UPMC for Life PPO Salute (PPO)
Pennsylvania Medicare Advantage Plan (2023 Plan)
Monthly Premium
Additional Coverage
Overall Government Star Rating
5.0Ready to Enroll Online?
Plan Overview
UPMC for Life PPO Salute (PPO) 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 PPO which determines in-network doctors who accept the health plan and whether a referral is needed.
Cost Summary
UPMC for Life PPO Salute (PPO) has a monthly premium cost of $0 per month, with an annual deductible of $1,600 per year for inpatient hospital services and $226 for outpatient services with a total plan deductible of $1,826 per year from in-network and out-of-network providers. and a maximum out of pocket cost sharing of $8,950 In and Out-of-network $5,500 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 PPO Salute (PPO) are defined below.
Additional Benefits and Coverage
UPMC for Life PPO Salute (PPO) 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 PPO Salute (PPO) includes coverage for hearing, vision, dental.
Medicare Advantage health plans can offer even more additional benefits. UPMC for Life PPO Salute (PPO) includes coverage for the following additional benefits:
Other benefits
Comparing the Quality Score of UPMC for Life PPO Salute (PPO) 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 PPO Salute (PPO) received an overall government quality rating of 5.0 stars out of 5 stars.
UPMC for Life PPO Salute (PPO) 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 PPO Salute (PPO) 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
$5,500 In-network
Medical Benefits
Doctor Services
Out-of-network: 20% coinsurance per visit
Out-of-network: 20% coinsurance per visit
Tests, labs, & imaging
Out-of-network: 20% coinsurance
Out-of-network: $0 copay
Out-of-network: 20% coinsurance
Out-of-network: 20% coinsurance
Hospital Services
$1,600 deductible for days 1 through 60
$400 copay per day for days 61 through 90
Out-of-network: In 2023 the amounts for each benefit period are:
$1,600 deductible for days 1 through 60
$400 copay per day for days 61 through 90
Out-of-network: 20% coinsurance per visit
Skilled nursing facility
$0 copay for days 1 through 20
$200 copay per day for days 21 through 100
Out-of-network: In 2023 the amounts for each benefit period are:
$0 copay for days 1 through 20
$200 copay per day for days 21 through 100
Preventive services
Out-of-network: $0 copay
Ambulance
Out-of-network: 20% coinsurance
Therapy services
Out-of-network: 20% coinsurance
Out-of-network: 20% coinsurance
Mental health services
Out-of-network: 20% coinsurance
Out-of-network: 20% coinsurance
Out-of-network: 20% coinsurance
Out-of-network: 20% coinsurance
Opioid treatment services
Other services
Out-of-network: 20% coinsurance per item
Out-of-network: 20% coinsurance per item
Out-of-network: 20% coinsurance per item
Prescription Drug Benefits
Tier drug costs for: Standard retail pharmacy drug cost for 1-month
Part B Drugs
Out-of-network: 20% coinsurance
Out-of-network: 20% coinsurance
Extra Benefits
Hearing
Out-of-network: 20% coinsurance
Out-of-network: 50% coinsurance
Out-of-network: $690-1,890 copay
Preventive Dental
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Comprehensive dental
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Vision
Out-of-network: 50% coinsurance
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
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