Self-servicing update
Apr. 2024Important Notices
Beginning Monday, April 15, 2024, UPMC Health Plan participating providers who need a general claim status, member eligibility or benefit information, help creating or verifying on an authorization, assistance accessing an EOP, or to check information will be required to use our self-servicing options on our online portal at upmchealthplan.com/providers or our Interactive Voice Response system (IVR). If you have any questions, please contact the Provider Services Web Support Team at 1-800-937-0438.
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