Medicare AdvantageCoverageMedium impact
Important updates on influenza prevention and treatment
UPMC Health Plan·Family Medicine, Internal Medicine, General Practice +2 more·Provider Notice
Effective date
Feb 1, 2025
We identified it
Jun 20, 2026
Summary
UPMC Health Plan now offers $0 cost share for oseltamivir (generic Tamiflu) for Medicare members 65+ with Part D benefits, effective February 1, 2025. The policy emphasizes antiviral therapy within 2 days of flu symptoms for high-risk patients and continues to recommend flu vaccines and masking.
Action Required
Immediately: Front desk staff should inform UPMC for Life and UPMC for Life Complete Care (HMO D-SNP) members that oseltamivir prescriptions are now covered at $0 cost share at preferred, in-network pharmacies. Providers should consider prescribing antiviral therapy within 2 days for high-risk flu patients (adults 65+, pregnant women, those with asthma, chronic lung disease, diabetes, or heart disease). Update patient education materials to include masking recommendations and continued flu vaccine advocacy.