Welcome to UPMC Health Plan!
Get what you need, use your plan with confidence, and jump right into your coverage.
This page lays out everything you need to make the most of your coverage. It’s worth keeping handy. Whether you’re brand-new or coming back for another plan year, you’ll find clear steps, helpful tips, and quick links that make it easier to use your benefits with confidence.
Once you have your member ID number, you can easily manage your plan with the UPMC Health Plan member site and app
UPMC Health Plan member site
Sign InForgot username or passwordIf you forgot your user ID or need assistance, please call our Help Desk at 1-800-937-0438.
New to UPMC Health Plan? Create your Login to access key information anytime, anywhere.
With your Login,1 you can access the UPMC Health Plan member site and app for plan information, 24/7 video visits2 for virtual care, the UPMC MyHealth 24/7 Nurse Line3 for no-cost health advice from a UPMC nurse, and more!
University of Pittsburgh employee access
Having trouble?
Call our Web Support Services team toll-free at 1-800-937-0438 (TTY: 711). Help is available Monday through Friday from 8 a.m. to 5 p.m.
Unlock the full potential of your UPMC Health Plan experience
With a UPMC Health Plan Login, you’ll have access to all personalized information, materials, and resources you need to get the most out of your benefits. Plus, you can use the same username and password to access the UPMC Health Plan app, member site, and 24/7 video visits.
Review your coverage
Your Schedule of Benefits lists the medical services that are covered under your plan. It also details the levels of coverage provided for those services. Before you seek care from any providers, review your Schedule of Benefits for details about your copayments, coinsurance amounts, and out-of-pocket maximum.
View your schedule of benefits
Understand the costs of your plan
Did you enroll for health insurance through your employer? You may pay your share of the premium cost through a payroll deduction.
Did you purchase health insurance on your own? Learn how to pay your monthly bill.
Your Explanations of Benefits (EOBs) provide details about the health care you and your covered family members have received and what we've paid during the plan. You can view your EOBs on the UPMC Health Plan member site and app.
Find a primary care provider
Make searching for or confirming your primary care provider (PCP) a priority. Your PCP’s goal is to help keep you healthy and give you the best possible care. PCPs offer no-cost preventive care—including annual check-ups and vital screenings—and can coordinate any additional services you need. You can choose or confirm your PCP on the UPMC Health Plan member site or app.
Review your member guide
Whether you are a new or returning member, it’s important to take a few minutes to review your member guide. We update this guide each year, and the information it contains will help you take control of your health and your health care expenses.
Download the UPMC Health Plan app
Our app makes it easy to navigate your insurance benefits, find the care you need, access virtual care with 24/7 video visits, and get answers to your questions through live chat. Get peace of mind from knowing your health insurance information is available on demand.
Update your communication preferences
Traditional mail could take days to arrive. Go paperless4 to receive your documents electronically and notifications by email or text message. You can update your preferences at any time with the UPMC Health Plan member site or app.
Pharmacy services
Find a pharmacy near you, get a personal review of your medications, and ensure your medications are covered with our drug search tool. With your pharmacy benefits and online tools, you can:
- Use mail-order pharmacy options to quickly and securely refill and renew your prescriptions.
- Check medication costs and see what’s covered.
- Find in-network pharmacies near you.
- Get help from our 24/7 support team.
Once you access the drug search tool, go to What kind of care are you looking for? and select Medication from the dropdown.
Review your care options
Getting the right care at the right time is important. As a UPMC Health Plan member, you have options to address an illness or injury. Knowing all your options can help you quickly get care in a cost-effective way.
Review your recommended care
As a UPMC Health Plan member, you have access to many preventive services at no cost to you. That means you can receive your screenings without breaking the bank. Preventive screenings are important because they can help your health care provider detect diseases and conditions early, when they may be most treatable. Access preventive services that can help you stay well. Use the UPMC Health Plan member site or app to find out which preventive screenings are recommended for you and to schedule appointments.
Take the MyHealth Questionnaire
Complete this well-being assessment each year to receive a confidential overview of your health. Afterward, talk with your health care providers about any concerns you have. Having these conversations can help your providers identify issues early. Once complete, review your action plan and complete activities that can help you improve your health and manage your health care expenses. You can access it on the member site and app at any time under the Wellness tab.
Submit any necessary forms
Transition of Care (TOC) form (PDF): If you join UPMC Health Plan while receiving ongoing treatment from a nonparticipating provider, you can request to keep receiving care from that provider for up to 90 days from the date your UPMC Health Plan coverage begins (your effective date). To get started, complete this form and email it to your provider. You can also print the form, fill out the fields in black ink, and mail or fax it to your provider. Your provider must return the form and any applicable documentation to UPMC Health Plan within 30 days of your effective date.
- Personal Representative Designation (PRD) form (PDF): Your dependents over the age of 13 must complete, sign, and date a PRD form to give UPMC Health Plan permission to share the dependent's personal health information with you, a guardian, a family member, or another custodian.
- View any other forms about your coverage and benefits on the UPMC Health Plan member site.
Other programs and tools for you
- Find doctors, hospitals, and pharmacy information with our provider directory search tool.
- Sign up for one-on-one health coaching for help making healthy lifestyle changes.
- Use digital health tools, such as the UPMC Health Plan app, to take your wellness resources with you.
- Access women’s health benefits, such as breast cancer and cervical cancer screenings and our maternity health coaching program, Baby Steps.
- Learn about behavioral health programs that can help you improve or maintain your mental health.
1UPMC employees can sign in to the UPMC Health Plan member site through Infonet. University of Pittsburgh employees can sign in to the site through Pitt Passport.
2Members who are in Pennsylvania at the time of a virtual visit may select a UPMC-employed provider, subject to availability and discretion of the provider. Members located outside of Pennsylvania at the time of service or those who select Talk Therapy or Psychiatry services will receive care from a provider employed or contracted by Online Care Network II PC (OCN), also known as Amwell Medical Group. It is at the discretion of OCN providers to choose whether to treat patients ages 0 to 2. OCN is not an affiliate of UPMC. Limitations may apply for members of ASO plans that have opted out of coverage. Talk Therapy or Psychiatry services through UPMC Health Plan telehealth services are not covered services for UPMC Community HealthChoices participants, UPMC for You members, or UPMC for Kids members. 24/7 video visits for children ages 0-2 are not available from 9 p.m. to 8 a.m. or outside of Pennsylvania. If a member is under the age of 18, the member’s parent or legal guardian must be with the member during the video portion of the visit, and the child and parent or legal guardian must be in Pennsylvania during the visit. Providers are not available to treat members who are in Puerto Rico.
3UPMC nurses who answer calls are licensed to assist members in Pennsylvania, West Virginia, Maryland, New York, and Ohio. Members must be in one of those states when calling the UPMC MyHealth 24/7 Nurse Line. The UPMC MyHealth 24/7 Nurse Line is not a substitute for medical care. If an emergency arises, please call 911 or your local ambulance service, go to the nearest emergency room, or call or text the Suicide and Crisis Lifeline at 988. Nurses cannot answer plan or benefit questions. For plan or benefit information, please contact Member Services at the phone number on your ID card or call 1-844-220-4785 (TTY: 711) Monday through Friday from 8 a.m. to 6 p.m.
4Changing your preferences will replace getting your documents in the mail. If you want to continue receiving your printed plan materials in the mail, you don’t need to do anything. We’ll always mail a hard copy to you unless you update your preferences.