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Health Insurance

Coverage for individuals and families

High-quality plans to address your health care needs

We have a variety of plans to fit all needs. But don't worry about having too many choices! Getting health insurance is all about worrying less.

No matter which plan you choose, you and your family will have access to high-quality health care, generous discounts on vision care and materials, and dental/vision coverage for kids.

    With UPMC Health Plan, you’ll have access to:

  • $0 preventive care that can help you and your family stay healthy. Screenings, immunizations/vaccines, and health exams for adults and children are covered at 100 percent.1
  • No-cost preventive medications.2
  • Top-ranked doctors and hospitals, plus a national extended network when you need it.3
  • Virtual visits anytime, anywhere—covered at 100 percent—through UPMC AnywhereCare.4
  • Three free counseling sessions through LifeSolutions®. You can use these over-the-phone sessions to discuss your family, relationship, or work concerns. You can also have free consultations related to financial wellness, legal issues, and more.
  • Our exceptional Health Care Concierge team. This team can help you understand your insurance and make the most of your benefits.
  • Free health coaching to support you in making lifestyle changes or managing a health condition.
  • The UPMC Health Plan mobile app, which puts your insurance information in the palm of your hand. You can use it to access digital member ID cards for you and your family, live chat with a Health Care Concierge, track recent claims, and more.

You have options when it comes to buying coverage:

  1. Shop online. Use our shopping tool to find plan options that fit your needs and budget. Just tell us a little bit about yourself, and we'll show you plans that match.
  2. Shop by phone. If you have a question about a plan, need more information, or want our help walking through a purchase, we're happy to help! We can be reached at 1-877-563-0292.
    • Nov. 1, 2020 – Jan. 15, 2021: Seven days a week from 8 a.m. to 8 p.m.
    • Jan. 16 – Oct. 31, 2021: Monday through Friday from 8 a.m. to 5 p.m.
  3. Shop at our stores. Wish you could get in-person, one-on-one help with choosing a plan? You can. Visit a UPMC Health Plan Connect Center near you.

Browse Networks

UPMC Partner Network (EPO)

For residents of Allegheny, Bedford, Blair, Clinton, Erie, Lawrence, Lycoming, Mercer, Tioga, and Venango counties
The UPMC Partner Network is our most affordable network option. The network includes all UPMC providers as well as some non-UPMC providers. In a true emergency, you can seek care from any emergency department, even if the hospital is not in the Partner Network. The emergency care you receive will be covered at the in-network benefit level.

UPMC Partner Network Residents of Allegheny, Bedford, Blair, Clinton, Erie, Lawrence, Lycoming, Mercer, Tioga, and Venango counties may purchase this plan. Plan not offered to individuals living in the following counties: Adams Adams Armstrong Armstrong Beaver Beaver Berks Berks Bradford Bradford Bucks Bucks Butler Butler Carbon Carbon Cambria Cambria Cameron Cameron Centre Centre Chester Chester Clarion Clarion Clearfield Clearfield Columbia Columbia Crawford Crawford Cumberland Cumberland Dauphin Dauphin Delaware Delaware Elk Elk Fayette Fayette Forest Forest Franklin Franklin Fulton Fulton Greene Greene Huntingdon Huntingdon Indiana Indiana Jefferson Jefferson Juniata Juniata Lancaster Lancaster Lebanon Lebanon Lehigh Lehigh Lackawanna Lackawanna Luzerne Luzerne Mifflin Mifflin Monroe Monroe Montour Montour McKean McKean Montgomery Montgomery Northhampton Northampton Northumberland Northum- berland Perry Perry Philadelphia Philadelphia Pike Pike Potter Potter Schuylkill Schuylkill Snyder Snyder Somerset Somerset Sullivan Sullivan Susquehanna Susquehanna Union Union Warren Warren Washington Washington Wayne Wayne Westmoreland Westmoreland Wyoming Wyoming York York Plan offered to individuals living in the following counties: Allegheny Allegheny Bedford Bedford Blair Blair Clinton Clinton Erie Erie Lawrence Lawrence Lycoming Lycoming Mercer Mercer Tioga Tioga Venango Venango Partner Network Overview (PDF)
Find Partner Network Providers
Check Partner Network Drug Formulary

UPMC Select Network (EPO)

For residents of Allegheny, Beaver, Butler, Fayette, Washington, and Westmoreland counties
The UPMC Select Network includes all UPMC providers as well as a select group of non-UPMC providers. Like the Partner Network, the Select Network is designed to encourage you to seek care from UPMC providers. However, the Select Network covers more non-UPMC providers than the Partner Network. You can seek care from any emergency department in a true emergency situation, even if the hospital is not in the Select Network. The emergency care you receive will be covered at the in-network benefit level.

