SimpliveraCoverage Companion

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UPMC for Life HMO Rx Choice (HMO) — UPMC HEALTH PLAN, INC. | Simplivera

UPMC for Life HMO Rx Choice (HMO)

UPMC HEALTH PLAN, INC.

HMO

MOOP (in-network): $5,000
MOOP (combined): —
Part C+D premium: $26/mo
Part D premium: $26/mo

Plan information

Contract / Plan / Segment: H3907 / 057 / 006
Part D drug coverage: Included ($26/mo)

Other segments for this plan:

Segment 004 Segment 005 Segment 001 Segment 002 Segment 003 Segment 007

Service area

PA: 1 county