Preventive Services to Help You Stay Well
At UPMC Health Plan, we believe the disease or condition that’s easiest to treat is the one you never get. That’s why we cover many preventive services for children and adults at 100 percent. That means you will pay nothing.
Preventive services fall into three categories:
- Screenings1
- Immunizations
- Health exams
Common adult screenings include well-visits, breast cancer screenings, cervical cancer screenings, and colorectal cancer screenings. Common adult immunizations include the tetanus, diphtheria, and pertussis (Tdap) vaccine, as well as those for the flu and shingles2 (Shingles is an infection of the nerves.) If you have children covered under your plan, they are covered at 100 percent for a variety of developmentally appropriate screenings and immunizations.
During a routine preventive exam, your doctor may find something that requires follow-up care. What then? If your routine preventive service leads to the need for follow-up care, or if you need to be treated for an injury or illness, those additional services will likely be covered—but not at 100 percent.3
For a list of preventive services that your plan covers at no cost to you, log in to the UPMC Health Plan member site. Click on “Coverage and Benefits” at the top of the page, then click “Coverage Overview” from the dropdown menu.
At the bottom of the page, you can choose to review your Schedule of Benefits and the Preventive Services Reference Guide.
General versions of the Preventive Services Reference Guide (that address both Adults and Children) are available below.
Documents in the Coverage Overview section of the member site are specific to your plan, so we encourage you to log in to ensure that you are reviewing the correct information.
MyHealthfinder tool
Want personalized recommendations to help you take charge of your health? Use the U.S. Department of Health and Human Services’ MyHealthfinder tool. Enter your information and click on the “Get Results” button to find out which preventive services you should consider having this year.
1This is the medical term for testing to find a disease before it causes symptoms.
2If you have a UPMC for Life plan, the shingles vaccine is covered under your Part D plan benefits. To check whether your plan has Part D prescription drug coverage, see your Summary of Benefits.
3For additional information and/or help finding an in-network provider, please contact a Health Care Concierge at the phone number on your ID card or call 1-844-220-4785 (TTY: 711) Monday through Friday from 8 a.m. to 6 p.m.
4 Centers for Disease Control and Prevention. Flu and Children. Reviewed Sept. 5, 2024. Accessed Sept. 10, 2025. Flu and Children | Influenza (Flu) | CDC
5Source: Centers for Disease Control and Prevention
UPMC Health Plan's use of this material does not imply or constitute endorsement or recommendation by the Centers of Disease Control and Prevention, Agency for Toxic Substances and Disease Registry, Department of Health and Human Services, or the U.S. government of UPMC Health Plan, its affiliates, or their respective services.