Formulary updates effective Jan. 1, 2026

Dec. 2025Pharmacy Updates
Please be aware as of January 2026, there will be updates impacting formularies for all lines of business, coverage of adalimumab products, coverage of continuous glucose monitors (CGM), and billing processes for hyaluronate intra-articular injections and select intravenous and subcutaneous products. Please review the full details that include additional information on each change.

Recent Announcements

UPMC Dental Advantage celebrates 15-years of growth

From pilot program to now serving all product lines
Jan. 2026What's New

Provider Directory Updates and Required Attestation

As you know, UPMC Health Plan requires all providers to verify their provider directory information at least every 90 days (quarterly).
Jan. 2026Important Notices

Important: Expedited appeals fax requirement

Please remember that you must adhere to the designated process for submitting expedited appeals to have them processed in a timely manner. Follow these guidelines to help you successfully submit expedited appeals:
Jan. 2026Important Notices