While health insurance is an expense, it can provide a lot of value by helping you and your family access the care you need to get or stay healthy. Before you select your plan, it’s a good idea to see if you are eligible for financial assistance with extended enhanced subsidies, which can lower the cost of your monthly health insurance premiums this year.1 You may qualify for financial help even if you weren’t eligible before through Pennie®, Pennsylvania’s health insurance marketplace.
The value of choosing UPMC Health Plan
As a member of UPMC Health Plan, you will feel supported in focusing on your total well-being. We want to make sure you have everything you need to be as healthy and happy as possible. We do this by:
Providing access to care to help keep you healthy.
Helping you take care of your mental and physical health.
- Six free counseling sessions through LifeSolutions®6
- Free health coaching to help you make healthy changes in your life
- The RxWell app to support your total well-being
Supporting you when you need it.
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1 Eligibility for financial assistance is based on annual adjusted gross income. Annual income amounts are determined by the federal government. To determine your eligibility for financial assistance, you must confirm your eligibility on the Pennie website.
2 Preventive care will be covered at 100 percent only when it is received from a participating provider and it is billed as preventive. A separate cost share may apply if additional medical services are received during the same visit or if your preventive care appointment becomes diagnostic in nature.
3 Tier 5 preventive medications on UPMC Health Plan's Advantage Choice formulary will be covered with no cost share for members who meet certain criteria in accordance with the Patient Protection and Affordable Care Act of 2010.
4 Go to upmchealthplan.com/BEST for award information.
5 UPMC Health Plan commercial members and their dependents who reside or are traveling in Ohio will continue to access care through the SuperMed PPO Network and, while traveling outside of the state of Ohio, can also utilize the Cigna PPO Network.
6 UPMC AnywhereCare Virtual Counseling is available to UPMC Health Plan members who are located in Pennsylvania at the time of the visit. The service is available to members of your household who are 18 years old and older. If further counseling is needed, the counselor may refer you or your household members to relevant community resources.
7 Only the virtual visit with the provider will be covered at 100 percent. Prescription drug and other costs related to the visit or recommended by the provider will not be included in the virtual visit coverage and will be your responsibility. If you are enrolled in the UPMC Advantage Silver HSA $4,000/$0, UPMC Advantage Gold HSA $3,000/$0, or UPMC Advantage Catastrophic $9,100/$0 plans, UPMC AnywhereCare virtual visits will be covered at 100 percent after you meet your deductible. This information is not a complete description of benefits.
Contact the plan for more information. Limitations, copayments, and restrictions may apply.