UPMC MyCare Advantage is a tiered benefit plan designed to improve the health outcomes of employees with its focus on patient-centered care. It offers members in-network access to UPMC facilities with the opportunity for cost savings. With a choice of multiple plan designs and benefit levels, you can choose the option that best suits the needs of your employees and your business.
- Multiple plan design options (PPO or HMO with qualified high-deductible health plan)
- A tiered benefit design
- Plan designs that promote coordinated care
- Competitive pricing
- Available to companies with two or more employees located in Allegheny, Beaver, Bedford, Blair, Butler, Erie, Lawrence, Mercer, Venango, Washington, and Westmoreland counties.
- Members get the highest level of benefits and lowest out-of-pocket costs when they receive care from Level 1 doctors and hospitals. With in-network access to nationally recognized doctors and hospitals near home, members can enjoy patient-centered care and valuable cost savings.
- Participating providers include: all UPMC doctors, hospitals, and facilities, and these community-based partners: Grove City Medical Center, Heritage Valley Health System (Beaver, Sewickley), St. Clair Hospital, Butler Memorial Hospital, Jameson Hospital, Kane Community Hospital, Monongahela Valley Hospital, Washington Health System Greene, Washington Hospital, and Excela Health (Frick, Latrobe, Westmoreland).
- Members also have the choice of extended access to Level 2 participating providers with increased cost sharing.
- Members of a PPO plan have the choice of out-of-network services at a greater cost sharing with Level 3 benefits.
UPMC MyCare Advantage is available for groups of two to 50 with PPO Plans only.
Value-added Benefits and Services
Additional features included in your coverage free of charge:
- Health coaching: Lifestyle coaching and condition management coaching are offered to members over the phone, in addition to self-paced health coaching programs online.
- MyHealth OnLine: Our secure member portal is personalized to help employees reach their goals and needs.
- UPMC AnywhereCare: When nonemergency medical issues arise, employees are able receive a care plan and prescription (if needed), usually within minutes, right from their computer, tablet, or smartphone — 24/7.
UPMC Health Plan members located in Pennsylvania at the time of service will have a virtual visit with a UPMC-employed provider. If a member is located outside Pennsylvania, service will be delivered by a separate provider group - Online Care Group (OCG). UPMC AnywhereCare is currently not available in Texas or Arkansas.