How the Plan Works
UPMC HealthyU is a unique health insurance plan that rewards you for making healthy choices. As a member, you can earn reward dollars in a health incentive account (HIA) by completing the activities recommended for you. These activities are designed to help you understand and improve your health. The plan options for FEHB members are:
Both plan options include a health incentive account (HIA) that enables you to earn up to $250 for Self-Only coverage and up to $500 for Self Plus One and Self and Family coverage.
UPMC Health Plan automatically applies any HIA reward dollars you have accumulated toward the plan cost-sharing. Please note that your deductible must be met in the HDHP Option PPO before your HIA reward dollars can be utilized.
Depending on the option you select, you will pay 15 or 20 percent coinsurance. If you have earned HIA reward dollars, this can reduce the amount of your out-of-pocket expense.
The deductible, coinsurance, and copayments apply to your out-of-pocket maximum. The out-of-pocket maximum is the most you'll have to pay in one plan year. At that point HealthyU pays 100 percent of your eligible medical expenses, including prescription and medical copayments.
Watch the FEHB 2022 Plan Overview.
In addition to earning reward dollars that can be used for your out-of-pocket medical expenses, our plans also offer:
- Preventive care at no cost to you.
- Access to a broad network of care providers and pharmacies including the top-ranked* doctors and hospitals of UPMC.
- Award-winning customer service from UPMC Health Plan’s Health Care Concierge team.**
- All the resources of MyHealth, the acclaimed health and wellness program developed by UPMC.
- Online tools and resources on our secure member website: MyHealth OnLine. Log in to learn more about your health plan benefits, get personalized information about your doctors, and track your personal health information. You can even review your prescriptions and receive important reminders for preventive screenings.
- On-the-go access to your member ID card, status of claims, and more if you download the UPMC Health Plan mobile app.
- Self-guided programs and expert health coaches to help you manage a chronic condition or make lifestyle changes.
- Discounts and savings at gyms, spas, and sporting goods and health food.
- 2022 Preventive Services Guide
UPMC HealthyU is a unique health insurance plan that allows you to earn reward dollars for completing healthy activities. Here are some of the most important healthy activities that may be incentivized:
- MyHealth Questionnaire – This confidential assessment takes 20 minutes to complete and will ask you key questions about your health and wellness. Afterward, you’ll receive a wellness score and access to activities that can help you improve your fitness, learn about or manage a condition, or progress toward your health goals.
- Biometric screening – This health screening can be done at your doctor’s office and measures your total cholesterol and glucose levels, as well as your blood pressure, height, weight, and body mass index (BMI).
- Condition or lifestyle management coaching – A health coach will help you manage a chronic condition, so you can live your healthiest life possible. Chronic conditions include heart disease, diabetes, asthma, COPD, and depression. Lifestyle programs include smoking cessation, stress management, physical activity, weight management, and nutrition.
The complete list of activities can be found in the Healthy Activities Guide.
The COVID-19 vaccine is worth a one-time credit of 25 reward dollars for eligible subscribers and spouses. Here’s how you can earn:
- Complete the FEHB Self-Report Form located on our secure member website, MyHealth OnLine.
- Provide a copy of the Centers for Disease Control and Prevention COVID-19 vaccination card showing the date the vaccination was received after Dec. 1, 2020.
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The most you can earn in one plan year is $250 for Self-Only coverage or $500 for Self Plus One or Self and Family coverage.
Yes. Any unused reward dollars—at a value up to two times your annual deductible—automatically roll over to the next year.
On the Standard HMO, you can use them toward deductible, coinsurance, and prescription drug copayments, regardless of if your deductible has been met. On the HDHP option, you must first meet your deductible, then you can use your reward dollars on coinsurance and prescription drug copayments.
No, but if you choose not to, you'll miss out on savings toward your out-of-pocket medical expenses.
It depends on which HealthyU plan option you have. If you are enrolled in the Standard Option HMO plan, the reward dollars in your health incentive account are automatically applied toward your deductible if it has not been met. If you are enrolled in the HDHP option, the reward dollars in your health incentive account only apply after your deductible has been met.
Yes. Any reward dollars you have earned will automatically roll over to the plan option you select within UPMC Health Plan.
No, preventive care is covered at 100 percent even if your deductible has not been met, so they are at no additional cost. Learn about our preventive health services.
*Visit upmchealthplan.com/best for award information.
**UPMC Health Plan has earned one of 10 coveted 2021 Grand Stevie® Awards for its exemplary customer service. Grand Stevie trophies are awarded to companies that submit an exceptional body of work for the Stevie Awards competition. More than 2,300 nominations from companies in 51 nations were considered in this year’s competition.
In 2021, the Health Plan also earned five Gold Stevie Awards for its sales and customer service excellence, including Best Back-Office Customer Service Team and Sales Support Team of the Year.
We are committed to helping you achieve your best health. Rewards for participating in a wellness program are available to all members. If you think you might be unable to meet a standard for a reward under this wellness program, you might qualify for an opportunity to earn the same reward by different means. Contact us at 1-855-395-8762, and we will work with you and your doctor to find a wellness program with the same reward that is right for you in light of your health status.