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plans.upmcmedicare.com Open in urlscan Pro
40.85.190.10  Public Scan

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Submitted URL: https://late.upmcmedicare.com/
Effective URL: https://plans.upmcmedicare.com/choose?utm_source=Direct&utm_medium=DM&utm_content=General&utm_campaign=choose
Submission: On May 15 via api from US — Scanned from DE

Form analysis 1 forms found in the DOM

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  <div id="JsonForm-form-87971102-7df8-4690-83a8-1abf435399df-Loader" style="display: none"></div>
  <div class="row" id="JsonForm-form-87971102-7df8-4690-83a8-1abf435399df-Body" style="">
    <div class="col-12">
      <p class="open-sans">Fill out the information below to receive the FREE <em>Plan Compare Guide</em>&nbsp;by mail. You will also have the option to receive an electronic copy by providing your email address.</p>
    </div>
    <div class="col-md-12">
      <div class="form-group mt-0">
        <label for="JsonForm-form-87971102-7df8-4690-83a8-1abf435399df-Input-firstName">First Name*</label>
        <input type="input" class="form-control" id="JsonForm-form-87971102-7df8-4690-83a8-1abf435399df-Input-firstName" placeholder="First Name" value="">
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    <div class="col-md-12">
      <div class="form-group mt-0">
        <label for="JsonForm-form-87971102-7df8-4690-83a8-1abf435399df-Input-lastName">Last Name*</label>
        <input type="input" class="form-control" id="JsonForm-form-87971102-7df8-4690-83a8-1abf435399df-Input-lastName" placeholder="Last Name" value="">
      </div>
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      <div class="form-group mt-0">
        <label for="JsonForm-form-87971102-7df8-4690-83a8-1abf435399df-Input-emailAddress">Email</label>
        <input type="input" class="form-control" id="JsonForm-form-87971102-7df8-4690-83a8-1abf435399df-Input-emailAddress" placeholder="Email" value="" pattern="^.+@[^.].*.[a-z]{2,}$">
      </div>
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    <div class="col-md-12">
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        <label for="JsonForm-form-87971102-7df8-4690-83a8-1abf435399df-Input-phoneNumber">Phone</label>
        <input type="input" class="form-control" id="JsonForm-form-87971102-7df8-4690-83a8-1abf435399df-Input-phoneNumber" placeholder="Phone" value="" pattern="[0-9]*" maxlength="10">
      </div>
    </div>
    <div class="col-12">
      <p class="phone-disclaimer">When I provide my phone number, I am giving UPMC <em>for Life</em> permission to contact me about UPMC <em>for Life</em> plans and how to enroll.</p>
    </div>
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        <label for="JsonForm-form-87971102-7df8-4690-83a8-1abf435399df-Input-city">City*</label>
        <input type="input" class="form-control" id="JsonForm-form-87971102-7df8-4690-83a8-1abf435399df-Input-city" placeholder="City" value="">
      </div>
    </div>
    <div class="col-md-12">
      <div class="form-group mt-0">
        <label class="mb-2 mt-0">State*</label>
        <select class="custom-select" id="JsonForm-form-87971102-7df8-4690-83a8-1abf435399df-Input-stateCode">
          <option selected="" value="">- Select State -</option>
          <option value="PA">PA</option>
          <option value="OH">OH</option>
        </select>
      </div>
    </div>
    <div class="col-md-12">
      <div class="form-group mt-0">
        <label for="JsonForm-form-87971102-7df8-4690-83a8-1abf435399df-Input-zipcode">Zip Code*</label>
        <input type="input" class="form-control" id="JsonForm-form-87971102-7df8-4690-83a8-1abf435399df-Input-zipcode" placeholder="Zip Code" value="" maxlength="5" minlength="5" pattern="[0-9]*">
      </div>
    </div>
    <div class="col-md-12">
      <div class="form-group mt-0">
        <label class="mb-2 mt-0">County*</label>
        <select class="custom-select" id="JsonForm-form-87971102-7df8-4690-83a8-1abf435399df-Input-county">
          <option selected="" value="">County</option>
          <option value="Adams">Adams</option>
          <option value="Allegheny">Allegheny</option>
          <option value="Armstrong">Armstrong</option>
          <option value="Beaver">Beaver</option>
          <option value="Bedford">Bedford</option>
          <option value="Blair">Blair</option>
          <option value="Butler">Butler</option>
          <option value="Cambria">Cambria</option>
          <option value="Cameron">Cameron</option>
          <option value="Chester">Chester</option>
          <option value="Clarion">Clarion</option>
          <option value="Clearfield">Clearfield</option>
          <option value="Clinton">Clinton</option>
          <option value="Crawford">Crawford</option>
          <option value="Cumberland">Cumberland</option>
          <option value="Dauphin">Dauphin</option>
          <option value="Elk">Elk</option>
          <option value="Erie">Erie</option>
          <option value="Fayette">Fayette</option>
          <option value="Forest">Forest</option>
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          <option value="Greene">Greene</option>
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          <option value="Lancaster">Lancaster</option>
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          <option value="Lebanon">Lebanon</option>
          <option value="Lycoming">Lycoming</option>
          <option value="McKean">McKean</option>
          <option value="Mercer">Mercer</option>
          <option value="Mifflin">Mifflin</option>
          <option value="Perry">Perry</option>
          <option value="Somerset">Somerset</option>
          <option value="Tioga">Tioga</option>
          <option value="Union">Union</option>
          <option value="Venango">Venango</option>
          <option value="Warren">Warren</option>
          <option value="Washington">Washington</option>
          <option value="Westmoreland">Westmoreland</option>
          <option value="York">York</option>
        </select>
      </div>
    </div>
    <div class="col-12">
      <div class="formDisclaimer required">
        <p>*Required</p>
        <p>Personal information collected here will be kept strictly confidential.</p>
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      <button type="submit" class="btn btn-primary">Send my Information Kit</button>
    </div>
  </div>
</form>

