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.
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 1,700 hearing aid products from top manufacturers.
- More than 5,500 providers.
- A patient advocate who will coordinate all clinic appointments and provide assistance throughout the process of getting fitted for a hearing aid.
- 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 return policy if the member is not completely satisfied.
- A money-back guarantee.
1 We offer six hearing health benefit plans with benefit allowances ranging from $1,000 to $6,000. It is sold as a rider to medical plans. This benefit is available to groups with 51 or more employees.
2 The hearing health benefit deductible will apply in the event of loss or damage to a hearing aid. The amount of the deductible will vary depending on the make and model of the hearing aid.