A non-government entity
UPMC for Life PPO Salute (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UPMC for Life PPO Salute (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UPMC for Life PPO Salute (PPO) in 2026, please refer to our full plan details page.
UPMC for Life PPO Salute (PPO) is a PPO plan offered by UPMC Health System available for enrollment in 2025 to people living in Western, Central, and Northeastern Pennsylvania. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that UPMC for Life PPO Salute (PPO) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about UPMC for Life PPO Salute (PPO).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For UPMC for Life PPO Salute (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $50.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $13900.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $13900.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
Sign up for UPMC for Life PPO Salute (PPO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
Prescription drugs are not covered by UPMC for Life PPO Salute (PPO).
Additional Benefits
The UPMC for Life PPO Salute (PPO) plan offers comprehensive medical coverage that minimizes upfront costs by featuring no copay for primary care, specialist visits, outpatient services, and preventative screenings. Instead of copays, members will typically pay a standard 20% coinsurance for these doctor visits, outpatient hospital care, diagnostics, and durable medical equipment. For inpatient hospital stays and skilled nursing facility care, the plan utilizes Medicare-defined copays with no coinsurance. This plan also includes valuable supplemental benefits, such as preventive dental, home health care, and over-the-counter items with no copay and no coinsurance. Comprehensive dental is available with no copay and a 50% coinsurance up to a $5,000 annual limit, while vision services feature up to a $300 annual eyewear allowance. Additionally, members can access up to 12 one-way transportation trips per year to approved locations with no copay and no coinsurance.
Inpatient Hospital See details
Inpatient hospital care is partially covered by UPMC for Life PPO Salute (PPO) for acute and psychiatric stays, which require Medicare-defined copayments and no coinsurance. Prior authorization is required, and additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
UPMC for Life PPO Salute (PPO) covers outpatient services with no copays, although a 20% coinsurance applies to outpatient hospital services, observation services, ambulatory surgical center services, and outpatient substance abuse sessions. Outpatient blood services are covered with no copay, no coinsurance, and no deductible, though prior authorization is required for surgical and hospital services.
Partial Hospitalization See details
UPMC for Life PPO Salute (PPO) covers partial hospitalization services with no copay and a 20% coinsurance.
Ambulance and Transportation Services See details
UPMC for Life PPO Salute (PPO) covers ambulance services with no copay and a coinsurance of 0% to 20% for ground transport and 20% for air transport. Transportation services are partially covered, offering up to 12 one-way trips per year to plan-approved locations with no copay and no coinsurance, while trips to non-approved health-related locations are not covered.
Emergency Services See details
UPMC for Life PPO Salute (PPO) covers emergency services with a 20% coinsurance (up to $115) and no copay, which is waived if you are admitted to the hospital within three days. Urgently needed services require a 20% coinsurance (up to $40) and no copay, while worldwide emergency and urgent care are covered with copays up to $115 and a 20% coinsurance for emergency transportation.
Primary Care See details
UPMC for Life PPO Salute (PPO) covers primary care, specialist visits, mental health, and physical therapies with no copay and a 20% coinsurance, though prior authorization is required for therapy services. Telehealth benefits are also covered with no copay and 0% to 20% coinsurance, while podiatry and chiropractic services are not covered.
Preventive Services See details
UPMC for Life PPO Salute (PPO) provides partially covered preventive services, featuring no copay and no coinsurance for Medicare-covered zero-dollar screenings and select benefits like counseling and in-home safety assessments. Other covered services, including kidney disease education and glaucoma screenings, have no copay but require a 20% coinsurance, while annual physical exams and weight management programs are not covered.
Hearing Services See details
Hearing services are partially covered by UPMC for Life PPO Salute (PPO) with no deductible, featuring hearing exams with no copay (except for routine exams which have a 20% coinsurance) and prescription hearing aids with a $690 to $1,890 copay and no coinsurance. OTC hearing aids, as well as inner ear, outer ear, and over the ear prescription hearing aids, are not covered.
Vision Services See details
Vision services are partially covered by UPMC for Life PPO Salute (PPO), featuring no copays for exams and eyewear but requiring a 20% coinsurance for routine exams and contact lenses. While there is no deductible and up to $300 in annual eyewear coverage is provided, individual eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
UPMC for Life PPO Salute (PPO) features partially covered dental services, offering preventive care (exams, cleanings, and x-rays) with no copay and no coinsurance, Medicare-covered dental with no copay and 20% coinsurance, and comprehensive treatments with no copay and 50% coinsurance up to a $5,000 annual limit. Specific sub-services that are not covered under this plan include fluoride, implants, orthodontics, adjunctive general services, maxillofacial prosthetics, and other diagnostic or preventive dental services.
Home Infusion bundled Services See details
UPMC for Life PPO Salute (PPO) covers home infusion bundled services with no copay and no coinsurance, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs carry a 0% to 20% coinsurance with no copay, while Medicare Part B insulin is covered with a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by UPMC for Life PPO Salute (PPO) with no copay and a 20% coinsurance.
Medical Equipment See details
UPMC for Life PPO Salute (PPO) covers durable medical equipment, prosthetics, and diabetic equipment with no copays and a 20% coinsurance, though diabetic supplies can range from no coinsurance to 20% coinsurance. Prior authorization is required for these benefits, and coverage may be limited to preferred vendors or specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are partially covered by UPMC for Life PPO Salute (PPO), requiring a 20% coinsurance and no copay for diagnostic procedures, radiological services, and outpatient X-rays. Prior authorization is required for these covered services, while laboratory services are not covered.
Home Health Services See details
Home Health Services are covered under UPMC for Life PPO Salute (PPO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
UPMC for Life PPO Salute (PPO) features some covered cardiac rehabilitation services with no copay, but in practice, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
UPMC for Life PPO Salute (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance and Medicare-defined copays, though prior authorization is required. A prior three-day inpatient hospital stay is not required for admission, but additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by UPMC for Life PPO Salute (PPO), which offers over-the-counter (OTC) items and meal benefits with no copay and no coinsurance. Acupuncture is not covered under this benefit.
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