UPMC for Kids Access to Primary Care Providers

UPMC for Kids’ large provider network gives your child easy access to care at award-winning hospitals. You don’t need a referral to see in-network providers.

Having a primary care provider (PCP) is required with this plan—and it’s a smart idea to build a relationship with your child’s doctor. Your child’s PCP is the first person to call when your child gets sick or injured. The PCP knows your child’s health history and is the best person to treat your child.

Your child’s PCP will also:

• Provide well-child exams and preventive services.
• Direct your child’s care if your child needs tests or specialist care.

The PCP can be a pediatrician, a family practitioner, or an internal medicine doctor.

When your child is enrolled, you will have the opportunity to select a PCP for your child. The name of the group will appear on your child’s member ID card. Your child can see any PCP in that group.

You can change your child’s PCP at any time by calling our Health Care Concierge team. After you change your child’s PCP, your child will receive a new member ID card.

The UPMC for Kids provider network gives your child easy access to care. You don’t need a referral to see in-network providers. You can find information about our provider network by calling us at 1-800-650-8762 (TTY: 711) or visiting our provider directory.

Your child’s PCP can provide routine care and see your child when they are sick. The PCP will help coordinate the care your child needs.

The PCP can help decide when your child needs to see a specialist. You do not need a referral from the PCP for your child to see a specialist who participates in the UPMC for Kids network.

Except in an emergency, your child must use a participating UPMC for Kids provider. This includes physicians, hospitals, dentists, pharmacies, and other providers.

If your child has an emergency, you should take them to the nearest emergency room. If you aren’t sure it is an emergency and waiting will not harm your child’s health, contact your child’s PCP first.

With 24/7 video visits, children ages 0 to 17 can have virtual visits with UPMC providers over live video.

This service is perfect for problems such as a sore throat, cough, runny nose, sinus infection, cold or flu symptoms, back pain, and poison ivy. Simply sign in and describe your symptoms. You will be connected to a provider—often within minutes—who can provide a diagnosis and care plan. You can even get a prescription if needed.

Benefits of 24/7 video visits include:

• One more way to access health care
• Less serious conditions can be addressed before they become more serious
• Less time from your day because e-visits take minutes, not hours
• Peace of mind that you’re always covered when symptoms arise

Visit the 24/7 video visits page for more information or to sign up.

*UPMC for Kids members who are in Pennsylvania at the time of a virtual visit may select a UPMC- employed provider, subject to availability and discretion of the provider. Members temporarily traveling outside of Pennsylvania at the time of service will receive care from a provider employed or contracted by Online Care Network II PC (OCN), also known as Amwell Medical Group. It is at the discretion of OCN providers to choose whether to treat patients ages 0 to 2. OCN is not an affiliate of UPMC. In order for a UPMC for Kids member to have a 24/7 video visit, the member’s parent or legal guardian must be with the child during the video portion of the visit. 24/7 video visits are not covered services for UPMC for Kids members using Talk Therapy or Psychiatry services. 24/7 video visits for children ages 0-2 are not available from 9 p.m. to 8 a.m. or outside of Pennsylvania. Providers are not available to treat members who are in Puerto Rico.