Medicaid implementation/Member enrollment reminder

Sep. 2022Important Notices
Please be aware that questions regarding PA Medicaid enrollment and eligibility are addressed by the Pennsylvania Department of Human Services (DHS) and cannot be answered directly by UPMC Health Plan Provider Services.

If you are a provider receiving patient inquiries regarding Medicaid plan enrollment or MCO plan changes, please direct these Medicaid-covered individuals to the following resources:
  • Pennsylvania enrollment site
  • Toll-free number: 1-800-440-3989
    TTY: 1-800-618-4225
    Hours of operation: Monday – Friday, 8 a.m. – 6 p.m.

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 products
Sep. 2025Pharmacy Updates