UPMC Health Plan Ancillary Benefits

Dental, vision, and hearing health care coverage is available in a variety of models to support the overall health of your employees. Employers with 51 or more eligible employees can bundle dental, vision, and hearing health care benefits with their UPMC Health Plan medical coverage. Employers with 2 to 50 eligible employees can pair dental and vision with UPMC Health Plan medical coverage. Dental and vision benefits can also be purchased as stand-alone options.

UPMC Dental Advantage

Employers can purchase UPMC Dental Advantage as a standalone benefit or integrate it with their UPMC Health Plan medical coverage. Members have access to a vast network through one of three plan models—Basic, Standard, and Premium.

  • Prior authorization is not required for major services.
  • There is increased coverage for nonsurgical periodontal treatment, including topical application of fluoride for adults with a history of surgical periodontal treatment.
  • There is coverage for microbial tests and brush biopsies.
  • An additional cleaning is offered to pregnant members.
  • New for 2024! Maximum Rollover Benefit – The Maximum Rollover Benefit can be included in specific plan offerings and allows members to roll over their unused Plan Year Maximum Amount for use in future years.

UPMC Vision Care

UPMC Vision Care, administered by National Vision Administrators (NVA®), gives members access to a national network of vision providers. There are a variety of plan designs with both copay and no-copay options:

  • Exam Only Plus
  • Classic Plus
  • Deluxe Plus
  • Prime Plus
  • Premier Plus
  • Elite Plus

Features of the plans:

  • Discounts on eye exams, lenses, lens options, frames, and contact lenses when members use a participating provider
  • A mail-order contact lens service
  • Fixed copayments for lens add-ons (excludes Exam Only plan)
  • Discounts on LASIK procedures at the UPMC Eye Center, QualSight LASIK, TLC Laser Eye Centers, and LASIK Centers of America

Hearing Health Care Benefit

Our hearing health benefit is provided in partnership with Amplifon Hearing Health Care.1 Amplifon has negotiated discounts with a nationwide network of contracted providers, and members can use their benefits to lower providers' already discounted prices.

Hearing health benefit members are eligible for one hearing exam every 36 months. They also have access to:

  • More than 1,400 hearing aid products from top manufacturers.
  • Nearly 6,000 clinic locations.
  • One year of free follow-up care, a two-year supply of batteries or a standard charging station, a three-year warranty covering defects and repairs by the manufacturer, and a one-time replacement of the device in the event of loss or damage.2
  • 60-day, risk free trial with no restocking fee.

Additional Benefits

Fertility Health and Family-Forming Benefits

UPMC Health Plan is working with Carrot Fertility to help employers offer comprehensive, inclusive fertility health and family-forming benefits that are accessible and affordable.

If employers choose to offer Carrot, employees will have access to:

  • Personalized support for:
    • Understanding fertility health.
    • Assisted reproduction (such as in vitro fertilization).
    • Adoption.
    • Gestational carrier arrangements.
    • Egg, sperm, and embryo preservation.
    • Menopause/low testosterone (low T).
  • Unlimited, free virtual visits with fertility health and family-forming experts to navigate options, costs, and questions.
  • Employer-sponsored funds for fertility and family-forming services.
  • Exclusive partnerships and discounts, as well as expert-authored educational videos, articles and more.

Contact your producer or account manager to learn more about Carrot.

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