UPMC Health Plan will soon offer individual health insurance options for coverage longer than 6 months. If you are interested in our individual products, complete the form below. A UPMC Health Plan representative will be in contact with you.
Your Contact Information
First name: *
Last name: *
E-mail address:
Phone number:
Preferred contact method: *
e-mail
phone
* - required field
Basic Coverage Information
(optional)
Home ZIP code:
Age:
Gender:
Male
Female
Coverage needed for:
Select One
Just Myself
Myself and 1 or more family members
Start date:
Select One
As soon as possible
Approximately 30 days from now
Approximately 60 days from now
Approximately 90 days from now
Not sure
Other Information
(optional)
Your current health insurance:
Select One
Assurant
Aetna
Celtic
Health America
Highmark
Other Carrier
Uninsured
How did you hear about Individual Advantage?
Select One
Billboard
Friend
Insurance Agent
Newspaper
TV
Radio
Web
Not Sure
Other
Your request for information about UPMC Individual Advantage guaranteed renewable health insurance does not constitute an application for coverage.