Prospective Members

Located in the heart of Marquette, Upper Peninsula Health Plan (UPHP) has been serving citizens of our beautiful Upper Peninsula for more than 20 years. We take pride in our home and believe that the health and well-being of its citizens – our neighbors – is our responsibility. Each day, our work is guided by our founding values: Members first. Connected to communities. Value employees and volunteers. And partnerships with providers.

Our Medicare Advantage and Medicare-Medicaid Plans are exclusive to the citizens of the Upper Peninsula and were created with your needs in mind. When you enroll in one of our Medicare plans, you not only receive top-of-the-line health care and service – you become a member of the UPHP family.

Learn more about our plans in the chart below or review the applicable Summary of Benefits below:

Plan UPHP Advantage (HMO)UPHP Choice (HMO)UPHP MI Health Link (Medicare-Medicaid Plan)
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Plan Premium

$113 (2020)

$114 (2021)

$0$0
Yearly Part B Deductible$0$0$0
Yearly Part D Deductible$0

$435 (2020)

$285 (2021)

(Applies to Tiers 2, 3, 4 and 5)

$0
Maximum Out-of-Pocket for Medicare-covered Services

$6,700 (2020)

$7,550 (2021)

$11,300 (POS 2021)

$6,700 (2020)

$7,550 (2021)

$0
CopaymentsThere 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.
CoinsuranceThere 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 AmountNot ApplicableNot ApplicableIf 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.
Formulary (Drug List)

View the UPHP Advantage Formulary

(List of Covered Drugs)

View the UPHP Choice Formulary

(List of Covered Drugs)

View the UPHP MI Health Link Formulary

(List of Covered Drugs)

Eligibility RequirementsMust 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).
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Upper Peninsula Health Plan is an HMO plan with a Medicare contract.  Enrollment in the Upper Peninsula Health Plan depends on contract renewal.  This information is not a complete description of benefits. Call 1-877-349-9324 (TTY: 711), seven days a week from 8 a.m. to 9 p.m. Eastern time for more information.  The call is free. Benefits, formulary, pharmacy network, provider network, premium, and/or copayments/coinsurance may change on January 1 of each year. Limitations, copayments, and restrictions may apply. You must continue to pay your Medicare Part B premium.  The Formulary, pharmacy network, and/or provider network may change at any time.  You will receive notice when necessary.  As a member of UPHP, if you are unhappy with the care or service you receive, you may file a complaint with us by going to the Grievances and Appeals page.  You may also file a complaint electronically by using the Medicare Complaint Form  (clicking this link will take you away from UPHP’s website)

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Page Last Updated: 10/13/2020