UPMC MyCare Advantage

MyCare Advantage

Overview

Through its tiered benefit design, UPMC MyCare Advantage reduces costs for employers and gives members the power to choose the level of benefits that best meets their needs. This plan combines cost savings with a patient-centered care approach, allowing members to receive specialized, coordinated care with the opportunity to save on out-of-pocket costs with selection of benefit levels.

Features

  • Plan design options include exclusive provider organization (EPO) and preferred provider organization (PPO) plans, including a qualified high deductible health plan
  • All plans feature the Premium Network, our broadest network, giving in-network access to the best hospitals and doctors near the places where members work and live
  • Plan designs that promote coordinated care
  • Competitive pricing

Network

  • Members receive the highest level of benefits and lowest out-of-pocket costs when they receive care from Level 1 doctors and hospitals. The Level 1 network includes all UPMC-owned hospitals and providers plus additional community doctors and hospitals. In all, members have access to more than 13,350 providers and over 60 hospitals and facilities. Whether your employees need access to cancer treatment, behavioral health, children’s health, or maternity care and women’s services, their choices include nationally recognized doctors and hospitals.
  • Members have access to more than 18,000 additional providers within the UPMC Premium Network. Members do not need a referral to see providers in Level 2, but there is a higher cost share. Members of a PPO plan have the choice of out-of-network services at a greater cost sharing.

Eligible groups

UPMC MyCare Advantage is now available in Allegheny, Beaver, Bedford, Berks, Blair, Butler, Clinton, Cumberland, Dauphin, Fayette, Lawrence, Lycoming, Tioga, Washington, and Westmoreland counties.

Wellness support comes with every plan

  • Health coaching – Telephone-based lifestyle coaching and condition management coaching that can help your employees improve their health and make lifestyle changes that last.
  • 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. Non-emergent conditions such as sinus infection, allergies, or pink eye can be treated. 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).