Navigators/Certified Application Counselors
Welcome aboard, navigators and certified application counselors!
You have been tasked with the vital responsibility of educating people who are looking for insurance coverage on Pennie®, Pennsylvania’s health insurance marketplace.
One of the goals of the Affordable Care Act (ACA) is making affordable health insurance available to as many people as possible. This can help people stay healthy and evenly spreads heath care coverage costs. You will distribute fair and impartial information about enrollment in qualified health plans and tell clients about the financial assistance that's available to them. You will also make them aware of other plan options like Medicaid, Medicare, and the Children’s Health Insurance Program (CHIP).
UPMC Health Plan is here to assist you during the Open Enrollment period.* As you help your clients make the best decision about their health insurance, we can answer your questions about UPMC Health Plan coverage for individuals and families, how to buy marketplace plans in Pennsylvania, and more. Turn to this website for important information and resources throughout the Open Enrollment period.
If you cannot find the information you need on this website, please call UPMC Health Plan’s hotline for navigators and certified application counselors at 1-855-306-8276.**
Resources for Navigators and Certified Application Counselors
Refer to these resources when you're speaking to your clients about UPMC Health Plan coverage, general health care reform, and health insurance-related questions.
- UPMC Health Plan Navigator Event PowerPoint
Get an overview of UPMC Health Plan health insurance plans for individuals and families, and learn key considerations for 2025 Open Enrollment. - UPMC Health Plan Provider Directory
Find a doctor or health care provider in the UPMC Health Plan network. - Advantage Choice Pharmacy Benefit Guide (Prescription Drug Formulary) – Effective beginning Jan. 1, 2025
- UPMC Health Plan Networks
Learn about our high-quality provider networks. - Helpful information about Pennie
Pennie is a state-based health insurance marketplace.
Resources for Your Clients
These resources offer valuable information about how health insurance, health care, and Pennie work. We also offer printable worksheets for you to fill out with your clients to help them better understand the process of selecting a health insurance plan.
Links to health insurance information:
- Health Insurance Basics
Why you need health insurance, where you can use it, and how you can use it. - Health Care Glossary
A comprehensive dictionary of health care terms. - Benefits of Choosing UPMC Health Plan
Learn more about UPMC Health Plan’s benefits such as the value of our health coverage, network, and health and wellness resources. - Health Care Reform Basics
The important information you need to know about health care reform, so you can help your clients pick a plan that’s right for them. - What is a special enrollment period?
Learn about the special situations that may qualify your clients to purchase or change their health insurance after the Open Enrollment period.
Printable Resources:
- 2025 Sales Guide
Learn about our plans for individuals and families, the networks your clients can choose from, and the benefits of choosing UPMC Health Plan. - 2025 Rate Guide
A list of prices for our health insurance plans.
Materiales en Español
- UPMC Health Plan: Cobertura Para Personas y Familias con la Que Puede Contar
- UPMC Advantage Hojas de Tarifas
More Information
You and your clients can find more information about UPMC Health Plan's high-quality plan options from these sources:
- UPMC for Kids (CHIP)
- UPMC for You (Medicaid)
- UPMC for Life (Medicare)
- UPMC Health Plan Connect Centers
Shop on the UPMC Health Plan Marketplace.*
Contact a UPMC Health Plan sales representative.**
*The UPMC Health Plan Marketplace is an online shopping site only for UPMC Health Plan products and is not Pennie. To access this site, visit upmchealthplan.com/marketplace. To access Pennie, please visit pennie.com.
**This hotline is for navigators and certified application counselors only. It is not for general public use.
†This link is for individuals and families that want to speak to a sales representative about UPMC Health Plan coverage.