UPMC for Life Medicare Advantage 2024-2025 Review

UPMC for Life Medicare Advantage pros and cons

Our full review

UPMC for Life Medicare star ratings

Average star rating, weighted by enrollment: 4.41

UPMC for Life Medicare Advantage plans are rated above the industry average, receiving an average rating of 4.41 stars out of 5 from the Centers for Medicare & Medicaid Services (CMS) for 2025, weighted by enrollment^[0]

CMS maintains star ratings for Medicare Advantage plans on a 5-point scale, ranking plans from best (5 stars) to worst (1 star). The agency bases these ratings on plans’ quality of care and measurements of customer satisfaction, and ratings may change from year to year.

You can find a plan’s rating with the Medicare plan finding tool.

What does UPMC for Life Medicare Advantage cost?

In 2025, less than a third of UPMC for Life Medicare Advantage prescription drug plans (28%) that aren’t special needs plans (SNPs) have a $0 premium^[0]

(Most people pay this standard Part B amount, but if your income is above a certain threshold, you’ll pay the income-related monthly adjustment amount (IRMAA). Some Medicare Advantage plans cover part or all of your Part B premium.)

Requirements for copays, coinsurance and deductibles vary depending on your plan, location and the services you use. Other out-of-pocket costs to consider include:

• Whether the plan covers any part of your monthly Medicare Part B premium.

• The plan’s yearly deductibles and any other deductibles, such as a drug deductible.

• Copayments and/or coinsurance for each visit or service. For instance, there may be a $10 copay for seeing your primary doctor and a $45 copay for seeing a specialist.

• The plan’s in-network and out-of-network out-of-pocket maximums.

• Whether your medical providers are in-network or out-of-network, or how often you may go out of network for care.

• Whether you require extra benefits, and if the plan charges for them.

To get a sense of costs, use Medicare’s plan-finding tool to compare information among available plans in your area. You can select by insurance carrier to see only UPMC for Life plans or compare across carriers.

Available UPMC for Life Medicare Advantage plans

UPMC for Life offers Medicare Advantage prescription drug plans as well as Medicare Advantage plans without drug coverage.

Plan offerings include the following types:

HMO plans

A health maintenance organization (HMO) generally requires that you use a specific network of doctors and hospitals. You may need a referral from your primary doctor in order to see a specialist, and out-of-network benefits are usually very limited.

PPO plans

Preferred provider organization (PPO) plans provide the most freedom, allowing you to see any provider that accepts the insurance. You may not need to choose a primary doctor, and you don’t need referrals to see specialists. You can seek out-of-network care, although it may cost more than seeing an in-network doctor.

SNPs

Special needs plans (SNPs) restrict membership to people with certain diseases or characteristics. Hence, the benefits, network and drug formularies are tailored to the needs of those members. UPMC for Life offers one type of SNP:

• Dual-Eligible SNP: For people who are entitled to Medicare and who also qualify for assistance from a state Medicaid program.

UPMC for Life Medicare Advantage service area

UPMC for Life offers Medicare Advantage plans in only two states: Pennsylvania and Ohio. (The provider is available in only two counties in Ohio.) UPMC for Life covers nearly 220,000 Medicare Advantage beneficiaries^[0]