UPMC Select Network Residents of Allegheny, Beaver, Butler, Fayette, Washington, and Westmoreland counties may purchase this plan. Plan not offered to individuals living in the following counties: Adams Adams Armstrong Armstrong Berks Berks Bedford Bedford Blair Blair Bradford Bradford Bucks Bucks Carbon Carbon Cambria Cambria Cameron Cameron Centre Centre Chester Chester Clarion Clarion Clearfield Clearfield Clinton Clinton Columbia Columbia Crawford Crawford Cumberland Cumberland Dauphin Dauphin Delaware Delaware Erie Erie Elk Elk Forest Forest Franklin Franklin Fulton Fulton Greene Greene Huntingdon Huntingdon Indiana Indiana Jefferson Jefferson Juniata Juniata Lancaster Lancaster Lawrence Lawrence Lebanon Lebanon Lehigh Lehigh Lackawanna Lackawanna Luzerne Luzerne Lycoming Lycoming Mercer Mercer Mifflin Mifflin Monroe Monroe Montour Montour McKean McKean Montgomery Montgomery Northhampton Northampton Northumberland Northum- berland Perry Perry Philadelphia Philadelphia Pike Pike Potter Potter Schuylkill Schuylkill Snyder Snyder Somerset Somerset Sullivan Sullivan Susquehanna Susquehanna Tioga Tioga Union Union Venango Venango Warren Warren Wayne Wayne Wyoming Wyoming York York Plan offered to individuals living in the following counties: Allegheny Allegheny Beaver Beaver Butler Butler Fayette Fayette Washington Washington Westmoreland Westmoreland Select Network Overview (PDF)
Find Select Network Providers
Check Select Network Drug Formulary

UPMC Standard Network (HMO)

For residents of Crawford and Clearfield counties
The UPMC Standard Network gives you access to many high-quality providers. This includes all UPMC doctors and hospitals, a certain group of non-UPMC providers, and most community hospitals.

You must select a primary care provider and get a referral to see most specialists. In an emergency, you can visit any emergency department. Your emergency care will be covered at the highest benefit level, even if the hospital does not participate with UPMC Health Plan.

UPMC Standard Network Residents of Clearfield and Crawford counties may purchase this plan. Plan not offered to individuals living in the following counties: Adams Adams Allegheny Allegheny Armstrong Armstrong Beaver Beaver Berks Berks Bedford Bedford Blair Blair Bradford Bradford Bucks Bucks Butler Butler Carbon Carbon Cambria Cambria Cameron Cameron Centre Centre Chester Chester Clarion Clarion Clinton Clinton Columbia Columbia Cumberland Cumberland Dauphin Dauphin Delaware Delaware Erie Erie Elk Elk Fayette Fayette Forest Forest Franklin Franklin Fulton Fulton Greene Greene Huntingdon Huntingdon Indiana Indiana Jefferson Jefferson Juniata Juniata Lancaster Lancaster Lawrence Lawrence Lebanon Lebanon Lehigh Lehigh Lackawanna Lackawanna Luzerne Luzerne Lycoming Lycoming Mercer Mercer Mifflin Mifflin Monroe Monroe Montour Montour McKean McKean Montgomery Montgomery Northhampton Northampton Northumberland Northum- berland Perry Perry Philadelphia Philadelphia Pike Pike Potter Potter Schuylkill Schuylkill Snyder Snyder Somerset Somerset Sullivan Sullivan Susquehanna Susquehanna Tioga Tioga Union Union Venango Venango Warren Warren Washington Washington Wayne Wayne Westmoreland Westmoreland Wyoming Wyoming York York Plan offered to individuals living in the following counties: Clearfield Clearfield Crawford Crawford Standard Network Overview (PDF)
Find Standard Network Providers
Check Standard Network Drug Formulary

UPMC Premium Network (PPO)

