UPMC for Kids Access to Primary Care Providers

UPMC for Kids’ large provider network gives your children 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 form 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, go 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.

If you need nonemergency care right away and can’t get to the doctor, consider UPMC AnywhereCare. With this service, you can do an e-visit with a UPMC provider straight from your computer, tablet, or phone. Anytime, day or night. And there is no cost for UPMC for Kids members.

UPMC AnywhereCare 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. A provider will get back to you — often within minutes — with a diagnosis and care plan. You can even get a prescription if needed.

Benefits of UPMC AnywhereCare include:

• One more way to access great healthcare
• Less serious conditions get taken care of 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

For more information about UPMC AnywhereCare or to sign up, visit www.upmcanywherecare.com.

*UPMC for Kids members 3 years and older can seek treatment through UPMC AnywhereCare. Members located in Pennsylvania at the time of the service will have a virtual visit with a UPMC-employed provider. UPMC AnywhereCare virtual visits are not covered services when UPMC for Kids members are traveling outside of Pennsylvania. UPMC AnywhereCare is currently not available in Texas or Arkansas.

UPMC AnywhereCare is not a substitute for emergency medical care. If you have an emergency, go to the nearest emergency department, call 911, or your local ambulance service.