UPMC for Life Earns a 4.5 Star Rating from CMS
HMO plans also earn an “excellent” 5 Summary Star Rating for Part D drug plan services
PITTSBURGH (Oct. 14, 2019) – UPMC for Life, the Medicare Advantage product of UPMC Health Plan, was awarded 4.5 out of a possible 5 Overall Star Rating for its HMO and PPO plans for 2020 according to ratings released by the Centers for Medicare & Medicaid Services (CMS). This ranking places UPMC for Life among the highest-rated Medicare plans in the nation.
The increased score means that all UPMC for Life HMO and PPO members will be enrolled in plans with an Overall Star Rating of 4.5. The UPMC for Life HMO plans also scored a perfect 5 Summary Star Rating for Part D drug plan services. These enhanced Star Ratings help UPMC for Life maintain the strong benefits and programs currently offered to members and reflect the strength and stability of their products over the last several years.
“This 4.5 Star Rating reflects UPMC for Life’s commitment to our more than 160,000 members across Pennsylvania and our efforts to help each member live their fullest, healthiest life,” said Namita Ahuja, MD, senior medical director, Medicare and geriatric programs at UPMC Health Plan. “We believe that a strong partnership between the member, their doctors, and us as their insurance carrier helps us to deliver the highest quality of care. We hope this score resonates with our members and the communities we serve as we continue to expand our benefits and personalized care programs.”
CMS rates all Medicare Advantage and prescription drug plans each year to assist Medicare beneficiaries and their families in comparing plans based on quality and performance. The Star Ratings combine scores for the types of services each Medicare Advantage plan offers. Ratings range from a low of “1” star, which is poor, to the highest possible “5” stars, which is excellent.
Among the areas CMS reviews to determine its ratings include:
- How members rate each plan's services and care;
- How well each plan's doctors detect illnesses and keep members healthy; and
- How well each plan helps its members use recommended and safe prescription medications.
Enhanced Plan Benefits for 2020
Earlier this month, UPMC for Life announced a bold new program to help Pennsylvanians who have diabetes or diabetes risk factors manage their care. This program includes personalized wellness plans for each UPMC for Life member and significantly reduced copays for diabetes medications.
As part of the new program, beginning in 2020, all brand diabetes medications on the UPMC for Life formulary will be moving from Tier 3 to Tier 2, which means UPMC for Life members will have copays as low as $10 for a 30-day supply when they are filled at a preferred pharmacy. For example, members will be able to purchase a three-month supply of insulin for $20 when they use a preferred pharmacy or mail-order, which can lead to potential savings of over $300 each year.
UPMC for Life health coaches are specially trained in chronic condition management and can help members stay on track with their health goals, including lifestyle improvements such as beginning an exercise program, losing weight, eating healthy, stopping smoking, reducing stress, and providing reminders to take medications.
UPMC for Life also offers members a preventive incentive program that rewards eligible members for getting their recommended preventive care such as an annual wellness visit, mammograms, colorectal screenings, and diabetic retinal eye exams. Members who complete their recommended preventive care can receive up to $155 in rewards for 2019. Members have a secure member website, MyHealth OnLine, where they can track their screenings to know which they have already completed and which they still need to complete to earn rewards.
Enrollment Details
The 2020 Annual Election Period is Oct. 15 through Dec. 7, 2019. Medicare beneficiaries can add or drop Part D prescription drug coverage, switch or change to a Medicare Advantage plan, or change to Original Medicare. Changes in coverage will be effective Jan. 1.
Medicare beneficiaries who are interested in UPMC for Life can get information on the 2020 plans online at www.upmchealthplan.com/medicare or by calling UPMC for Life toll-free at
1-877-381-3765 seven days a week from 8 a.m. to 8 p.m. TTY users should call 711.
Every year, Medicare evaluates plans based on a 5-star rating system. 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., UPMC Health Coverage Inc., and UPMC for You Inc.
Y0069_201391_M
##
About UPMC Insurance Services Division
The UPMC Insurance Services Division is owned and operated by the UPMC, a world-renowned health care provider and insurer based in Pittsburgh, Pa. 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 Employer Group and Individual health insurance, Medicare, Special Needs, Children’s Health (CHIP), Medical Assistance, Behavioral Health, Employee Assistance Programs (EAP), Workers' Compensation, and Absence Management products and services to 3.5 million members. For more information, visit www.upmchealthplan.com.