UPMC for You has been awarded a Medicaid Managed Care Contract for all five Physical HealthChoices zones across the Commonwealth of Pennsylvania
Aug. 2022Important Notices
"UPMC for You has been awarded a Medicaid Managed Care Contract for all five Physical HealthChoices zones across the Commonwealth of Pennsylvania, currently planned to go live1 on Sept. 1, 2022. A comprehensive training is available online for your reference and participation. You can also review a list of frequently asked questions at upmchp.us/ProviderFAQ. Thank you for your continued support of UPMC for You and the great care you provide to our members. We wouldn’t be at more than a half a million members strong and growing without you!
1Go-live implementation dates and communication timelines are subject to change at discretion of the Pennsylvania Department of Human Services."
1Go-live implementation dates and communication timelines are subject to change at discretion of the Pennsylvania Department of Human Services."
Recent Announcements
Important announcement – Telehealth submissions
As of October 1, 2025, UPMC Health Plan continues to accept the submission of telehealth claims. Providers may conduct telehealth visits for UPMC Health Plan members in all UPMC Insurance products. UPMC Insurance products include UPMC Advantage group and individual products, UPMC for Life Medicare Advantage plans, UPMC for Kids CHIP plans, UPMC Community HealthChoices, and UPMC for You Medical Assistance plans.Sep. 2025Important Notices
October 2025 UPMC for You and UPMC Community HealthChoices Formulary Update
Effective October 1st, 2025, Xifaxan and Retin-A (cream, gel) will no longer be covered by UPMC for You and UPMC Community HealthChoices due to non-participation in the Medicaid Drug Rebate Program.Sep. 2025Pharmacy Updates
Biosimilar Medication Formulary Updates
Updates to formulary biosimilar medications for denosumab, eculizumab, and ustekinumab productsSep. 2025Pharmacy Updates