The Difference You Can Count On
UPMC Health Plan serves more than 590,000 members with its Commercial, CHIP, Medical Assistance, and Medicare Advantage products.
With no referrals required, you will have access to over 2,200 primary care physicians, more than 5,300 specialists, and 73 of the region’s hospitals.
Members have access to all of the hospitals of the University of Pittsburgh Medical Center, one of the top-ranked health systems in the nation (U.S. News & World Report, America’s Best Hospitals, 7-18-11), plus many non-UPMC facilities.
Our members also receive additional benefits and services, such as:
Assist America® Travel Assistance
If you’re traveling more than 100 miles from home, you can still have easy access to health care through our travel assistance partner, Assist America. Medical services are just a phone call away, 24 hours a day, 365 days a year.
Health Care Concierge Program**
Our Health Care Concierges are available to help our members find network providers, schedule appointments, provide benefit information, and assist with claims questions.
MyHealth Advice Line
Experienced registered nurses are on hand to answer questions and give general health advice, 24 hours a day, seven days a week.
MyHealth OnLine**
This confidential, Internet-based resource offers members access to their most current health data and can help them keep track of prescription refills, their personal health history, and more.
Care Management Programs
UPMC's care managers are here to help you live with and manage chronic medical conditions, such as heart disease, asthma, diabetes, and high blood pressure.
Complex Case Management
If you have a complex medical or behavioral health condition, you may feel like you could use some extra help. Good news! We can provide that help. Our complex case management program gives you access to a health coach who will work with you and your doctors.
We will contact you if we feel you can benefit from our program. If you agree to be in a program, a health coach will work with your provider and with you and your caregivers to develop a plan that meets your needs. You don't have to take part in the program if you don't want to, and you can stop at any time. If you have questions about the complex case management program, please call us at 1-866-778-6073. Representatives are available Monday through Friday from 8 a.m. to 5:30 p.m. TTY for hearing impaired users please call toll-free at 1-800-361-2629.
If you would like more information about becoming a member, please give us a call toll-free at 1-866-405-8762 from 8 a.m. to 8 p.m.,** seven days a week or click on one of the links below. TTY/TDD users should call 1-866-407-8762.
Enhanced Benefits
Our members pay nothing for one routine eye exam every two years. You also receive an allowance toward one pair of glasses or contacts every two years. You pay nothing for one routine hearing test every year and are eligible for a hearing aid allowance every three years. In addition, our members pay nothing for preventive services, including oral exams, cleanings, and x-rays, up to one visit every six months. Additional comprehensive dental benefits may be available, depending on your Medical Assistance category.
**Please note: The products and services described are neither offered nor guaranteed under our contract with the Medicare program. In addition, they are not subject to the Medicare appeals process.
Any dispute regarding these products and services may be subject to the UPMC Health Plan grievance process.