Renewing Your Health Insurance
Top Reasons to Renew with UPMC Health Plan
1Preventive 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 may apply if additional medical services are received during the same visit or if your preventive care appointment becomes diagnostic in nature.
2Tier 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.
3Go to upmchealthplan.com/BEST for award information.
4UPMC 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.
524/7 video visits are available only to members who are in Pennsylvania at the time of their virtual visit. Members may select a UPMC provider, subject to provider availability and discretion. Members must accurately verify their physical location and that they are in Pennsylvania at the time of the visit. Limitations may apply for members of administrative services only (ASO) plans who have opted out of coverage. A parent or legal guardian must be present during the video portion of the visit for children younger than 18. Providers employed or contracted by UPMC retain discretion regarding the treatment of patients ages 0-2. 24/7 video visits for children ages 0-2 are unavailable from 11 p.m. to 7 a.m. in Pennsylvania.
6Only the video 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, UPMC Advantage Gold HSA, or UPMC Advantage Catastrophic plan, UPMC video 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.