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Are you considering our health insurance plans?

Benefit Plans

Deciding what health insurance is right for you and your family is a difficult decision. Use the links below and to the left to learn more about UPMC Health Plan and what benefits we offer.

How do I understand what is covered?

Benefit Grid image thumbnail

Selecting the right health insurance for you and your family can be confusing. If you are starting a new job or in a transition in your life, you already have a lot to think about. Our website will help you navigate your decision.

The Summary of Benefits (also known as SOB or plan benefit grid) your employer provided is a good place to start.

So, get out your benefit grid and we'll walk you through it. >>


Is my doctor in the UPMC Health Plan network?

Find out if your doctor is on our network.

To search our doctor directory, you will need to know the plan your employer is offering. You can find this information on the Summary of Benefits your employer provided to you.

UPMC Health Plan's network throughout western Pennsylvania includes more than 80 hospitals and 7,600 physicians. Across the nation, our networks include nearly 4,000 hospitals and more than 500,000 physicians.

Are my prescriptions covered?

The Your Choice pharmacy program provides value and freedom of choice by offering you a variety of high-quality, cost-effective generic and brand-name prescription drugs. Use the link below to search for medications that are covered by Your Choice.

Search our Your Choice formulary (drug list)

Some additional medications may be covered based on your employer group. Refer to your prescription drug rider to see if your specific plan has any differences.

What vision benefits are covered?

If your plan includes vision benefits, UPMC Health Plan offers coverage for exams, lenses, frames, and contacts.

We offer managed vision care programs through Vision Benefits of America (VBA). Call 1-800-432-4966 or visit www.visionbenefits.com to locate participating VBA providers.

If your are considering our UPMC Small Business Advantage plan, click here to review your vision benefit information and locate a participating OptiCare provider.

What is the MyHealth Record?

MyHealth Record is a confidential personal health record (PHR) available to all UPMC Health Plan members through MyHealth OnLine that helps members keep health information current.

Here’s how it works: All your claims for tests, procedures, office visits, prescriptions, and other covered benefits is automatically loaded into your MyHealth Record. Then you fill in the rest of your health history, such as family history, new symptoms, over-the-counter medications, and other health-related information that may not be captured in our claims database. Then print and share your record with your doctor.

The MyHealth Record is held to the same security standards as customer information in the banking and finance industries. As a member, only you can view, edit, or print your record.

In addition to the MyHealth Record, MyHealth OnLine allows members to:

 


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