Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026
UPMC for Life HMO Premier Rx, 2027
H3907Contract059Plan
HMO · 31 counties in Pennsylvania
Run by UPMC Health Plan, Inc. (contract H3907), sold as UPMC for Life, owned by UPMC Health System
UPMC for Life HMO Premier Rx (H3907-059) costs $0 a month in 2027, the same as in 2026, with an in-network out-of-pocket limit of $6,500 to $7,000 depending on the county ($5,000 to $6,700 in 2026). It leaves 11 counties it served in 2026, where 13,144 of its members lived; they choose another plan for 2027 (the counties are listed below).
What changes from 2026 to 2027?
| What you pay or get | 2026 | 2027 | Change |
|---|---|---|---|
| In-network out-of-pocket limit, by county | $5,000 to $6,700 | $6,500 to $7,000 | ▲up $300 at the top |
| Drug deductible | $350 | $700 | ▲up $350 |
| Part B premium reduction, monthly (best in its area) | $2 | $0.50 | ▼down $1.50 |
| Specialist visit (best in its area) | $35 copay | $40 copay | ▲up $5 |
| Hospital stay, in network (best in its area) | $140 a day for days 1–7, then $0 a day for days 8–90 | $175 a day for days 1–3, then $0 a day for days 4–90 | changed |
| Skilled nursing facility, in network (best in its area) | $10 a day for days 1–20, then $218 a day for days 21–100 | $10 a day for days 1–20, then $221 a day for days 21–100 | ▲up $30for a 30-day stay |
| Comprehensive dental, yearly limit (best in its area) | $4,500 a year | $2,100 a year | ▼down $2,400 |
| Eyewear, yearly limit (best in its area) | $270 a year | $200 a year | ▼down $70 |
| Counties served | 28 | 31 | ▲up 3 |
| Drug tier 4, non-preferred drug | 31% of the cost | 29% of the cost | ▼down 2 points |
| Drug tier 5, specialty tier | 29% of the cost | 25% of the cost | ▼down 4 points |
| 10 lines do not change | |||
| Monthly premium | $0 | $0 | no change |
| Primary care visit (best in its area) | $0 copay | $0 copay | no change |
| Emergency room (best in its area) | $130 copay | $130 copay | no change |
| Medical deductible, in network (best in its area) | none | none | no change |
| Ground ambulance, in network (best in its area) | $50 copay | $50 copay | no change |
| Hearing aids, yearly limit for both ears (best in its area) | not offered | not offered | no change |
| Over-the-counter items, yearly (best in its area) | not offered | not offered | no change |
| Drug tier 1, preferred generic | $15 | $15 | no change |
| Drug tier 2, generic | $20 | $20 | no change |
| Drug tier 3, preferred brand | 24% of the cost | 24% of the cost | no change |
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS plan benefit package files, 2027 and 2026; CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026). Plan details can change during the year; confirm on Medicare Plan Finder.
What will prescriptions cost?
| Tier | What the tier holds | 2026, standard pharmacy | 2027, standard pharmacy | 2027, preferred pharmacy |
|---|---|---|---|---|
| Tier 1 | Preferred Generic | $15 | $15 | $0 |
| Tier 2 | Generic | $20 | $20 | $0 |
| Tier 3 | Preferred Brand | 24% of the cost | 24% of the cost | 24% of the cost |
| Tier 4 | Non-Preferred Drug | 31% of the cost | 29% of the cost | 29% of the cost |
| Tier 5 | Specialty Tier | 29% of the cost | 25% of the cost | 25% of the cost |
Source: CMS plan benefit package files, 2027 and 2026. Insulin is capped at $35 a month by law. A drug's tier is set by the plan's formulary.
How does it compare with plans sold where it is?
In the counties it serves, 143 plans open to everyone are sold for 2027, this one included. Against the others, 49 plans have a lower out-of-pocket limit, 5 the same, 88 a higher one. On the premium, 78 the same, 64 a higher one.
