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

Bridging Smiles and Systems: Collaborative Care for Children with Chronic Conditions

Please join us for a live, CME-accredited and CEU-accredited webinar on May 13 from noon to 1p.m., that will explore the critical connection between oral health and pediatric chronic conditions such as diabetes, asthma, congenital heart disease, and ADHD.
Apr. 2026Education/Webinars

Certified Community Health Worker (CCHW) Provider Billing Notification

UPMC for You will now reimburse for up to three certified community health worker (CCHW) visits per member per calendar year for Medicaid recipients, per the Pennsylvania Department of Human Services (PA DHS).
Apr. 2026Important Notices

CME Webinar: First Annual Dr. Jim Withers Lecture

Please join us for the First Annual Dr. Jim Withers Lecture, featuring Dr. Jim Withers, a global leader in compassionate, justice-centered care
Apr. 2026Education/Webinars