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| Member Handbook Provides information to help you understand your UPMC for Kids benefits and how to access services. |
Pharmacy Benefits Booklet Provides a description of pharmacy services and a list of the medications that are covered |
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| Summary of Benefits Provides information on UPMC for Kids benefits and copayments that apply to some members |
UPMC for Kids Exclusions Provides information on the services and supplies that are not covered by UPMC for Kids or have limitations on the coverage |
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| MyHealth OnLine Brochure Provides information to help access you online benefits through MyHealth OnLine |
Privacy Statement Describes how UPMC for Kids protects your child's health information |
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| Member Rights and Responsibilities Lists the rights and responsibilities of UPMC for Kids members |
Member Complaints and Grievances Provides an explanation of the procedures necessary to file a complaint or grievance with UPMC for Kids |
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| Notice of Privacy Practices Describes HIPAA and the use of your child's or teen's protected health information |
Renewal App - English UPMC for Kids renewal application for CHIP health insurance in English |
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| Renewal App - Spanish Solicitud de renovación para el Programa de seguro médico para niños (CHIP) de UPMC for Kids en español |
Personal Representative Designation Form Form by which the head of household gives a designated person written permission to discuss your child's health information and benefits with UPMC for Kids |
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| Member Authorization to Use or Disclose Protected Health Information Form that gives UPMC for Kids written permission to share protected health information |
Income Guidelines Chart Family income guidelines used to determine eligibility for CHIP programs |
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| Quick Reference Guide Provides information on when a prior authorization or referral is needed for a service |
