UPMC for Life PPO Premier Rx (PPO)
Available to residents of Butler County, PA for 2026. Contract H5533, plan 013, segment 0.
Plan details
| Monthly drug premium | $0.00 |
|---|---|
| Drug deductible | $500.00Tier 1 and 2 exempt |
| Plan type | Medicare Advantage |
| Contract / plan | H5533-013-0 |
| Offered by | UPMC for Life |
| Parent organization | UPMC Health System |
| Formulary drugs | 3,629 |
CMS star ratings
- Overall
- 4.5 out of 5 stars for Overall
- Health plan (Part C)
- 4.5 out of 5 stars for Health plan (Part C)
- Drug plan (Part D)
- 4.5 out of 5 stars for Drug plan (Part D)
Published per contract — every plan under contract H5533 shares this rating.
Drug tiers — preferred pharmacy, initial coverage
| Tier | Cost-sharing |
|---|---|
| Tier 1 | $0.00 |
| Tier 2 | $0.00 |
| Tier 3 | 23% |
| Tier 4 | 28% |
| Tier 5 | 27% |
Also available in 24 other PA counties
Plan facts come from the CMS quarterly prescription drug plan public use files.