urlscan.io logo urlscan.io
SecurityTrails logo

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

Back to summary
Submitted URL: https://dollars.upmcmedicare.com/
Effective URL: https://plans.upmcmedicare.com/dollars?utm_medium=Direct&utm_campaign=AEP2024&utm_source=dollars
Submission: On May 17 via api from US — Scanned from DE

Form analysis 1 forms found in the DOM

<form id="JsonForm-form-f371b3f1-6f81-4d46-82a8-1aa24df54d23" x-instance="form-f371b3f1-6f81-4d46-82a8-1aa24df54d23" class="bs-jsonform">
  <div id="JsonForm-form-f371b3f1-6f81-4d46-82a8-1aa24df54d23-Loader" style="display: none"></div>
  <div class="row" id="JsonForm-form-f371b3f1-6f81-4d46-82a8-1aa24df54d23-Body" style="">
    <div class="col-12">
      <p class="open-sans">Fill out the information below to receive the FREE <em>Dollars and Sense</em> booklet 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-f371b3f1-6f81-4d46-82a8-1aa24df54d23-Input-firstName">First Name*</label>
        <input type="input" class="form-control" id="JsonForm-form-f371b3f1-6f81-4d46-82a8-1aa24df54d23-Input-firstName" placeholder="First Name" value="">
      </div>
    </div>
    <div class="col-md-12">
      <div class="form-group mt-0">
        <label for="JsonForm-form-f371b3f1-6f81-4d46-82a8-1aa24df54d23-Input-lastName">Last Name*</label>
        <input type="input" class="form-control" id="JsonForm-form-f371b3f1-6f81-4d46-82a8-1aa24df54d23-Input-lastName" placeholder="Last Name" value="">
      </div>
    </div>
    <div class="col-md-12">
      <div class="form-group mt-0">
        <label for="JsonForm-form-f371b3f1-6f81-4d46-82a8-1aa24df54d23-Input-emailAddress">Email</label>
        <input type="input" class="form-control" id="JsonForm-form-f371b3f1-6f81-4d46-82a8-1aa24df54d23-Input-emailAddress" placeholder="Email" value="" pattern="^.+@[^.].*.[a-z]{2,}$">
      </div>
    </div>
    <div class="col-md-12">
      <div class="form-group mt-0">
        <label for="JsonForm-form-f371b3f1-6f81-4d46-82a8-1aa24df54d23-Input-phoneNumber">Phone</label>
        <input type="input" class="form-control" id="JsonForm-form-f371b3f1-6f81-4d46-82a8-1aa24df54d23-Input-phoneNumber" placeholder="Phone" value="" pattern="[0-9]*" maxlength="10">
      </div>
    </div>
    <div class="col-12">
      <div class="phone-disclaimer">
        <p>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>
    </div>
    <div class="col-md-12">
      <div class="form-group mt-0">
        <label for="JsonForm-form-f371b3f1-6f81-4d46-82a8-1aa24df54d23-Input-addressLine1">Street Address*</label>
        <input type="input" class="form-control" id="JsonForm-form-f371b3f1-6f81-4d46-82a8-1aa24df54d23-Input-addressLine1" placeholder="Street Address" value="">
      </div>
    </div>
    <div class="col-md-12">
      <div class="form-group mt-0">
        <label for="JsonForm-form-f371b3f1-6f81-4d46-82a8-1aa24df54d23-Input-city">City*</label>
        <input type="input" class="form-control" id="JsonForm-form-f371b3f1-6f81-4d46-82a8-1aa24df54d23-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-f371b3f1-6f81-4d46-82a8-1aa24df54d23-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-f371b3f1-6f81-4d46-82a8-1aa24df54d23-Input-zipcode">Zip Code*</label>
        <input type="input" class="form-control" id="JsonForm-form-f371b3f1-6f81-4d46-82a8-1aa24df54d23-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-f371b3f1-6f81-4d46-82a8-1aa24df54d23-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>
          <option value="Fulton">Fulton</option>
          <option value="Greene">Greene</option>
          <option value="Huntingdon">Huntingdon</option>
          <option value="Indiana">Indiana</option>
          <option value="Jefferson">Jefferson</option>
          <option value="Juniata">Juniata</option>
          <option value="Lancaster">Lancaster</option>
          <option value="Lawrence">Lawrence</option>
          <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>
      </div>
    </div>
    <div class="col-0">
      <input type="hidden" id="JsonForm-form-f371b3f1-6f81-4d46-82a8-1aa24df54d23-Input-region" value="">
    </div>
    <div class="col-0">
      <input type="hidden" id="JsonForm-form-f371b3f1-6f81-4d46-82a8-1aa24df54d23-Input-autoResponderSegmentProperty" value="Region">
    </div>
    <div class="col-md-12">
      <div class="form-group mt-0 fieldhp">
        <label for="JsonForm-form-f371b3f1-6f81-4d46-82a8-1aa24df54d23-Input-APassword"></label>
        <input type="input" class="form-control" id="JsonForm-form-f371b3f1-6f81-4d46-82a8-1aa24df54d23-Input-APassword" placeholder="" value="">
      </div>
    </div>
    <div class="col-md-12">
      <div class="form-group mt-0 fieldhp">
        <label for="JsonForm-form-f371b3f1-6f81-4d46-82a8-1aa24df54d23-Input-BPassword"></label>
        <input type="input" class="form-control" id="JsonForm-form-f371b3f1-6f81-4d46-82a8-1aa24df54d23-Input-BPassword" placeholder="" value="">
      </div>
    </div>
    <div class="col-0">
      <input type="hidden" id="JsonForm-form-f371b3f1-6f81-4d46-82a8-1aa24df54d23-Input-trackingCode" value="">
    </div>
    <div class="col-0">
      <input type="hidden" id="JsonForm-form-f371b3f1-6f81-4d46-82a8-1aa24df54d23-Input-tfn" value="18666994740">
    </div>
    <div class="col-0">
      <input type="hidden" id="JsonForm-form-f371b3f1-6f81-4d46-82a8-1aa24df54d23-Input-AutoResponderIds_0_" value="2f205d0b-12f6-402a-a8a3-837da5c12290">
    </div>
    <div class="col-0">
      <input type="hidden" id="JsonForm-form-f371b3f1-6f81-4d46-82a8-1aa24df54d23-Input-pageKey" value="7ca3900c-d774-4aa3-8406-7a734b6f825f">
    </div>
    <div class="col-0">
      <input type="hidden" id="JsonForm-form-f371b3f1-6f81-4d46-82a8-1aa24df54d23-Input-website" value="https://plans.upmcmedicare.com/dollars?utm_medium=Direct&amp;utm_campaign=AEP2024&amp;utm_source=dollars">
    </div>
    <div class="col-0">
      <input type="hidden" id="JsonForm-form-f371b3f1-6f81-4d46-82a8-1aa24df54d23-Input-clientPersonCode" value="">
    </div>
    <div class="col-0">
      <input type="hidden" id="JsonForm-form-f371b3f1-6f81-4d46-82a8-1aa24df54d23-Input-fulfillmentPackageCode" value="">
    </div>
    <div class="col-0">
      <input type="hidden" id="JsonForm-form-f371b3f1-6f81-4d46-82a8-1aa24df54d23-Input-utmSource" value="dollars">
    </div>
  </div>
  <div class="row" id="JsonForm-form-f371b3f1-6f81-4d46-82a8-1aa24df54d23-Controls" style="">
    <div class="mt-3 col-12">
      <button type="submit" class="btn btn-primary">Get my Booklet</button>
    </div>
  </div>
</form>

