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.

UPMC Health Plan's telemedicine service, UPMC AnywhereCare, has expanded to offer care to children of all ages. With UPMC Children's AnywhereCare, children ages 0-17 can have virtual visits 24/7 with UPMC Children's Hospital of Pittsburgh providers over live video. Anytime, day or night. Members who are 18 years old and older will continue to use UPMC AnywhereCare.

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 health care
• 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

Visit UPMC AnywhereCare for more information or to sign up.

*UPMC Children’s AnywhereCare is available only to patients who are in Pennsylvania. In order for a child to have a UPMC Children’s AnywhereCare visit, the child’s parent or legal guardian must be with the child during the video portion of the visit, and the child and parent or legal guardian must be in Pennsylvania during the visit. If you are located outside of Pennsylvania at the time of service, you may select the standard UPMC AnywhereCare module, and you will receive care from a provider employed or contracted by Online Care Network II PC (“OCN”) at the discretion of the provider. OCN is not an affiliate of UPMC.

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.