Text Content

1-866-435-8043 (TTY: 711)

seven days a week from 7 a.m. to 9 p.m.*


YES! I WOULD LIKE TO KNOW MORE ABOUT MY HEALTH CARE OPTIONS. I UNDERSTAND THERE
IS NO COST AND NO OBLIGATION.


THANK YOU FOR TAKING THE TIME TO REQUEST YOUR FREE PLAN COMPARE GUIDE FROM UPMC
FOR LIFE BEFORE THE MEDICARE ANNUAL ELECTION PERIOD ENDS ON DEC. 7, 2023.



Fill out the information below to receive the FREE Plan Compare Guide by mail.
You will also have the option to receive an electronic copy by providing your
email address.

First Name*
Last Name*
Email
Phone

When I provide my phone number, I am giving UPMC for Life permission to contact
me about UPMC for Life plans and how to enroll.

Street Address*
City*
State* - Select State - PA OH
Zip Code*
County* County Adams Allegheny Armstrong Beaver Bedford Blair Butler Cambria
Cameron Chester Clarion Clearfield Clinton Crawford Cumberland Dauphin Elk Erie
Fayette Forest Fulton Greene Huntingdon Indiana Jefferson Juniata Lancaster
Lawrence Lebanon Lycoming McKean Mercer Mifflin Perry Somerset Tioga Union
Venango Warren Washington Westmoreland York

*Required

Personal information collected here will be kept strictly confidential.





















Send my Information Kit


HAVE A QUESTION? CALL US!

Have a quick question you'd like to get answered? We're here to help!
Call toll-free: 1-866-435-8043 (TTY: 711)
seven days a week 7 a.m. to 9 p.m.*

*You can call us Oct. 1 through Dec. 31, seven days a week, from 7 a.m. to 9
p.m. and from Jan. 1 through Sept. 30, seven days a week, from 8 a.m. to 8 p.m.

UPMC for Life has a contract with Medicare to provide HMO, HMO SNP, and PPO
plans. The HMO SNP plans have a contract with the PA State Medical Assistance
program. Enrollment in UPMC for Life depends on contract renewal. UPMC for Life
is a product of and operated by UPMC Health Plan Inc., UPMC Health Network Inc.,
UPMC Health Benefits Inc., and UPMC Health Coverage Inc.

Copyright © 2024 UPMC Health Plan Inc. All rights reserved.

 * Legal Disclaimer
 * Notice of Privacy Practices

Y0069_241226_C

Last Updated: 09/28/2023