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Medicare Advantage · Local PPO
UPMC for Life
Plan year 2027

UPMC for Life PPO Rx Choice (PPO) H5533-020

Monthly premium
$43
+ your Part B premium
Max out-of-pocket
$7,000
in-network annual cap
Primary care
$0
per visit copay
Specialist
$35
per visit

Your costs at a glanceIn-network, for the 2027 plan year

Medical deductible
$0
Max out-of-pocket, in and out of network
$10,000
Rx deductible
$700
Inpatient hospital
$175
/day
days 1–5, then $0
Inpatient mental health
Days 1-5: $200/day, Days 6-90: $0/day
Outpatient surgery
$225
–$350
Emergency room
$130
Urgent care
$50

What's included, and what it's actually worth3 benefits included. Tap any card for the detail

Hearing

$690–$1,890copay per hearing aid
Details$690–$1,890 copay per hearing aid
This is a supplemental benefit with plan-specific limits. See plan documents for details.

Vision

$175/yr eyewear allowance
Eyewear allowance$175/yr eyewear allowance
This is a supplemental benefit with plan-specific limits. See plan documents for details.
See more details about this plan
Doctor Visits: PCP$0 copay
In-network$0 copay per visit
Doctor Visits: Specialist$35 copay
In-network$35 copay per visit
Inpatient Hospital$175/day, days 1–5
In-network$175/day for days 1-5, $0/day for days 6-90
Outpatient Surgery$225–$350
In-network$225–$350 per procedure
Mental HealthDays 1-5: $200/day, Days 6-90: $0/day
Inpatient psychiatricDays 1-5: $200/day, Days 6-90: $0/day
Fitness$0 fitness benefit

Your coverageCheck your coverageFrom the doctors and prescriptions you added

Our take

Where this plan shines

See your primary doctor for $0.
No separate medical deductible.

Things to know before you enroll

This plan’s out-of-pocket maximum is above the national median.
Limited coverage while traveling outside the plan’s service area.
Questions? Talk to a licensed agent at1-866-764-3312 (TTY: 711)

Plan documents

Plan questions

Common questions about UPMC for Life PPO Rx Choice (PPO) (Local PPO)

What does UPMC for Life PPO Rx Choice (PPO) (Local PPO) cover?

UPMC for Life PPO Rx Choice (PPO) (Local PPO) is a Medicare Advantage plan that the current plan record identifies as including Part D prescription drug coverage. The plan record also identifies Part D prescription drug coverage. Published supplemental benefits include vision ($175/yr eyewear allowance), hearing ($690–$1,890 copay per hearing aid), and fitness ($0 fitness benefit). Review the plan documents for covered services, limits, and rules. Coverage can change each plan year.

Learn about Medicare Advantage

How much does UPMC for Life PPO Rx Choice (PPO) (Local PPO) cost in 2027?

The published 2027 monthly plan premium for UPMC for Life PPO Rx Choice (PPO) (Local PPO) is $43. Any Medicare premiums you owe are separate from the listed plan premium. The listed medical deductible is $0. The listed Part D deductible is $700. The in-network medical out-of-pocket maximum is $7,000; it does not include Part D drug spending. Published visit costs include primary care $0 and specialist visits $35. These figures are plan data, not a personal yearly-cost estimate.

Understand Medicare drug-cost limits

Can I use my current doctors with UPMC for Life PPO Rx Choice (PPO) (Local PPO)?

CMS lists UPMC for Life PPO Rx Choice (PPO) (Local PPO) as a Local PPO plan. A network label alone does not confirm that a specific doctor participates. Use the doctor lookup tool, then confirm with the doctor's office and the plan before receiving care. Provider networks and member costs can change. Emergency care and travel coverage can follow different network rules.

Check your doctors

Does UPMC for Life PPO Rx Choice (PPO) (Local PPO) cover my prescriptions?

The current plan record for UPMC for Life PPO Rx Choice (PPO) (Local PPO) does not include tier-level formulary costs. The listed Part D deductible is $700. A tier listing does not confirm that a specific prescription is covered. Check each medication against the plan's current formulary, restrictions, pharmacy network, and costs before enrolling.

Check your prescriptions

What dental, vision, and hearing benefits does UPMC for Life PPO Rx Choice (PPO) (Local PPO) include?

The current plan record for UPMC for Life PPO Rx Choice (PPO) (Local PPO) lists vision ($175/yr eyewear allowance) and hearing ($690–$1,890 copay per hearing aid). The current data does not list dental as offered benefits. Benefit allowances, frequency, eligibility, and participating providers can have additional limits, so review the Summary of Benefits or Evidence of Coverage for the complete rules.

When can I enroll in UPMC for Life PPO Rx Choice (PPO) (Local PPO)?

UPMC for Life PPO Rx Choice (PPO) (Local PPO) is a 2027 Medicare Advantage plan. The Annual Enrollment Period runs from October 15 through December 7, with changes taking effect January 1. The Medicare Advantage Open Enrollment Period runs from January 1 through March 31 for people already enrolled in Medicare Advantage. A qualifying circumstance may create a Special Enrollment Period outside those dates. Confirm the enrollment window and effective date that apply to you before changing coverage.

Review Medicare enrollment periods

More plan options

Browse the full 2027 Medicare Advantage with drug coverage directory. This plan is offered in Pennsylvania. Plan availability can vary by county.

Helpful next steps

UPMC for Life PPO Rx Choice H5533-020 (PPO) — 2027 Costs & Benefits