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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 2025, 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 2025.
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 $45.00. 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 $10100.00 (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 $10100.00 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)
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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 a range of benefits including coverage for inpatient and outpatient services, with coinsurance typically around 20%. The plan also covers ambulance services with varying coinsurance, emergency services with no copay, and a variety of primary care services with 20% coinsurance. Additional benefits include coverage for preventive services, hearing and vision services, and dental services with varying coinsurance and coverage limits. Home health services are covered with no copay, while medical equipment and diagnostic services are covered with 20% coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered, but the specific cost-sharing details are not provided. Additional days, non-Medicare-covered stays, and upgrades for acute and psychiatric care are not covered.
Outpatient Services See details
Outpatient Services include coverage for outpatient hospital services and observation services with a 20% coinsurance, Ambulatory Surgical Center (ASC) Services with a 20% coinsurance, individual and group sessions for outpatient substance abuse with a 20% coinsurance, and outpatient blood services with a waived deductible for the first three pints.
Partial Hospitalization See details
Partial Hospitalization is covered by the UPMC for Life PPO Salute (PPO) plan. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance Services are covered by the UPMC for Life PPO Salute plan. Ground Ambulance Services have a coinsurance of 0% - 20%, while Air Ambulance Services have a 20% coinsurance; there is no copay for ambulance services. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the UPMC for Life PPO Salute (PPO) plan. Emergency Services and Urgently Needed Services have a 20% coinsurance, and no copay. Worldwide Emergency Coverage has a $125 copay, Worldwide Urgent Coverage has a $55 copay, and Worldwide Emergency Transportation has a 20% coinsurance.
Primary Care See details
The UPMC for Life PPO Salute (PPO) plan covers primary care physician services, chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, other health care professional, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Primary Care Physician Services, Physician Specialist Services, Occupational Therapy Services, and Physical Therapy have a 20% coinsurance. Chiropractic Services and Group Sessions for Mental Health and Psychiatric services have a 20% coinsurance. Individual sessions for mental health and psychiatric services have a coinsurance between 20%. Additional Telehealth Benefits have a coinsurance between 0%-20%. Opioid Treatment Program Services have a coinsurance between 20%. Podiatry Services are not covered.
Preventive Services See details
Preventive Services are generally covered by UPMC for Life PPO Salute (PPO), although annual physical exams, health education, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, enhanced disease management, telemonitoring services, and in-home support services are not covered. Kidney Disease Education Services, Glaucoma Screenings, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKGs following a Welcome Visit have a 20% coinsurance. In-Home Safety Assessments, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Fitness Benefits, Remote Access Technologies, Home and Bathroom Safety Devices and Modifications, and Counseling Services are covered.
Hearing Services See details
Hearing services are covered, including hearing exams with at most 20% coinsurance for routine exams. Prescription hearing aids are covered with a copay between $690 and $1890 for all types, but inner, outer, and over-the-ear hearing aids are not covered, and OTC hearing aids are not covered.
Vision Services See details
The UPMC for Life PPO Salute (PPO) plan covers vision services, including eye exams with a 20% coinsurance. Eyewear is also covered, with a combined maximum plan benefit coverage of $300 every year, and a 20% coinsurance for contact lenses.
Dental Services See details
Dental Services include coverage for Medicare Dental Services with 20% coinsurance, and other dental services including oral exams (2 per year), and dental x-rays (bitewing x-rays once per 12 months, and panoramic x-rays once per 36 months). Additional services are covered with 50% coinsurance: restorative services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery. However, fluoride treatment, adjunctive general services, maxillofacial prosthetics, implant services, and orthodontics are not covered. Orthodontic services have a maximum plan benefit of $5,000 per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay and 0-20% coinsurance, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the UPMC for Life PPO Salute (PPO) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered by UPMC for Life PPO Salute (PPO), including Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment with a coinsurance that varies between 0% and 20%. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the UPMC for Life PPO Salute (PPO) plan. Diagnostic Procedures/Tests, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services have a coinsurance of at most 20%, while Lab Services are not covered.
Home Health Services See details
Home Health Services are covered with no copay and no coinsurance, but require authorization. Additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the UPMC for Life PPO Salute (PPO) plan. This includes Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization. This plan charges the Medicare-defined cost share for tier 1, but does not cover additional days beyond Medicare-covered, nor does it cover non-Medicare-covered stays.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) Items and a Meal Benefit. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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