Healthcare Options with UPMC Medicare Advantage: Available locations, plan choices, and associated prices
UPMC, the University of Pittsburgh Medical Center, has been providing health services to over 3.9 million people across Pennsylvania, parts of Maryland, West Virginia, and Ohio since 1994. The healthcare provider offers a variety of Medicare Advantage plans, designed to go beyond basic hospital and medical services coverage.
UPMC's Medicare Advantage plans include benefits such as prescription drug coverage, which is included as part of the plan, unlike Original Medicare that may require separate drug plans. These plans also offer enhanced care programs for chronic conditions like COPD, featuring multidisciplinary, patient-centered approaches with telehealth, pharmacist-led medication management, education, and lifestyle support.
Health incentive programs, like "Take a Healthy Step," are another feature of UPMC's Medicare Advantage plans. Members earn points for completing healthy activities, which can be converted into reward dollars to help cover out-of-pocket costs such as deductibles, coinsurance, and pharmacy copays.
Additional support for specialized needs is also provided, with coverage options related to drug and alcohol rehab and possibly dental and vision care through Medicaid wrap plans associated with UPMC. However, specific Medicare Advantage rehab benefits are less detailed.
UPMC also offers PPO plans, providing more flexibility in choosing providers. The monthly premium for PPO plans ranges from $0 to $140.
For those who qualify for both Medicare and Medicaid, UPMC offers the UPMC for Life Complete Care plan (HMO SNP), which includes additional benefits such as an OTC medication and healthful groceries allowance, wellness counseling, and home-delivered meals.
Each UPMC for Life plan offers the same basic coverage as Original Medicare, including inpatient stays, outpatient visits, laboratory and diagnostic services, preventive care, mental health services, physical and occupational therapy, durable medical equipment, emergency care, and some transportation services.
The maximum out-of-pocket amount for HMO plans ranges from $4,500 to $7,550, and for PPO plans, it ranges from $5,000 to $8,000 in 2025.
In addition to Medicare Advantage plans, UPMC provides group health insurance, employee assistance, workers' compensation products, and children's health insurance programs (CHIP).
It's important to note that UPMC's Medicare Advantage plans are only available to residents of Pennsylvania and some parts of Ohio. The costs associated with these plans include monthly Advantage plan premiums, original Medicare premiums, copays and coinsurance, and deductibles.
The Medicare program, funded by the government, helps people aged 65 and over with their healthcare costs. Younger people may qualify if they have certain conditions or disabilities. Medicare Advantage plans offer the same basic coverage as original Medicare plus some extra benefits.
[1] UPMC Medicare Advantage Plans: https://www.upmc.com/medicare [2] UPMC Chronic Condition Management: https://www.upmc.com/services/chronic-condition-management [3] UPMC Substance Use Disorder Services: https://www.upmc.com/services/substance-use-disorder-services [4] Medicare Advantage Plans: https://www.medicare.gov/what-medicare-covers/learn-about-what-original-medicare-covers/what-medicare-doesnt-cover [5] UPMC Health Incentive Programs: https://www.upmc.com/services/wellness/programs/health-incentive-programs
- UPMC's Medicare Advantage plans offer additional benefits beyond basic hospital and medical services coverage, including prescription drug coverage and health incentive programs that reward members for completing healthy activities.
- UPMC provides coverage options for specialized needs, such as drug and alcohol rehab, dental, and vision care through Medicaid wrap plans, offering a comprehensive approach to health and wellness.
- Medicare Advantage plans, like those offered by UPMC, go beyond the basic coverage of Original Medicare, incorporating elements of science and health organizations, such as enhanced care programs for chronic conditions and multidisciplinary approaches that encompass telehealth, pharmacist-led medication management, education, and lifestyle support.
