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UPMC for Life PPO Salute (PPO) Medicare Advantage Plan H5533-016-1 • 2027 • Westmoreland County, PA

CMS Rating: ☆☆☆☆☆ (4.5 out of 5 stars*)
Monthly Premium
$0.00Plus Part B premium.
Medical Deductible
$0.00
Maximum Out-of-Pocket
$9850.00In-network
Part B Giveback
−$50.00 reduction
Prescription Coverage
Not Included
Additional Benefits
Dental, Vision, Hearing
Service Area
Westmoreland County, PA
Local Enrollment
108 beneficiaries in Westmoreland County
Last update:

UPMC for Life PPO Salute (PPO) Introduction

This Medicare Advantage PPO plan, UPMC for Life PPO Salute, is offered by UPMC for Life and uses a Preferred Provider Organization (PPO) provider network. It comes without prescription drug coverage. For the 2027 plan year, the monthly premium is $0.00, the medical deductible is $0.00, and the in-network maximum out-of-pocket is $9850.00. The plan is identified by CMS Plan ID H5533-016-1.

Enrollment in this plan requires residence in Westmoreland County, Pennsylvania. CMS enrollment data reports 108 plan members in Westmoreland County. New members can call the plan directly at (877)381-3765 (TTY 711) for assistance.

Compare Similar Plans in Westmoreland County

Compare this plan with the two most-enrolled PPO plans available in Westmoreland County, Pennsylvania. Enrollment is based on CMS local enrollment data.

PPO plan comparison for Westmoreland County, Pennsylvania
Plan Detail UPMC for Life PPO Salute Complete Blue PPO Distinct Aetna Medicare Premier Plus
CMS Plan ID H5533-016-1 H3916-035-2 H5522-005-0
Local Enrollment 108 7,828 2,726
Monthly Premium $0.00 $41.00 $39.00
Medical Deductible $0.00 $0.00 $0.00
Maximum Out-of-Pocket $9,850.00 $6,950.00 $7,150.00
Part B Giveback −$50.00 reduction Not offered Not offered
Primary Care 20% coinsurance $0 copay $0 copay
Specialist 20% coinsurance $30 copay $25 copay
Part D Deductible Not Applicable $700.00 $700.00
CMS Star Rating 4.5 4.5 4.5
Dental $0 copay $0 copay $0 copay
Vision $0 copay $0 copay $0 copay
Hearing $0 copay $10 copay $0 copay

Want to explore more options? Browse all Medicare Advantage plans in Westmoreland County, or compare Medicare Advantage plans across Pennsylvania, including premiums, out-of-pocket costs, CMS ratings, and enrollment.

Plan Benefits

UPMC for Life PPO Salute includes cost-sharing, which refers to out-of-pocket expenses for covered healthcare services. The tables below outline the most common in-network out-of-pocket costs associated with plan H5533-016-1.

You can also compare 2027 costs and coverage with last year, side-by-side: Plan H5533-016-1 Cost Compare.

Office Visits

Primary care
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Specialist
In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Preventive and Wellness Services

Annual wellness exam
Not covered
Telehealth benefit
In-network: 0%-20% coinsurance
Routine chiropractic
Not covered
Fitness benefits
Coming soon
Health education
Not covered
Counseling services
Not covered
Over-the-counter drug benefits
In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance
Health transportation (non-emergency)
Coming soon

Diagnostic, Lab, and Imaging Services

Diagnostic radiology services
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Lab services
In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance
Outpatient x-rays
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Diagnostic tests and procedures
In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Emergency and Urgent Care Services

Emergency room care
20% coinsurance
Worldwide emergency care
Coming soon
Urgent care
20% coinsurance
Inpatient hospital care
In-network:
Tier 1
$0 per day for days 1-60
$434 per day for days 61-90
$868 per day for days 91-150
Out-of-network:
$0 per day for days 1-60
$434 per day for days 61-90
$868 per day for days 91-150
Skilled Nursing Facility
In-network:
Tier 1
$0 per day for days 1-20
$217 per day for days 21-100
Out-of-network:
Ground ambulance
In-network: 0%-20% coinsurance
Out-of-network: 20% coinsurance

Mental Health Services

Outpatient individual therapy
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Outpatient group therapy
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Inpatient psychiatric hospital care
In-network:
Tier 1
$0 per day for days 1-60
$434 per day for days 61-90
$868 per day for days 91-150
Out-of-network:
$0 per day for days 1-60
$434 per day for days 61-90
$868 per day for days 91-150

Rehabilitation Services

Physical therapy and speech and language therapy
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Occupational therapy
In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Medical Equipment and Supplies

Diabetes supplies
In-network: 0%-20% coinsurance
Out-of-network: 20% coinsurance
Durable medical equipment
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Prosthetics
In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Medicare Part B Drugs

