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Health care that works together for you

UPMC Health Plan has two plans that work together to provide you with your health care coverage—UPMC for Life Complete Care and UPMC Community HealthChoices. You can enroll in these plans if you are eligible for Medicare and Medical Assistance (Medicaid). When you’re a member of both UPMC for Life Complete Care and UPMC Community HealthChoices, we can more effectively coordinate your health care and make it less confusing. Plus, you get extra benefits to help you stay healthy and independent.

  • UPMC for Life Complete Care (HMO SNP) is a Medicare Advantage plan that gives you medical and prescription drug coverage. UPMC for Life Complete Care acts as your primary health care coverage. You have $0 premium, $0 medical copays, and $0 prescription copays. You even get additional benefits that can save you money and help you stay healthy, including an allowance to buy over-the-counter (OTC) products and groceries, vision care, dental care, hearing care, transportation services, unlimited gym memberships, and home-delivered meals.
  • UPMC Community HealthChoices is a Medicaid plan that provides secondary coverage for most of your medical, prescription, vision, and dental services. If you are eligible for long-term services and supports (LTSS), UPMC Community HealthChoices will coordinate and pay for these services along with your medical coverage.

If your UPMC for Life Complete Care plan does not fully cover something you need, UPMC Community HealthChoices may help cover the cost.* When you have both plans, you can have peace of mind that most of your health care services are covered. You’ll have only one member ID card and one point of contact for all your health care information. And we’re here for you when you need it most with a personal care team that can help schedule doctor’s appointments, understand your treatment plan, and connect you with support in your community.

Here’s how these plans work together to help you get the most out of your health care coverage.

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Dental Coverage

UPMC for Life Complete Care:
  • $0 copay for two oral cleanings and exams every year
  • $4,000 or $7,250 yearly allowance (depending on your plan) for additional dental services
UPMC Community HealthChoices:
  • $0 copay for two oral cleanings and exams every year
  • Restorations (fillings) and simple tooth removal
  • Up to a $500 yearly allowance for certain dental services

Vision Coverage

UPMC for Life Complete Care:
  • $0 copay for one routine vision exam each year
  • $575 yearly allowance for eyewear or contact lenses
UPMC Community HealthChoices:
  • $0 copay for two routine vision exams each year
  • Specialist eye exam with PCP prescription
  • Up to a $100 allowance every 12 months for eyewear or contacts

Gym Benefits

UPMC for Life Complete Care: Unlimited free gym memberships through SilverSneakers® to participating fitness facilities plus one free personal training session each year. The option to work out from the safety of home with in-home fitness kits.

UPMC for Life Complete Care Shop Healthy Card

UPMC for Life Complete Care: A $400 quarterly allowance—that’s up to $1,600 per year—to buy over-the-counter (OTC) health care products and groceries.

Transportation Benefit

UPMC for Life Complete Care: Depending on your plan, 12 or 60 one-way trips (6 or 30 roundtrips) to and from plan-approved locations, including doctor’s offices, health care facilities, and pharmacies.

UPMC Community HealthChoices: Nonmedical trips may be covered for those with Medicaid long-term services and supports based on your service plan.

Home Safety Benefits

UPMC for Life Complete Care: Select up to six home safety products per year.

UPMC Community HealthChoices: Additional bathroom safety products may be covered for those with Medicaid long-term services and supports based on your service plan.

Hearing Benefits

UPMC for Life Complete Care:
  • $0 for one hearing exam and hearing aid fitting each year
  • $3,000 or $5,000 allowance (depending on plan) for hearing aids every three years
UPMC Community HealthChoices: Additional hearing services may be covered for those with Medicaid long-term services and supports based on your service plan.

Inpatient and Outpatient Medical Services

UPMC for Life Complete Care:
  • $0 copay for inpatient medical services
  • $0 copay for outpatient medical services
UPMC Community HealthChoices:
  • $0 copay for inpatient medical services
  • $0 copay for outpatient medical services

Part D Prescription Drug Coverage

UPMC for Life Complete Care Prescription Perks:
  • $0 copay for covered Part D prescription drugs
  • All members have a $0 copay no matter the level of Extra Help (Low Income Subsidy) they receive.

24/7 Health Care Access

UPMC for Life Complete Care:
  • $0 copay for medical advice over the phone from experienced registered nurses
  • $0 copay for an online virtual visit with a UPMC provider
UPMC Community HealthChoices:
  • $0 copay for medical advice over the phone from experienced registered nurses
  • $0 copay for an online virtual visit with a UPMC provider via UPMC AnywhereCare

*UPMC for Life Complete Care benefits must be used before UPMC Community HealthChoices benefits can be used.

**All UPMC for Life Complete Care allowance amounts are based on the 2023 benefit year. Some benefit allowances are monthly or quarterly based. For more information about benefit allowances, call us toll-free at 1-844-575-8241 (TTY: 711).

***UPMC Health Plan members located in Pennsylvania at the time of virtual visit may select a UPMC-employed provider or a provider from Online Care Network II PC (OCN), subject to availability and discretion of the provider. Members located outside of Pennsylvania will receive service from OCN. OCN is not an affiliate of UPMC.



View our Caring for Life eNewsletter to learn more:

Learn more about the UPMC for Life Complete Care plan available in your area

Learn more about UPMC Community HealthChoices
This information is not a complete description of benefits. Call 1-844-575-8241 (TTY: 711) for more information.

This information is available for free in other languages. Please call our customer service number at 1-800-606-8648 (TTY: 711).

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., and UPMC Health Coverage Inc.

SilverSneakers is a registered trademark of Tivity Health Inc. SilverSneakers GO is a trademark of Tivity Health Inc. © 2021 Tivity Health Inc. All rights reserved.
UPMC for Life Complete Care (HMO SNP) Members
Call us toll-free: 1-800-606-8648
TTY: 711

24 hours a day, 7 days a week

UPMC for Life Complete Care Prospective Members
Call us toll-free: 1-844-575-8241
TTY: 711

Jan. 1 – Sept. 30:
Seven days a week from 8 a.m. to 8 p.m.

Oct. 1 – Dec. 31:
Seven days a week from 7 a.m. to 9 p.m.

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Last Updated: 10/01/2022
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