Documents & Resources for Members

Please call the UPMC Community HealthChoices Health Care Concierge Team at 1-844-833-0523 (TTY: 711) to request any of these documents in hard copy or alternative format.

• Notice of Privacy Practices
• Member Authorization to Use/Disclose PHI
• Personal Representative Designation Form
• Summary of Benefits
• Participant Handbook
• Prescription Drug Search
• UPMC Community HealthChoices Pharmacy Formulary (Non-PDL) (PDF) | Formulary in JSON format (JSON)
• Provider Directory Search
• MyHealth OnLine
• Participant Advisory Committee Application
• Participant Advisory Committee Application (PDF)
• Southwest PA – Participant Advisory Committee Meeting Minutes
  • September 2022
  • June 2022
  • March 2022
  • December 2021
  • September 2021
  • June 2021
  • March 2021
• Southeast PA – Participant Advisory Committee Meeting Minutes
  • September 2022
  • June 2022
  • March 2022
  • December 2021
  • September 2021
  • June 2021
  • March 2021
• Northwest PA – Participant Advisory Committee Meeting Minutes
  • September 2022
  • June 2022
  • March 2022
  • December 2021
  • September 2021
  • June 2021
  • March 2021
• Northeast PA – Participant Advisory Committee Meeting Minutes
  • September 2022
  • June 2022
  • March 2022
  • December 2021
  • October 2021
  • September 2021
  • June 2021
• Lehigh/Capital – Participant Advisory Committee Meeting Minutes
  • September 2022
  • June 2022
  • March 2022
  • December 2021
  • October 2021
  • September 2021
  • June 2021
• Being Independent Matters newsletter
  • Issue 2, 2022
  • Issue 1, 2022
  • Issue 3, 2021
  • Issue 2, 2021
  • Issue 1, 2021
• Caring for Life newsletter
  • Issue 2, 2022
  • Issue 1, 2022
  • Issue 3, 2021
  • Issue 2, 2021
  • Issue 1, 2021

CHC Member Healthy Lifestyle Articles

• CHC Member Healthy Lifestyle Article – Back Pain
• CHC Member Healthy Lifestyle Article – Heart Disease
• CHC Member Healthy Lifestyle Article – Doctor Visit
• CHC Member Healthy Lifestyle Article – Stress
• CHC Member Healthy Lifestyle Article – Chronic Condition
• CHC Member Healthy Lifestyle Article – Oral Hygiene
• CHC Member Healthy Lifestyle Article – Asthma
• CHC Member Healthy Lifestyle Article – Lifestyle
• CHC Member Healthy Lifestyle Article – Osteoporosis

繁體中文/Mandarin (Chinese):

• 隐私惯例通知 – Notice of Privacy Practices
• 个人代表委托表 – Personal Representative Designation Form
• 福利摘要 – Summary of Benefits
• 参与者手册 – Participant Handbook
• UPMC Community HealthChoices 药房指南 – UPMC Community HealthChoices Pharmacy Guide
• COVID-19 非处方 (OTC) 检测报销表
• 独立事务通讯. – Being Independent Matters Newsletter

한국어/Korean:

• 개인 정보 보호 관행 고지 – Notice of Privacy Practices
• 개인 대리인 지정 양식 – Personal Representative Designation Form
• 혜택 요약 – Summary of Benefits
• 참가자 핸드북 – Participant Handbook
• UPMC Community HealthChoices 약국 가이드 – UPMC Community HealthChoices Pharmacy Guide
• COVID-19 일반의약품(OTC) 검사기 비용 환급 신청서
• 독립 문제(Being Independent Matters) 뉴스레터 – Being Independent Matters Newsletter

ខ្ខ្មែរ/Mon-Khmer (Cambodian):

• សេចក្តីជូនដំណឹងពីការអនុវត្តឯក្ជនភាព – Notice of Privacy Practices
• ទម្រង់ចាត្់តំងត្ំណាងផ្ទាល់ខ្លួន – Personal Representative Designation Form
• សងេបអំពីអត្ថម្បសោជន៍ – Summary of Benefits
• សេៀវសៅណណនំអនក្ចូលរួរ – Participant Handbook
• ការណែនាំអំពីឱសថស្ថានរបស់គម្រោង UPMC Community HealthChoices – UPMC Community HealthChoices Pharmacy Guide
• ទំំរង់់ស្នើើសុំំសំំណងសម្រា ប់់កាារធ្វើ�ើតេស្តត COVID-19 ដែ�លគ្មាានវេេជ្ជជបញ្ជាា (OTC)
• ព្រឹត្តិប័ត្រព័ត៍មានអំពីសារៈសំខាន់នៃភាពឯករាជ្យ – Being Independent Matters Newsletter

Tiếng Việt/Vietnamese:

• Thông báo Thực hiện Quyền riêng tư – Notice of Privacy Practices
• Mẫu Chỉ định Người đại diện Cá nhân – Personal Representative Designation Form
• Tóm tắt Quyền lợi – Summary of Benefits
• Sổ tay Người tham gia – Participant Handbook
• Hướng dẫn về Nhà thuốc của UPMC Community HealthChoices – UPMC Community HealthChoices Pharmacy Guide
• Mẫu yêu cầu hoàn trả chi phí xét nghiệm Thuốc không kê toa COVID-19 (OTC)
• Là Bản tin Vấn đề Độc lập – Being Independent Matters Newsletter

Русский/Russian:

• Уведомление о политике сохранения конфиденциальности – Notice of Privacy Practices
• Форма назначения личного представителя – Personal Representative Designation Form
• Краткое описание льгот – Summary of Benefits
• Справочник участника программы – Participant Handbook
• Рецептурный справочник UPMC Community HealthChoices – UPMC Community HealthChoices Pharmacy Guide
• Бланк заявки на возмещение за безрецептурные (OTC) тесты на COVID-19
• Информационное письмо «Важность самостоятельности» – Being Independent Matters Newsletter