PITTSBURGH — UPMC Health Plan has expanded its UPMC for Life Specialty Plan into Clearfield, Crawford, and Greene counties, bringing its current service area to 20 counties in Western Pennsylvania.
UPMC for Life Specialty Plan, a Medicare HMO for persons with special needs, was introduced to the market on January 1, 2006. It is available to residents of the 20 counties who carry both Medicare and Medical Assistance coverage and typically have complex health issues.
UPMC Health Plan developed the plan, within guidelines established by the Centers for Medicare & Medicaid Services (CMS), to provide coordinated care designed to meet the unique needs of the so-called “dual eligible” population.
For 2007, UPMC for Life Specialty Plan members will receive all standard Medicare benefits, including prescription drug coverage. Specialty Plan members will also receive dental, hearing, and vision benefits, and will be eligible to participate in the fitness program Active&Fit(TM).
The UPMC for Life Specialty Plan has its own provider network and directory. This ensures that members will obtain effective care from providers who have experience with and are willing to treat special needs patients.
“We are pleased to now be able to serve those with special needs in Clearfield, Crawford, and Greene counties,” said John G. Lovelace, UPMC Health Plan’s vice president for Medicaid Services and Special Needs Plans. “This will enable us to better meet the health needs of our region.”
Special Needs Plans were created by the Medicare Modernization Act of 2003 to serve beneficiaries with serious long-term illnesses who may have multiple medical conditions.
In addition to Clearfield, Crawford, and Greene counties, the UPMC for Life Specialty Plan service area includes Allegheny, Armstrong, Beaver, Bedford, Blair, Butler, Cambria, Erie, Fayette, Indiana, Jefferson, Lawrence, Mercer, Somerset, Venango, Washington, and Westmoreland counties.
This fall, the UPMC for Life Specialty Plan has been sponsoring flu shot clinics at a number of locations in Western Pennsylvania. By the end of the program, more than 400 persons – primarily UPMC for Life Specialty Plan members, but also community residents – are expected to take advantage of this opportunity to receive free flu shots.
“This health promotion initiative provides extra value for our Specialty Plan members in areas where health resources may be low,” said Lovelace. “By bringing this service to the people, rather than making them go to a physician’s office, we hope to encourage more people to get the shots and hopefully reduce the amount of flu this coming season.”