Upper Peninsula Health Plan (UPHP)
Upper Peninsula Health Plan (UPHP)
853 West Washington St.Marquette, Michigan, 49855
9062257500
https://www.uphp.com/
Services Provided
Medicaid and Medicare Insurance for those who qualify that live in the Upper Peninsula.
Upper Peninsula Health Plan (UPHP) brings the residents of Michigan’s Upper Peninsula three Medicare and medicaid plan options from a local, Upper Peninsula-based organization. Select the plan name below to learn more about each plan.
| Contract |
UPHP Choice (HMO) |
UPHP Advantage (HMO) | UPHP MI Health Link (Medicare-Medicaid Plan) |
| Plan Premium | $0 | For calendar year 2019: $110
For calendar year 2020: $113 |
$0 |
| Yearly Part B Deductible | $0 | $0 | $0 |
| Yearly Part D Deductible | For calendar year 2019: $415 (applies to Tiers 3, 4, and 5)For calendar year 2020: $435 (applies to Tiers 2, 3, 4, and 5) |
$0 | $0 |
| Maximum Out-of-Pocket for Medicare-covered Services | $6,700 | $6,700 | $0 |
| Copayments | There are copayments under this plan. See the benefits chart in Chapter 4 of the UPHP Evidence of Coverage to learn about copayments and the benefits they apply to. | There are copayments under this plan. See the benefits chart in Chapter 4 of the UPHP Evidence of Coverage to learn about copayments and the benefits they apply to. | There are no copayments under this plan. |
| Coinsurance | There are coinsurance amounts under this plan. See the benefits chart in Chapter 4 of the UPHP Evidence of Coverage to learn about coinsurance amounts and the benefits they apply to. | There are coinsurance amounts under this plan. See the benefits chart in Chapter 4 of the UPHP Evidence of Coverage to learn about coinsurance amounts and the benefits they apply to. | There are no coinsurance amounts under this plan. |
| Patient Pay Amount | Not Applicable | Not Applicable | If you reside in a nursing facility you may be responsible for a patient pay amount. See the benefits chart in Chapter 4 of the UPHP MHL Member Handbook to learn more about the patient pay amount. |
| Doctor Office Visits | Covered | Covered | Covered |
| Specialist Office Visits | Covered | Covered | Covered |
| Hospitalization | Covered | Covered | Covered |
| Prescriptions | Covered | Covered | Covered |
| Emergent and Urgent Care | Covered | Covered | Covered |
| Eyeglasses | Not Covered | Covered | Covered |
| Fitness Benefit | Covered | Covered | Not Covered |
| Hearing Aids | Not Covered | Covered | Covered |
| Dental Care | Covered | Covered | Covered |
| Eligibility Requirements | Must live in Michigan’s Upper Peninsula; must have Medicare Parts A and B. | Must live in Michigan’s Upper Peninsula; must have Medicare Parts A and B. | Must live in Michigan’s Upper Peninsula; must have Medicare Parts A and B and have full Medicaid benefits. Learn more from the Michigan Department of Health & Human Services (clicking on this link will take you away from UPHP’s website). |
| Formulary (Drug List) | View the UPHP Choice Formulary(List of Covered Drugs) (Clicking on this link will take you away from UPHP’s website). | View the UPHP Advantage Formulary (List of Covered Drugs) (Clicking on this link will take you away from UPHP’s website). | View the UPHP MI Health Link Formulary(List of Covered Drugs) (Clicking on this link will take you away from UPHP’s website). |
Transportation:
Assistance is available for care that is medically necessary and UPHP will use the most cost-effective means of transportation. If you cancel or change an appointment, you need to tell UPHP before the day of the appointment.
- The UPHP transportation benefit is only available for UPHP-covered services
Eligibility:
Medicaid and Medicare