UPMC Inside Advantage

Overview

UPMC Inside Advantage for northwestern Pennsylvania is a tiered benefit plan that provides members with the same type of coverage as other UPMC Health Plan offerings — but with lower out-of-pocket costs when members receive care at a UPMC-owned facility or select Level 1 facilities near the places where they work and live.

Features

  • Plan design options include exclusive provider organization (EPO) and preferred provider organization (PPO) plans
  • All plans feature the Premium Network, our broadest network
  • A tiered benefit design
  • Competitive pricing

Network

Members have the lowest out-of-pocket costs when they receive care at Level 1 providers. Level 1 includes all UPMC-owned facilities along with many community-owned providers and facilities, such as Grove City Medical Center, Meadville Medical Center, Titusville Area Hospital, and Warren General Hospital. UPMC facilities in northwest Pennsylvania include UPMC Hamot, UPMC Horizon, UPMC Jameson, UPMC Kane, and UPMC Northwest. At Level 2, out-of-pocket costs may increase. Level 2 includes the rest of Premium Network-contracted facilities and the services affiliated with those contracted facilities, such as lab, x-ray, MRI therapy services, and more.

Eligible Groups

Employer groups with two or more employees located in Clarion, Crawford, Elk, Erie, Forest, McKean, Mercer, Potter, Venango, and Warren counties are eligible for UPMC Inside Advantage plans.

Wellness support comes with every plan

  • Health coaching – Telephone-based lifestyle coaching and condition management coaching that can help your employees improve their health, make lifestyle changes that last, stay motivated, keep goals in sight, and overcome obstacles.
  • MyHealth OnLine – Our secure member website with practical tips, tools, and strategies for better health. Your employees can also find a doctor, view their medical history, get information on their health plan benefits, and much more.
  • UPMC AnywhereCare* – A newly enhanced virtual visit platform that allows members to receive expert care using a computer, tablet, or smartphone. UPMC AnywhereCare connects a member to a provider using video technology. Ideal for nonemergent conditions, such as sinus infection, allergies, or pink eye. This service is available 24/7 from anywhere in the United States.

*Patients located in Pennsylvania at the time of the service will have a virtual visit with a UPMC-employed provider. If a patient is located outside Pennsylvania, the service will be delivered by a separate provider group — Online Care Group (OCG).