UPMC for Life HMO No Rx (HMO)
Pennsylvania Medicare Advantage Plan (2023 Plan)
Overall Government Star Rating5.0
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UPMC for Life HMO No Rx (HMO) is a Medicare Advantage Plan Without Prescription Drugs, which is available in Pennsylvania and offered by the health insurance company UPMC for Life. This plan’s network type is HMO which determines in-network doctors who accept the health plan and whether a referral is needed.
UPMC for Life HMO No Rx (HMO) has a monthly premium cost of $0 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $5,000 In-network. The most common benefit costs which people evaluate when choosing a plan are costs for a primary doctor visit, specialist doctor visit, emergency room visit, and ambulance. These costs are listed in this summary section and a full list of benefit costs for UPMC for Life HMO No Rx (HMO) are defined below.
Additional Benefits and Coverage
UPMC for Life HMO No Rx (HMO) is a Medicare Advantage plan which does not include Medicare Part D Prescription Drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. UPMC for Life HMO No Rx (HMO) includes coverage for hearing, vision, dental.
Medicare Advantage health plans can offer even more additional benefits. UPMC for Life HMO No Rx (HMO) includes coverage for the following additional benefits:
Comparing the Quality Score of UPMC for Life HMO No Rx (HMO) to Other Plans in Pennsylvania
Each year the federal government evaluates the quality of Medicare Advantage and Part D Prescription Drug plans based on a 5-star scoring system. For 2023, UPMC for Life HMO No Rx (HMO) received an overall government quality rating of 5.0 stars out of 5 stars.
UPMC for Life HMO No Rx (HMO) performed better than Pennsylvania’s State average overall quality score of 4.3 stars.
The government calculates an “Overall star rating” based on ratings for sub components including “Health plan star rating” and “Drug plan star rating”, which includes further subcomponents of each.
UPMC for Life HMO No Rx (HMO) received 5 stars for its health plan quality score which is better than the Pennsylvania State average health plan quality score of 4.3 stars.
Plan Benefits and Coverage Details
Tests, labs, & imaging
Skilled nursing facility
$80 per day for days 21 through 100
Mental health services
Opioid treatment services
Prescription Drug Benefits
Tier drug costs for: Standard retail pharmacy drug cost for 1-month
Part B Drugs
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In this article we rank Pennsylvania Medicare Advantage plans based on our evaluation of government 5-star quality scores. Each year the government rates the quality of Medicare Advantage health insurance plans with a 5-star quality score. An overall quality score is assigned to each plan which is based on the scores of various quality metrics.
The Medicare landscape in Pennsylvania is constantly changing. In this article we show a summary of new and returning health insurance companies offering Medicare Advantage Plans (Part C) and Medicare Prescription Drug Plans (Part D) in Pennsylvania.