UPMC Health Plan medical drug coverage updates

Jan. 2025Important Notices

UPMC Health Plan initiated changes to certain medical drug coverage policies for all lines of business on Jan. 1, 2025. Please visit upmchp.us/pharm-services-medical for more information. If you have questions about the changes, call Provider Services at 1-866-918-1595. Thank you for your continued support and for the great care you provide our members.

Recent Announcements

PA DOH Antibiotic Stewardship Resources

Order antibiotic stewardship resources at no cost
Jun. 2026Important Notices

Medical device correction: Omnipod (Insulet – May 2026)

Insulet Corporation Inc. has announced a medical device correction for certain Omnipod Pods. These pods are wearable devices that are used to deliver insulin.
Jun. 2026Pharmacy Updates

Clinical documentation required for medical policy prior authorizations

As you know, UPMC Health Plan requires certain clinical documentation/notes in support of a request for prior authorization for the listed procedures below in accordance with its established policies and procedures, in addition to CMS requirements that medical record documentation must support the medical necessity of the services requested.
Jun. 2026Important Notices