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Gina Pferdehirt
Director, Public Relations & Community Relations
UPMC Health Plan
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pferdehirtgm@upmc.edu
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Contact: Gina Pferdehirt |
Five of the six existing Medicare plans will feature lowered monthly premiums; New $0 premium, $0 deductible with Part D coverage HMO plan also added in Allegheny and Beaver counties
PITTSBURGH (Oct. 1, 2017) – UPMC for Life – the Medicare Advantage product of UPMC Health Plan – remains committed in 2018 to offering high quality plans at premium costs that are among the lowest in western Pennsylvania.
UPMC for Life is offering six plans in the 28 counties of Western Pennsylvania in 2018 – four HMO plans and two PPO plans along with a new HMO Medicare Premier Rx plan available in Allegheny and Beaver Counties – so that Medicare-eligible members can choose the one that best suits their needs.
Four of the six existing plans will feature lowered monthly premiums in 2018. And most UPMC for Life Medicare Advantage members will have access to a provider network that includes over 25,000 doctors and 155 hospitals in Pennsylvania, including the doctors and hospitals of UPMC. For nearly 20 years, UPMC has been one of the top-ranked hospitals in the nation.*
All UPMC for Life HMO plans maintain an “Excellent” accreditation from the National Committee for Quality Assurance (NCQA), the highest honor a managed care plan can receive.†
UPMC for Life Medicare Advantage members can also benefit from UPMC Health Plan’s Health Care Concierge program. Concierges are local customer service representatives who are knowledgeable about Medicare and are dedicated to answering members’ questions and to getting their problems solved with just one phone call.
For the second year in a row, UPMC Health Plan ranked highest in Pennsylvania in overall member satisfaction according to the J.D. Power 2017 Member Health Plan StudySM.
All of UPMC for Life's Medicare Advantage plans offer more benefits than Original Medicare alone, including low copays for primary care physician visits and complimentary membership at a participating fitness club through Silver&Fit™. Most plans will also offer preventive dental coverage.
The UPMC for Life HMO Deductible with Rx plan will lower its monthly plan premium to $20 (a $2 monthly plan premium reduction from 2017). UPMC for Life HMO Rx will also lower its plan premium cost to $81 per month for calendar year 2018 (a $2 monthly plan premium reduction from 2017) and UPMC for Life HMO Rx Enhanced plan will have a $263 monthly plan premium (an $8 monthly plan premium increase from 2017). In addition, UPMC for Life will continue to offer UPMC for Life HMO, a $0 monthly plan premium that does not include prescription drug coverage. This plan is considered ideal for persons who have prescription coverage through the Veterans Administration.
New for 2018 in Allegheny and Beaver counties is the UPMC for Life HMO Premier Rx plan, which will have a $0 monthly plan premium along with a $0 annual deductible and Part D prescription drug coverage. This plan will also have a $0 copay for primary care physician visits. This plan has a select network of providers that members can use for their care. Members will have full in-network access to UPMC and Heritage Valley Health System providers. Members can use any UPMC or Heritage Valley Health System provider for care without a referral.
UPMC for Life members enrolled in a plan that includes prescription drug coverage will also have a $0 copay for preferred generic (Tier 1) prescriptions when filled at a preferred pharmacy starting on Jan. 1, 2018. Preferred pharmacies will also offer members the lowest copays on generic (Tier 2), preferred brand (Tier 3), and non-preferred (Tier 4) drugs. This change is designed to help our members fill prescriptions as cost-effectively at preferred pharmacy locations, including Costco, Giant Eagle, Giant Food Stores, Kmart, Rite Aid, Sam’s Club, Walgreens, Walmart, and Wegmans.
For the second year in a row, all UPMC for Life HMO members will have full in-network coverage when traveling to the state of Florida. That means they maintain the same benefits and cost sharing when they see a provider in Florida as they do at home in Pennsylvania, simply by calling UPMC Health Plan to activate their travel benefit.
Medicare-eligible patients in Western Pennsylvania will also have the option to select among two PPO plans. UPMC for Life PPO Rx Enhanced plan will have a monthly plan premium of $135 and the UPMC for Life PPO High Deductible with Rx plan has a $35 monthly plan premium. Both PPO plans represent a $2 monthly plan premium reduction from 2017.
"UPMC for Life continues to offer great coverage, great value and security to the Medicare beneficiaries of Pennsylvania," said John Lovelace, president of government programs at UPMC Health Plan. "Our members have the security and peace of mind with in-network access to the top-ranked hospitals as well as the concierge support of our top-quality member services."
Most UPMC for Life plans include preventive dental coverage for cleanings and exams. The UPMC Dental Advantage Medicare benefit includes a $15 copay for one oral exam and a $0 copay cleaning every six months. It also offers a $15 copay for one bitewing x-ray every year.
All UPMC for Life members can take advantage of the Silver&Fit Exercise and Healthy Aging Program. This program provides membership at participating fitness facilities at no additional cost to the member. For those who prefer to work out at home, the program provides a variety of home fitness kits including walking, Pilates, yoga, dance, and cardio strength.
Additional benefits for all UPMC for Life plans include Assist America, which provides help when travelling more than 100 miles from home or to a foreign country. Help is available 24 hours a day, 365 days a year.
* U.S. News & World Report (America’s Best Hospitals, 8-8-17)
† This award was not given by Medicare. For more information about UPMC for Life's CMS Star Rating, go to www.Medicare.gov.
Medicare beneficiaries must continue to pay their Medicare Part B premium when enrolled in a UPMC for Life plan. 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 provider network may change at any time. You will receive notice when necessary. Other providers are available in our network.
UPMC for Life’s pharmacy network offers limited access to pharmacies with preferred cost-sharing in our PA service area. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including pharmacies with preferred cost-sharing, please call Member Services at 1-877-539-3080 (TTY: 711) seven days a week from 8 a.m. to 8 p.m. or consult the online pharmacy directory at www.upmchealthplan.com/medicare. Other pharmacies are available in our network.
UPMC for Life has a contract with Medicare to provide HMO and PPO plans. 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., and UPMC Health Benefits Inc.
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About UPMC Insurance Services Division
The UPMC Insurance Services Division is owned by UPMC (University of Pittsburgh Medical Center) a world-renowned health care provider and insurer based in Pittsburgh, Pa. As a provider-led organization that is part of an integrated health care delivery system, the UPMC Insurance Services Division is committed to providing its members better health, more financial security and the peace of mind they deserve. The UPMC Insurance Services Division partners with UPMC and community network providers to produce a combination of knowledge and expertise that provides the highest quality care at the most affordable price. The UPMC Insurance Services Division – which includes UPMC Health Plan, WorkPartners, UPMC for Life, UPMC for You, UPMC for Kids, and Community Care Behavioral Health — offers a full range of group health insurance, Medicare, Special Needs, CHIP, Medical Assistance, behavioral health, employee assistance and workers' compensation products and services to more than 3.2 million members. For more information, visit www.upmchealthplan.com.