Access to Care

As a UPMC Health Plan member, you’ll have access to our world-class provider network. For the 16th time, UPMC has been recognized by U.S. News & World Report as one of the nation’s top-ranked hospitals. Your network refers to the specific hospitals, facilities, physicians, and other providers included in your plan.

UPMC Premium Network Listing

You can have peace of mind knowing that all UPMC Health Plan participating providers have agreed to the following:

• At least 20 office hours each week.
• 24/7 on-call coverage.
• Coverage by another UPMC Health Plan provider when your doctor goes on an extended leave or vacation.
• Timely appointments depending on the type of care needed.

Extended Network

UPMC Health Plan provides access to high-quality care for your employees and their covered dependents who are traveling or living outside our service area. This national network is composed of the Cigna PPO Network1 for members who are outside the UPMC Health Plan service area and not in Ohio, and the SuperMed PPO Network for members in Ohio.² The Cigna PPO Network has more than 1 million health care providers and 6,100 hospitals.³

 

Free global emergency travel assistance

When you travel more than 100 miles from home for less than 90 days, you have access to care 24 hours a day, seven days a week. If you have a medical emergency, Assist America will connect you to medical resources, including doctors, hospitals, and pharmacies. Assist America also has translators readily available to assist you.

Learn More About Assist America

UPMC AnywhereCare

You can have a virtual visit with a provider right from your computer, tablet, or smartphone—anytime, day or night. This service is perfect for nonemergency conditions. If you think you may be experiencing life-threatening symptoms, call 911 or seek immediate medical attention. You must be older than age 18 to use UPMC AnywhereCare. UPMC AnywhereCare visits cost as little as a $5 copay with certain Aon Exchange plans!

Learn About UPMC AnywhereCare

UPMC MyHealth 24/7 Nurse Line

Get advice from a nurse by calling the UPMC MyHealth 24/7 Nurse Line. A registered nurse is available anytime, day or night, to help you decide what steps to take. There is no cost to you for this service.

Learn About UPMC MyHealth 24/7 Nurse Line

Preventive Services

The Affordable Care Act requires that certain preventive services are covered at no cost to you. These services fall into three categories:

• Screenings
• Immunizations
• Health exams

Common adult screenings include cholesterol, blood pressure, mammograms, and colonoscopies. Common adult immunizations include the tetanus, diphtheria, pertussis (Tdap) vaccine and vaccines for the flu and shingles. If you have children covered under your plan, they’ll be covered at 100 percent for a variety of screenings and immunizations.

Preventive Guidelines for Adults and Children (PDF) Preventive Drugs Available at $0 Cost Share (PDF)

 

¹ The Cigna PPO Network refers to the health care providers (doctors, hospitals, specialists) contracted as part of the Cigna PPO for Shared Administration. Cigna is an independent company and is not affiliated with UPMC Health Plan and its affiliates. Access to the Cigna PPO Network is available through Cigna’s contractual relationship with UPMC Health Plan. All Cigna products are provided exclusively by or through operating subsidiaries of Cigna Corp., including Cigna Health and Life Insurance Company. The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property Inc. Access to the Cigna PPO Network outside of the UPMC Health Plan service area is applicable for members in Bucks, Chester, Delaware, Franklin, Fulton, Juniata, Mifflin, Montgomery, Montour, and Philadelphia counties in Pennsylvania; and all other states except Ohio; Garrett and Allegany counties in Maryland; and Chautauqua, Cattaraugus, and Allegany counties in New York.

² UPMC Health Plan commercial members and their dependents who reside or are traveling in Ohio will continue to access care through the SuperMed PPO Network and, while traveling outside of the state of Ohio, can also utilize the Cigna PPO Network.

³ Cigna analysis of actual providers contracted as part of the Cigna PPO for Shared Administration as of December 2020. Data is subject to change.