How the Plan Works
Take a Healthy Step is a well-being program that rewards you for making healthy choices. As a member, you can earn reward dollars in a health incentive account (HIA) by completing activities that are recommended for you. These activities are designed to help you understand and improve your health. Here are the plan options for FEHB members:
Both plan options include an HIA.
The Standard Option HMO allows you to earn up to $250 for Self Only coverage and up to $500 for Self Plus One or Self and Family coverage. Any remaining balance from the 2023 plan year will be automatically applied toward eligible out-of-pocket expenses including deductible, coinsurance and pharmacy copayments.
There are four levels of Take a Healthy Step rewards. As you complete a level, UPMC Health Plan will deposit the reward dollars designated for that level onto a UPMC Consumer Advantage® debit card. Eligible members will receive the debit card at the beginning of their plan year and gain access to the Take a Healthy Step program on Jan. 22, 2024.
The High-Deductible Health Plan (HDHP) Option PPO allows you to earn $75 for Self Only Coverage and $150 for Self Plus One or Self and Family coverage. With premium pass through, your health savings (HSA) or health reimbursement arrangement (HRA; applicable if you are not eligible for an HSA) is funded along with a debit card to reimburse eligible out-of-pocket expenses.
Depending on which plan you select, you will have different deductible, coinsurance, and copayments. They will apply to your out-of-pocket maximum. The out-of-pocket maximum is the most you'll have to pay in a plan year.
The rewards you can earn will depend on your plan:
In addition to allowing you to earn reward dollars, our plans also offer:
- Coverage for 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 through our secure member website, MyHealth OnLine. Log in to learn about your health plan benefits, get 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, the status of claims, and more if you download the UPMC Health Plan app.
- Self-guided programs and expert health coaches to help you manage a chronic condition or make lifestyle changes.
- Discounts and savings at gyms and spas, and on sporting goods and health food.
- Preventive Services Guide
Take a Healthy Step is a unique health insurance plan that allows you to earn reward dollars for completing healthy activities. Here are some of the healthy activities that may be incentivized:
- MyHealth Questionnaire: This confidential assessment takes just 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 test can be done at your doctor’s office. It measures your total cholesterol and glucose levels, blood pressure, height, weight, and body mass index.
- Condition or lifestyle management coaching: A health coach can help you manage a chronic condition so you can live your healthiest life. Chronic conditions include heart disease, diabetes, asthma, chronic obstructive pulmonary disease (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.
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You can earn up to $250 for Self Only coverage or $500 for Self Plus One or Self and Family coverage.
Yes. Any unused reward dollars—up to two times your annual deductible—will automatically roll over to the next year.
HMO: Any rollover dollars will be applied first - new reward dollars can be used toward deductible, coinsurance, and prescription drug copayments.
HDHP: Any rollover dollars will be applied first - once you complete all 4 levels, you will receive the $75 HSA contribution.
No, but if you don't, you'll miss out on savings that can be applied toward your out-of-pocket medical expenses.
HMO: Reward dollars can be used can be applied toward your deductible, coinsurance and prescription drug copayments. With the debit card it is your choice.
HDHP: You will receive a $75 HSA contribution once Level 4 is completed.
No. Preventive care is covered at 100 percent even if your deductible has not been met, so they are available to you at no additional cost. Learn about our preventive health services.
*Visit upmchealthplan.com/best for award information.
**UPMC Health Plan earned 11 Stevie® Awards in 2023, including three Gold Stevie Awards for Achievement in Customer Experience, Customer Service Team of the Year, and Back-Office Customer Service Team of the Year.
UPMC for Life was named a "Best Insurance Company for Medicare Advantage" in Pennsylvania for 2024 by U.S. News & World Report (10-20-23). U.S. News & World Report used the Medicare star ratings data for its rankings, including Medicare's recent five-out-of-five overall star ratings of both UPMC for Life's HMO and PPO plans for 2024. UPMC for Life has been named a "Best Insurance Company for Medicare Advantage" in Pennsylvania for 2022, 2023, and 2024.
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 (TTY: 711), 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.
This is a summary of the features of UPMC Health Plan. Your policy from the Health Plan may not cover all your health care expenses. Before making a final decision on your coverage, please read the Health Plan's federal brochure RI 73-797. All benefits are subject to the definitions, limitations, and exclusions set forth in the federal brochure.