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UPMC Health System — 2026 Medicare Advantage plans

Contract year 2026 · data updated October 01, 2026 · source files

UPMC Health System filed 35 individual Medicare Advantage plan segments for 2026 under 4 CMS contracts, available across 2 states and 67 counties. This page reports CMS filings; MedicareBenefits.care is not affiliated with or endorsed by UPMC Health System and does not rank or recommend plans.

CMS public dataReported, not recommendedNo broker influenceNo paid placementDirect from CMS sources
35plan segments filed
4CMS contracts
2states
67counties
12with a $0 premium
3.5–4.5overall star range

Plan types: HMO (18) · PPO (14) · HMO D-SNP (3). Special Needs Plans: 3 of 35.

UPMC Health System Summaries of BenefitsEvery indexed SoB for this carrier, linked from its own site.

View SoBs

All 35 UPMC Health System plans filed for 2026

PlanTypePremiumIn-network MOOPOverall stars
UPMC for Life HMO Premier Rx (HMO)
H3907-059-001 · SoB
HMO$0$6,0004.5out of 5 stars, Above average
UPMC for Life HMO Premier Rx (HMO)
H3907-059-002 · SoB
HMO$0$5,0004.5out of 5 stars, Above average
UPMC for Life HMO Premier Rx (HMO)
H3907-059-003 · SoB
HMO$0$6,7004.5out of 5 stars, Above average
UPMC for Life HMO Premier Rx (HMO)
H3907-059-004 · SoB
HMO$0$5,0004.5out of 5 stars, Above average
UPMC for Life HMO Premier Rx (HMO)
H3907-059-005 · SoB
HMO$0$6,0004.5out of 5 stars, Above average
UPMC for Life PPO Essential Care Rx (PPO)
H5533-017-001 · SoB
PPO$0$8,0004.5out of 5 stars, Above average
UPMC for Life PPO Essential Care Rx (PPO)
H5533-017-002 · SoB
PPO$0$8,0004.5out of 5 stars, Above average
UPMC for Life PPO Premier Rx (PPO)
H5533-011-000 · SoB ✓
PPO$0$6,7004.5out of 5 stars, Above average
UPMC for Life PPO Premier Rx (PPO)
H5533-013-000 · SoB ✓
PPO$0$6,5004.5out of 5 stars, Above average
UPMC for Life Complete Care (HMO D-SNP)
H4279-004-000 · SoB
HMO D-SNP$8.10$9,2504.0out of 5 stars, Above average
UPMC for Life HMO Deductible Rx (HMO)
H3907-037-000 · SoB ✓
HMO$22$6,0004.5out of 5 stars, Above average
UPMC for Life PPO Rx Choice (PPO)
H5533-015-001 · SoB
PPO$25$5,5004.5out of 5 stars, Above average
UPMC for Life PPO Rx Choice (PPO)
H5533-015-003 · SoB
PPO$25$5,5004.5out of 5 stars, Above average
UPMC for Life Complete Care (HMO D-SNP)
H4279-001-000 · SoB
HMO D-SNP$26.50$9,2504.0out of 5 stars, Above average
UPMC for Life HMO Rx Choice (HMO)
H3907-057-001 · SoB
HMO$30$5,0004.5out of 5 stars, Above average
UPMC for Life HMO Rx Choice (HMO)
H3907-057-002 · SoB
HMO$30$5,0004.5out of 5 stars, Above average
UPMC for Life HMO Rx Choice (HMO)
H3907-057-003 · SoB
HMO$30$5,0004.5out of 5 stars, Above average
UPMC for Life HMO Rx Choice (HMO)
H3907-057-006 · SoB
HMO$30$5,0004.5out of 5 stars, Above average
UPMC for Life PPO Rx Choice (PPO)
H5533-015-002 · SoB
PPO$30$5,5004.5out of 5 stars, Above average
UPMC for Life PPO Rx Choice (PPO)
H5533-015-004 · SoB
PPO$30$6,0004.5out of 5 stars, Above average
UPMC for Life Complete Care (HMO D-SNP)
H7123-001-000 · SoB
HMO D-SNP$32.70$9,2503.5out of 5 stars, Average
UPMC for Life PPO High Deductible Rx (PPO)
H5533-003-000 · SoB ✓
PPO$33$7,5504.5out of 5 stars, Above average
UPMC for Life PPO Rx Choice (PPO)
H5533-015-006 · SoB
PPO$34$5,5004.5out of 5 stars, Above average
UPMC for Life HMO Rx Choice (HMO)
H3907-057-004 · SoB
HMO$40$6,0004.5out of 5 stars, Above average
UPMC for Life HMO Rx Choice (HMO)
H3907-057-005 · SoB
HMO$40$6,0004.5out of 5 stars, Above average
UPMC for Life HMO Rx Choice (HMO)
H3907-057-007 · SoB
HMO$40$5,0004.5out of 5 stars, Above average
UPMC for Life PPO Rx Enhanced (PPO)
H5533-008-000 · SoB ✓
PPO$58$7,5504.5out of 5 stars, Above average
UPMC for Life HMO Rx (HMO)
H3907-058-001 · SoB
HMO$90$4,5004.5out of 5 stars, Above average
UPMC for Life HMO Rx (HMO)
H3907-058-003 · SoB
HMO$90$4,5004.5out of 5 stars, Above average
UPMC for Life HMO Rx (HMO)
H3907-058-002 · SoB
HMO$97$4,5004.5out of 5 stars, Above average
UPMC for Life PPO Rx Enhanced (PPO)
H5533-005-000 · SoB ✓
PPO$140$7,5504.5out of 5 stars, Above average
UPMC for Life HMO Rx Enhanced (HMO)
H3907-006-000 · SoB ✓
HMO$295$7,5504.5out of 5 stars, Above average
UPMC for Life HMO No Rx (HMO)
H3907-002-000 · SoB ✓
HMO—$6,0004.5out of 5 stars, Above average
UPMC for Life PPO Salute (PPO)
H5533-016-001 · SoB ✓
PPO—$9,2504.5out of 5 stars, Above average
UPMC for Life PPO Salute (PPO)
H5533-016-002 · SoB ✓
PPO—$9,2504.5out of 5 stars, Above average

What the star rating means. CMS rates every Medicare Advantage contract (the "H" number in the plan ID — all plans under it share the rating) on a 1-to-5 scale each October, from about 40 measures of care quality, member experience, complaints and appeals, customer service and, for plans with drug coverage, drug safety and pricing. The 2026 rating is largely based on performance measured in 2024.

5 Excellent4 Above average3 Average2 Below average1 Poor

Not rated means CMS published no overall rating — usually a contract too new to be measured or with too few members ("not enough data"); it is not a low score. A 5-star contract can be joined outside the normal enrollment windows (the 5-star Special Enrollment Period, Dec 8 – Nov 30). Medicare.gov flags contracts rated below 3 stars for three years running as low-performing. Stars describe the contract's past performance as CMS measured it; they are not a recommendation, and they do not tell you whether a plan's network, drugs or costs fit you.

Before enrolling or making a coverage decision, confirm current details with the plan, Medicare.gov, your State Health Insurance Assistance Program (SHIP), or 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048). MedicareBenefits.care reports CMS-filed data and does not verify provider networks, pharmacy participation, or final plan terms.

States served: Ohio · Pennsylvania

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