UPMC for Life Coverage Criteria
UPMC for Life uses clinical criteria to make coverage decisions. You can click the link below to access the InterQual criteria used to make medical necessity coverage determinations. You must create an account if you currently do not have one. Just select "Create One Healthcare ID."
Our coverage policies can also help you better understand your plan’s health coverage requirements:
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 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.
SilverSneakers is a registered trademark of Tivity Health Inc. SilverSneakers GO is a trademark of Tivity Health Inc. © 2024 Tivity Health Inc. All rights reserved.
UPMC for Life Complete Care (HMO D-SNP) members
Call us toll-free: 1-800-606-8648
TTY: 711
Oct. 1 – March 31:
Seven days a week from 8 a.m. to 8 p.m.
April 1 – Sept. 30:
Monday through Friday from 8 a.m. to 8 p.m.
UPMC for Life Complete Care prospective members
Call us toll-free: 1-844-575-8241
TTY: 711
Oct. 1 – Mar. 31:
Seven days a week from 8 a.m. to 8 p.m.
April. 1 – Sept. 30:
Monday through Friday from 8 a.m. to 8 p.m. Saturday from 9 a.m. to 3 p.m.
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Last Updated: 9/10/2024
Last Updated: 9/10/2024