UPMC Health System — 2026 Medicare Advantage plans
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.
UPMC Health System Summaries of BenefitsEvery indexed SoB for this carrier, linked from its own site.
View SoBsAll 35 UPMC Health System plans filed for 2026
| Plan | Type | Premium | In-network MOOP | Overall stars |
|---|---|---|---|---|
| UPMC for Life HMO Premier Rx (HMO) H3907-059-001 · SoB | HMO | $0 | $6,000 | 4.5out of 5 stars, Above average |
| UPMC for Life HMO Premier Rx (HMO) H3907-059-002 · SoB | HMO | $0 | $5,000 | 4.5out of 5 stars, Above average |
| UPMC for Life HMO Premier Rx (HMO) H3907-059-003 · SoB | HMO | $0 | $6,700 | 4.5out of 5 stars, Above average |
| UPMC for Life HMO Premier Rx (HMO) H3907-059-004 · SoB | HMO | $0 | $5,000 | 4.5out of 5 stars, Above average |
| UPMC for Life HMO Premier Rx (HMO) H3907-059-005 · SoB | HMO | $0 | $6,000 | 4.5out of 5 stars, Above average |
| UPMC for Life PPO Essential Care Rx (PPO) H5533-017-001 · SoB | PPO | $0 | $8,000 | 4.5out of 5 stars, Above average |
| UPMC for Life PPO Essential Care Rx (PPO) H5533-017-002 · SoB | PPO | $0 | $8,000 | 4.5out of 5 stars, Above average |
| UPMC for Life PPO Premier Rx (PPO) H5533-011-000 · SoB ✓ | PPO | $0 | $6,700 | 4.5out of 5 stars, Above average |
| UPMC for Life PPO Premier Rx (PPO) H5533-013-000 · SoB ✓ | PPO | $0 | $6,500 | 4.5out of 5 stars, Above average |
| UPMC for Life Complete Care (HMO D-SNP) H4279-004-000 · SoB | HMO D-SNP | $8.10 | $9,250 | 4.0out of 5 stars, Above average |
| UPMC for Life HMO Deductible Rx (HMO) H3907-037-000 · SoB ✓ | HMO | $22 | $6,000 | 4.5out of 5 stars, Above average |
| UPMC for Life PPO Rx Choice (PPO) H5533-015-001 · SoB | PPO | $25 | $5,500 | 4.5out of 5 stars, Above average |
| UPMC for Life PPO Rx Choice (PPO) H5533-015-003 · SoB | PPO | $25 | $5,500 | 4.5out of 5 stars, Above average |
| UPMC for Life Complete Care (HMO D-SNP) H4279-001-000 · SoB | HMO D-SNP | $26.50 | $9,250 | 4.0out of 5 stars, Above average |
| UPMC for Life HMO Rx Choice (HMO) H3907-057-001 · SoB | HMO | $30 | $5,000 | 4.5out of 5 stars, Above average |
| UPMC for Life HMO Rx Choice (HMO) H3907-057-002 · SoB | HMO | $30 | $5,000 | 4.5out of 5 stars, Above average |
| UPMC for Life HMO Rx Choice (HMO) H3907-057-003 · SoB | HMO | $30 | $5,000 | 4.5out of 5 stars, Above average |
| UPMC for Life HMO Rx Choice (HMO) H3907-057-006 · SoB | HMO | $30 | $5,000 | 4.5out of 5 stars, Above average |
| UPMC for Life PPO Rx Choice (PPO) H5533-015-002 · SoB | PPO | $30 | $5,500 | 4.5out of 5 stars, Above average |
| UPMC for Life PPO Rx Choice (PPO) H5533-015-004 · SoB | PPO | $30 | $6,000 | 4.5out of 5 stars, Above average |
| UPMC for Life Complete Care (HMO D-SNP) H7123-001-000 · SoB | HMO D-SNP | $32.70 | $9,250 | 3.5out of 5 stars, Average |
| UPMC for Life PPO High Deductible Rx (PPO) H5533-003-000 · SoB ✓ | PPO | $33 | $7,550 | 4.5out of 5 stars, Above average |
| UPMC for Life PPO Rx Choice (PPO) H5533-015-006 · SoB | PPO | $34 | $5,500 | 4.5out of 5 stars, Above average |
| UPMC for Life HMO Rx Choice (HMO) H3907-057-004 · SoB | HMO | $40 | $6,000 | 4.5out of 5 stars, Above average |
| UPMC for Life HMO Rx Choice (HMO) H3907-057-005 · SoB | HMO | $40 | $6,000 | 4.5out of 5 stars, Above average |
| UPMC for Life HMO Rx Choice (HMO) H3907-057-007 · SoB | HMO | $40 | $5,000 | 4.5out of 5 stars, Above average |
| UPMC for Life PPO Rx Enhanced (PPO) H5533-008-000 · SoB ✓ | PPO | $58 | $7,550 | 4.5out of 5 stars, Above average |
| UPMC for Life HMO Rx (HMO) H3907-058-001 · SoB | HMO | $90 | $4,500 | 4.5out of 5 stars, Above average |
| UPMC for Life HMO Rx (HMO) H3907-058-003 · SoB | HMO | $90 | $4,500 | 4.5out of 5 stars, Above average |
| UPMC for Life HMO Rx (HMO) H3907-058-002 · SoB | HMO | $97 | $4,500 | 4.5out of 5 stars, Above average |
| UPMC for Life PPO Rx Enhanced (PPO) H5533-005-000 · SoB ✓ | PPO | $140 | $7,550 | 4.5out of 5 stars, Above average |
| UPMC for Life HMO Rx Enhanced (HMO) H3907-006-000 · SoB ✓ | HMO | $295 | $7,550 | 4.5out of 5 stars, Above average |
| UPMC for Life HMO No Rx (HMO) H3907-002-000 · SoB ✓ | HMO | — | $6,000 | 4.5out of 5 stars, Above average |
| UPMC for Life PPO Salute (PPO) H5533-016-001 · SoB ✓ | PPO | — | $9,250 | 4.5out of 5 stars, Above average |
| UPMC for Life PPO Salute (PPO) H5533-016-002 · SoB ✓ | PPO | — | $9,250 | 4.5out 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.