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The Value of Choosing UPMC Health Plan
Benefits of Choosing UPMC Health Plan
- Affordable comprehensive coverage
- Large and diverse provider network
- Award-winning customer service**
Health Insurance Basics
- Understand the language of health insurance
- Learn how to buy health insurance
- See if you’ve experienced a qualifying life event
Health Care Reform
- Learn about Pennie
- Learn about the Affordable Care Act
- See if you qualify for financial
assistance
Benefits to keep you healthy
Benefits like $0 preventive care that covers many health services for adults and children at 100 percent,1 no-cost preventive medications,2 and access to top-ranked doctors and hospitals and an extended network3,4 can help keep you healthy.
Mental and physical wellness benefits
Six free counseling sessions through LifeSolutions,®5 free health coaching, and the RxWell® well-being app can help you take care of your mental and physical health.
Support when you need it
Our virtual urgent care gives you access to 24/7 treatment that is covered at 100 percent by most plans.6 Use the UPMC Health Plan app for easy access to your health insurance information. Contact our exceptional Health Care Concierge team for help navigating your benefits through a quick online chat or phone call.
Health Insurance Plans and Services for Individuals and Families in PA
UPMC Health Plan offers plans and services for every need. Here you’ll find information on our individual health insurance plans, Medicare and Medicaid plans, coverage for children, Special Needs Plans, dental coverage, vision coverage, and other services.
*UPMC Health Plan received the highest score in Pennsylvania in the J.D. Power 2024 U.S. Commercial Member Health Plan Satisfaction Study, which measures members’ satisfaction with their commercial health plan experience. Visit jdpower.com/awards for more details.
**UPMC Health Plan earned 10 Stevie® Awards in 2024, including a prestigious Grand Stevie Award. The Stevie Awards are among the world’s top honors for customer service, contact center, business development, and sales professionals across multiple businesses and industries.
1 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.
2 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.
3 Go to upmchealthplan.com/best for award information.
4 Go to upmchp.us/networkaccess for network information.
5UPMC 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.
6Only 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 $2,500/10%, or UPMC Advantage Catastrophic $9,200/$0 plan, 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.
Contact the plan for more information. Limitations, copayments, and restrictions may apply.