay for Tier 1 and Tier 2 medications

$0 copay for Tier 1 and Tier 2 medications

X

UPMC for Life Complete Care Shop Healthy Card

Additional dollars to buy over-the-counter (OTC) and home safety products. Members who qualify* get additional allowances for healthy foods and household utilities.

Additional dollars to buy over-the-counter (OTC) and home safety products. Members who qualify* get additional allowances for healthy foods and household utilities.

X

Dental allowance for services like dentures, bridges, crowns, root canals, and more

$8,250

$3,995 (Southeastern PA)
$5,000 (Northeastern PA)

X

Vision allowance for contact lenses or eyeglasses—including progressive and transitional lenses

$575

$575

X

Coverage for hearing aids**

$0 copay every year

$0 copay every three years

X

Trips to plan-approved locations like the doctor’s office, health care facilities, pharmacies, and fitness centers. Members who qualify* can use some of their one-way trips to go to approved nonmedical locations, including grocery stores, salons, places of worship, libraries, banks, funeral homes, and community centers.

$0 copay for 60 one-way trips; up to 34 can be used for non-medical locations for members who qualify.

$0 copay for 20 one-way trips; up to 8 can be used for non-medical locations for members who qualify.

X

Up to five home safety products per year and one yearly in-home safety assessment

$0 copay

$0 copay

X

Unlimited gym memberships and one personal training session per year at a participating fitness center

FREE

FREE

X

Unlimited routine podiatry visits per year

$0 copay

$0 copay

X

*These benefits are part of the Special Supplemental Benefits for the Chronically Ill (SSBCI) program. To be eligible, you must qualify for the Low-Income Subsidy (LIS) and have one of the following chronic illnesses: chronic/disabling mental health conditions, metabolic disorders, cardiovascular disorders, substance use orders, diabetes, or other eligible conditions not listed. Eligibility in this benefit cannot be guaranteed solely on your condition. All applicable eligibility requirements must be met before the benefit is provided. For details, please contact us.

**Members must use a participating Amplifon hearing provider to take advantage of the $0 hearing aid copay. Go to upmchealthplan.com/find to find participating hearing providers. Routine hearing copays are excluded from the yearly deductible, if applicable, and do not count toward your annual maximum out-of-pocket.

Learn

Plan Benefits

Plan Benefits

Dental, Vision, and Hearing Coverage

Dental, Vision, and Hearing Coverage

Members

Get more benefits than Original Medicare