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Enhanced benefits for members

We offer many enhanced benefits that can help you. From no out-of-pocket costs to early medication refills, UPMC Health Plan is here for you.

$0 copay for virtual visits from UPMC AnywhereCare

If you or your child is under the weather, you can reach a health care professional 24/7 without leaving your home through UPMC AnywhereCare and Children’s AnywhereCare. Your smartphone, computer, or tablet is all you need! Until September 30, we will waive all member cost sharing, including deductibles or copayments, for all virtual health care visits with our network providers.*

With Children’s AnywhereCare, your child (ages 0-17) can now have a video visit with a provider from UPMC Children’s Hospital of Pittsburgh.**

Learn how to download the UPMC AnywhereCare mobile app

Visit UPMC AnywhereCare

No out-of-pocket costs for members for in-network, inpatient COVID-19 treatment

Now through September 30, we are waiving all deductibles, coinsurance, and copays for in-network, inpatient COVID-19 treatment for members. Self-insured employer groups can opt out of this coverage.

No-cost coronavirus (COVID-19) testing*

We are waiving deductibles, copayments, and other cost-sharing for coronavirus testing when ordered by your medical provider.

Learn how to get tested

Coverage for personal protective equipment (PPE) during dental care visits

With the health and safety of our members and providers in mind, UPMC Dental Advantage will provide coverage for in-network dental providers’ use of PPE from July 15, 2020, through September 30, 2020. PPE may include N95 masks, gowns, and other protective equipment.

If you receive a bill from an in-network UPMC Dental Advantage provider related to the use of PPE for dates of service on or after July 15, 2020, please contact your dental provider. The dental provider is responsible for submitting a claim to UPMC Dental Advantage for payment consideration. If you have questions, call a Health Care Concierge at the number on your member ID card. TTY users should call 711.

UPMC MyHealth 24/7 Nurse Line

Our nurses offer support and advice on a wide range of health issues, including coronavirus. The MyHealth 24/7 Nurse Line is available at 1-866-918-1591 (TTY: 711).

*UPMC Health Plan members located in Pennsylvania at the time of virtual visit may select a UPMC-employed provider or a provider from Online Care Network II, P.C. (OCN), subject to availability. Members located outside of Pennsylvania will receive service from OCN. OCN is not an affiliate of UPMC.

Your wait time for UPMC AnywhereCare may be longer than usual due to increased call volume. If there is a wait, you can stay in the virtual waiting room or choose "text me when the provider is available."

While almost all of our Individual and Group plans include extensive telehealth benefits, some ASO/self-funded employer plans do not cover telehealth services. Visits for COVID-19 diagnosis are covered with no member cost share.

If you have questions about your coverage, see your plan documents.

**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. Members located outside of Pennsylvania at the time of service will receive care from a provider employed or contracted by Online Care Network II PC (OCN). OCN is not an affiliate of UPMC. Your wait time for UPMC AnywhereCare may be longer than usual due to increased call volume. If there is a wait, you can stay in the virtual waiting room or choose “text me when the provider is available.”

Personal protective equipment (PPE) coverage is available to eligible members from July 15, 2020, through September 30, 2020. Commercial member benefits may vary by group. While all UPMC Dental Advantage individual, small employer, and standard large employer group plans include PPE coverage, some self-insured (ASO) employer groups may elect not to cover PPE. Balance billing is prohibited for covered services from in-network providers.