Out-of-pocket limits of the 143 plans open to everyone
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).
Where is it sold, and what does it cost there?
It stops serving 11 counties it served in 2026 (listed in the next section).
| Monthly premium | Out-of-pocket limit | Where |
|---|---|---|
| $0 | $6,500 | Allegheny (PA), Armstrong (PA), Beaver (PA), Crawford (PA), Erie (PA), Fayette (PA), Greene (PA), Lawrence (PA), McKean (PA), Mercer (PA), Venango (PA), Warren (PA), Washington (PA) |
| $0 | $7,000 | Berks (PA), Bradford (PA), Carbon (PA), Cumberland (PA), Dauphin (PA), Lancaster (PA), Lebanon (PA), Lehigh (PA), Lycoming (PA), Montour (PA), Northampton (PA), Perry (PA), Potter (PA), Susquehanna (PA), Union (PA), Wayne (PA), Wyoming (PA), York (PA) |
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).
What if you live in a county it leaves?
Its 2026 members in the 11 counties listed below cannot stay in it for 2027; each county page lists the 2027 plans sold there.
- Your coverage
- This plan ends for you on December 31, 2026, because it is no longer sold where you live.
- October 15 to December 7, 2026
- Open enrollment: join another Medicare Advantage plan, or Original Medicare with a drug plan. Coverage starts January 1, 2027.
- December 8, 2026 to the end of February 2027
- A special enrollment period because the plan is leaving: you can still join a plan, but coverage starts the first day of the month after you join, so choose by December 31 to have no gap.
- If you do nothing
- You are enrolled in Original Medicare when the plan ends, without a drug plan unless you join one (with Extra Help or full Medicaid, Medicare enrolls you in one).
- Without a drug plan
- Going 63 days or more in a row without drug coverage can mean a late enrollment penalty if you join a drug plan later; joining by the end of February keeps a January and February gap under 63 days, waiting longer does not.
- If you choose Original Medicare
- You have a guaranteed right to buy Medigap Plan A, B, C, D, F, G, K or L sold in your state by any insurance company; if you were new to Medicare on or after January 1, 2020, Plans D and G take the place of C and F. Apply from 60 days before to 63 days after the plan ends; the policy starts once your Medicare Advantage coverage ends. Other Medigap plans are not covered by this right.
| County | Members, Sept. 2026 |
|---|---|
| Westmoreland, PA | 2,829 |
| Blair, PA | 2,511 |
| Cambria, PA | 2,197 |
| Bedford, PA | 1,385 |
| Somerset, PA | 1,318 |
| Butler, PA | 1,265 |
| Clarion, PA | 704 |
| Clearfield, PA | 424 |
| Indiana, PA | 284 |
| Huntingdon, PA | 184 |
| Cameron, PA | 43 |
Source: CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11); Medicare.gov, “Special enrollment periods” and “When can I buy Medigap?” (read Oct. 7, 2026).
Who runs this plan?
- Plan ID
- H3907-059
- Legal name of the contract
- UPMC Health Plan, Inc.
- Sold as
- UPMC for Life
- Parent company
- UPMC Health System
- Plan type
- HMO
- 2026 star rating of the contract
- 4.5 of 5 overall; health plan 4.5 of 5, drug plan 5 of 5
- Members, September 2026
- 28,777
- Plan website, as filed with CMS
- https://www.upmchealthplan.com/medicare/
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS 2026 Star Ratings (October 2025); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11). CMS publishes the 2027 Star Ratings in October 2026.
What else should you check?
- Other 2027 plans in Allegheny, PAWhere most of its members live; premiums and limits side by side
- Every UPMC for Life plan for 2027Its contracts, counties and plans that end
- The other 9 plans of contract H3907Same company, same contract
- Is your prescription covered?Coverage share and tier for 2,259 drugs
Data, not advice. These are the plan's filed amounts, not a quote for you; confirm on Medicare Plan Finder or call the plan before you enroll.