Contact:
Denise Hughes
UPMC Health Plan
412-983-3836
Hughesdr2@upmc.edu
UPMC for Life Announces 2025 Benefits for Its Medicare Advantage Plans, Launches PPO Essential Care Rx Option
The new plan has a $0 premium and gives members $100 back each month in their Social Security check.
Pittsburgh (Oct. 1, 2024) – UPMC Health Plan has announced its UPMC for Life Medicare Advantage plan offerings for 2025 including a new plan with a $0 premium plan that will give members money back each month in their Social Security check.
UPMC for Life continues to offer great supplemental benefits, such as vision, dental, and hearing health care coverage, access to care while members are traveling, and the UPMC for Life Flex Spend Card.
“Whether you’re new to Medicare and are focused on affordability or you’re looking for plans with comprehensive supports and services, UPMC for Life continues to provide great options for everyone. Best of all, all these options provide access to high- quality care and coverage, in addition to award-winning customer service from our Health Care Concierge team,” said Angela Perri, Chief Medicare Officer for UPMC Health Plan. “The 2025 offerings continue our unwavering commitment to providing benefits that support our members’ whole health to maintain their independence.”
Medicare-eligible individuals can select their health plans during the Annual Enrollment Period, which runs from Oct. 15 through Dec. 7, 2024. During this time, new and existing beneficiaries can enroll in a Medicare Advantage or Part D plan or change their current coverage. New plans become effective on Jan. 1, 2025.
UPMC for Life’s benefits and features for 2025 include:
- The new, PPO Essential Care Rx (PPO) plan, which provides access to basic care and coverage with a $0 premium and $100 monthly Part B premium reduction. Members get great supplemental benefits, including vision, dental, and hearing health care;, free fitness memberships at participating locations, and the UPMC for Life Flex Spend Card. Plus, this PPO option allows members to access care out-of-network if needed.*
- Two veteran plan options that are designed by veterans for veterans. HMO No Rx (HMO) offers a $110 monthly Part B premium reduction and lower specialist visit, lab, and x-ray copays. PPO Salute (PPO) works with TRICARE For Life, so members have a $0 copay for most medical benefits, and coverage for vision, dental, and hearing services. The PPO Salute plan service area will now include southeastern Pennsylvania counties (Bucks, Chester, Delaware, Montgomery, and Philadelphia).
- Prescription coverage changes. Because of the Inflation Reduction Act, there will not be a coverage gap (donut hole) in 2025. Once a member’s yearly out-of-pocket drug costs reach $2,000, they will not pay anything for their Part D drugs. UPMC for Life will once again offer members $0 copays for Tier 1 and Tier 2 medications at preferred pharmacies.
- All members who have the UPMC for Life Flex Spend Card can now use their card to pay for memberships, classes, and other fitness activities at premier fitness locations outside the SilverSneakers® network. This includes locations like Club Pilates, Orangetheory, and CycleBar. Members can also purchase home safety products like transfer benches, shower chairs, grab bars, bed rails, couch canes, raised toilet seats, and more. The card can still be used for over-the-counter products, doctor office copays, and dental, vision, and hearing services.
- Members will continue to receive rewards for getting the preventive care they need. Reward dollars are automatically loaded onto their UPMC for Life Flex Spend Card when they complete certain preventive screenings by Dec. 31 each year. UPMC for Life will notify eligible members of the preventive screenings they need at the beginning of the new year.
UPMC for Life members also have the support of a dedicated, award-winning, Health Care Concierge team, that provides customized services, including medical appointment scheduling, assistance with digital health tool resources, and help to resolve coverage questions and concerns.
J.D. Power recently named UPMC for Life #No. 1 in Member Satisfaction among Medicare Advantage Plans in Pennsylvania. UPMC for Life received the highest score in Pennsylvania in the J.D. Power 2024 U.S. Medicare Advantage Study of members' satisfaction with their Medicare Advantage health plan experience. Results are based on award-eligible plans in Pennsylvania by J.D. Power. Visit jdpower.com/awards for more details.
Individuals who are eligible for Medicare and interested in UPMC for Life can enroll by phone or online from the comfort and safety of their homes. For those who want personal help understanding their plan benefits, the UPMC for Life Medicare Advisor team is available to answer questions and provide support. Interested beneficiaries can call UPMC for Life at 1-877-381-3765 (TTY: 711) seven days a week from 8 a.m. to 8 p.m. Medicare members can also go online to upmchealthplan.com/medicare to shop plans, find information about local community meetings, and chat with a Medicare Advisor. For more information about UPMC for Life and its 2025 Medicare Advantage plan offerings, visit upmchealthplan.com/medicare.
*Out-of-network/noncontracted providers are under no obligation to treat UPMC for Life members, except in emergency situations. Members should contact our customer service number or see their Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.
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.
About UPMC Insurance Services
The UPMC Insurance Services Division serves more than 4 million members and is owned and operated by UPMC, a world-renowned health care provider and insurer in Pittsburgh, Pennsylvania. The UPMC Insurance Services Division provides commercial products through UPMC Health Plan for both groups and individuals. Its commercial products also include workers' compensation and employee assistance from nationally known Workpartners®. Government products include Medicare Advantage plans (UPMC for Life); special needs plans for those who are eligible for Medicare and Medical Assistance (UPMC for Life Complete Care and UPMC Community HealthChoices); a Medical Assistance plan (UPMC for You); and Children's Health Insurance Program plans (UPMC for Kids). Community Care Behavioral Health Organization—one of the nation's largest nonprofit managed care behavioral health organizations—is also part of the Insurance Services Division. Community Care offers a full range of services to commercial and Medical Assistance members. For more information, visit upmchealthplan.com.
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