Text Content

1-866-699-4740 (TTY: 711)

seven days a week from 8 a.m. to 8 p.m.*


YES! SEND ME THE OFFICIAL DOLLARS AND SENSE BOOKLET, PUBLISHED BY UPMC FOR LIFE.
I UNDERSTAND THERE IS NO COST AND NO OBLIGATION.


THIS IS YOUR YEAR TO ENROLL IN MEDICARE AND YOU WILL SOON HAVE SOME IMPORTANT
DECISIONS TO MAKE ABOUT YOUR HEALTH CARE COVERAGE. MAKE SURE YOU HAVE THE RIGHT
INFORMATION.


GET TO KNOW YOUR MEDICARE OPTIONS WITH THIS FREE INFORMATION.


YOUR FREE DOLLARS AND SENSE BOOKLET FROM
UPMC FOR LIFE WILL HELP YOU UNDERSTAND YOUR OPTIONS AND MAKE AN INFORMED
DECISION ON YOUR MEDICARE COVERAGE.



Fill out the information below to receive the FREE Dollars and Sense booklet 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.













Get my Booklet


MEDICARE 101

Medicare can be confusing, and that's why we're here to help! Find information
on how it works, enrollment periods, Extra Help, and more.

 * Learn more about Medicare


PROVIDER ACCESS

Get access to UPMC plus other community doctors and hospitals across PA and out
of state.

 * Find a provider


CONTACT US

Our Medicare Advisors are standing by to provide you with the personal help you
need.

 * Ways to connect


HAVE A QUESTION? CALL US!


HAVE A QUESTION? CALL US. WE’RE HERE TO HELP.

Have a quick question you'd like to get answered? We're here to help!
Call toll-free: 1-866-699-4740 (TTY: 711)
seven days a week 8 a.m. to 8 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_232068_C

Last Updated: 06/29/2023