Chemotherapy
In-network: 0%-20% coinsurance
Out-of-network: 20% coinsurance
Other Part B drugs (Medicare-covered)
In-network: 0%-20% coinsurance
Out-of-network: 20% coinsurance

Dental Services

Oral exam
In-network: $0 copay
Out-of-network: 50% coinsurance
Dental x-rays
In-network: $0 copay
Out-of-network: 50% coinsurance
Cleaning
In-network: $0 copay
Out-of-network: 50% coinsurance
Periodontics
In-network: 50% coinsurance
Out-of-network: 50% coinsurance
Endodontics
In-network: 50% coinsurance
Out-of-network: 50% coinsurance
Restorative services
In-network: 50% coinsurance
Out-of-network: 50% coinsurance
Implant services
Not covered
Orthodontics
Not covered
Oral/Maxillofacial surgery
In-network: 50% coinsurance
Out-of-network: 50% coinsurance

Vision Services

Routine eye exam
In-network: $0 copay
Out-of-network: 50% coinsurance
Contact lenses
In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance
Eyeglass frames only
Not covered
Eyeglass lenses only
Not covered
Eyeglasses (frames & lenses)
In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance
Upgrades
In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance

Hearing Services

Hearing exam
In-network: $0 copay
Out-of-network: 50% coinsurance
Fitting/evaluation
In-network: $0 copay
Out-of-network: 50% coinsurance
Prescription hearing aids
In-network: $690-$1890 copay
Out-of-network: $5000 copay
OTC hearing aids
Not covered

Additional and Special Needs Services

Adult day health services
Not covered
Home-based palliative care
Not covered
Personal emergency response system
Coming soon
Weight management programs
Not covered
Wigs for chemotherapy-related hair loss
Coming soon
Alternative therapies
Not covered
Massage therapy
Not covered
Home/bathroom safety devices
In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance

Certain preventive services are covered 100% by UPMC for Life PPO Salute as a Part B benefit.

Prescription Drug Coverage

This plan does not include a Medicare Part D plan for prescriptions.

CMS 5-Star Performance Ratings (Contract ID: H5533)

CMS evaluates Medicare Advantage (Part C) and Part D plans annually using a 5-star rating system. Ratings reflect performance in preventive care, chronic condition management, and member experience.

2027 Medicare Star Ratings for Contract H5533
CMS Measure Star Rating
2027 Overall Rating ☆☆☆☆☆
Staying Healthy: Screenings, Tests, Vaccines ☆☆☆☆☆
Managing Chronic (Long Term) Conditions ☆☆☆☆☆
Member Experience with Health Plan ☆☆☆☆☆
Complaints and Changes in Plans Performance ☆☆☆☆☆
Health Plan Customer Service ☆☆☆☆☆
Drug Plan Customer Service ☆☆☆☆☆
Complaints and Changes in the Drug Plan ☆☆☆☆☆
Member Experience with the Drug Plan ☆☆☆☆☆
Drug Safety and Accuracy of Drug Pricing ☆☆☆☆☆
Medicare Advantage Plan Availability

UPMC for Life PPO Salute is available to eligible Medicare beneficiaries residing in Westmoreland County, Pennsylvania, including communities such as Monessen, New Kensington, Trafford, West Newton, Smithton, Greensburg, Acme, Apollo, Avonmore, Delmont, Derry, Export, Harrison City, Herminie, Hunker, Irwin, Jeannette, Latrobe, Ligonier, Mount Pleasant, Murrysville, New Alexandria, New Stanton, Ruffs Dale, Scottdale, Vandergrift, Youngwood, Bolivar, New Florence, Seward, and other areas throughout the county. Enrollment eligibility is based on county of residence, not city.

Medicare Plan Data Sources and Methodology
Primary CMS datasets used for this Medicare Advantage Plan resource.
Data Source Publisher Last Accessed
Landscape Source Files Centers for Medicare & Medicaid Services October 5, 2026
Medicare Part C & D Performance Centers for Medicare & Medicaid Services October 5, 2026
Plan Benefits Package Centers for Medicare & Medicaid Services October 5, 2026
Monthly Enrollment by Contract/Plan/State/County Centers for Medicare & Medicaid Services October 5, 2026

Data sources and methodology documentation.

Official plan information and secondary Medicare references.
Publisher Reference Last Accessed
UPMC for Life (official source) https://www.upmchealthplan.com/medicare/ October 4, 2026
CMS.gov Medicare Advantage Plan Fact Sheet 25 May, 2025
Medicare.gov Joining a plan 25 May, 2025
Medicare.gov Your coverage options 25 May, 2025

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Provenance documentation for this data is maintained under the U.S. Core Data for Interoperability (USCDI) Provenance standard.