For residents of Adams, Allegheny, Armstrong, Beaver, Bedford, Berks, Blair, Bradford, Butler, Cambria, Cameron, Carbon, Centre, Clarion, Clinton, Cumberland, Columbia, Dauphin, Elk, Erie, Fayette, Forest, Greene, Huntingdon, Indiana, Jefferson, Lackawanna, Lancaster, Lawrence, Lebanon, Lehigh, Luzerne, Lycoming, McKean, Mercer, Northampton, Northumberland, Perry, Potter, Schuylkill, Snyder, Somerset, Sullivan, Tioga, Union, Venango, Warren, Washington, Westmoreland, Wyoming, and York counties
The UPMC Premium Network—our highest-priced and broadest network and it is available throughout our service area. This network allows you to use in- and out-of-network providers. The Premium Network also offers the most flexibility in terms of cost sharing. You may pay less if you choose in-network providers than if you choose out-of-network providers. You can seek care from any emergency department in a true emergency situation, even if the hospital is not in the Premium Network. The emergency care you receive will be covered at the in-network benefit level.

UPMC Premium Network Residents of the following counties may purchase this plan: Adams, Allegheny, Armstrong, Beaver, Bedford, Berks, Blair, Bradford, Butler, Cambria, Cameron, Carbon, Centre, Clarion, Clinton, Cumberland, Columbia, Dauphin, Elk, Erie, Fayette, Forest, Greene, Huntingdon, Indiana, Jefferson, Lackawanna, Lancaster, Lawrence, Lebanon, Lehigh, Luzerne, Lycoming, McKean, Mercer, Northampton, Northumberland, Perry, Potter, Schuylkill, Snyder, Somerset, Sullivan, Tioga, Union, Venango, Warren, Washington, Westmoreland, Wyoming, and York. Plan not offered to individuals living in the following counties: Bucks Bucks Chester Chester Clearfield Clearfield Crawford Crawford Delaware Delaware Franklin Franklin Fulton Fulton Juniata Juniata Mifflin Mifflin Monroe Monroe Montgomery Montgomery Montour Montour Philadelphia Philadelphia Pike Pike Susquehanna Susquehanna Wayne Wayne Plan offered to individuals living in the following counties: Adams Adams Allegheny Allegheny Armstrong Beaver Beaver Bedford Bedford Berks Berks Blair Blair Bradford Bradford Butler Butler Carbon Carbon Cambria Cambria Cameron Cameron Centre Centre Clarion Clarion Clinton Clinton Columbia Cumberland Cumberland Dauphin Elk Elk Erie Erie Fayette Fayette Forest Forest Greene Greene Huntingdon Huntingdon Indiana Indiana Jefferson Jefferson Lancaster Lancaster Lawrence Lawrence Lebanon Lebanon Lehigh Lehigh Lackawanna Lackawanna Luzerne Luzerne Lycoming Lycoming Mercer Mercer McKean McKean Northhampton Northampton Northumberland Northum- berland Perry Perry Potter Potter Schuylkill Schuylkill Snyder Snyder Somerset Somerset Sullivan Sullivan Tioga Tioga Union Union Venango Venango Warren Warren Washington Washington Westmoreland Westmoreland Wyoming Wyoming York York Dauphin Armstrong Columbia Premium Network Overview (PDF)
Find Premium Network Providers
Check Premium Network Drug Formulary

Sample Individual and Family Plan Policies

Below are sample policy documents outlining the terms of coverage relative to various products offered by UPMC Health Plan Inc. and its affiliates, including UPMC Health Options Inc. and UPMC Health Coverage Inc. Please note that if you enroll in any product offered by UPMC Health Plan Inc. or its affiliates, you will receive policy documents outlining the terms of coverage specific to the product in which you enroll.

Sample 2021 Individual and Family Plan Policies

UPMC Advantage HMO Policy
UPMC Advantage HMO HSA Policy
UPMC Advantage EPO Policy
UPMC Advantage PPO Policy
UPMC Advantage EPO HSA Policy
UPMC Advantage PPO HSA Policy
UPMC Advantage EPO Catastrophic Policy
UPMC Advantage PPO Catastrophic Policy
UPMC Advantage HMO Catastrophic Policy
Tower UPMC Advantage PPO Policy

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 may apply if additional medical services are received during the same visit or if your preventive care appointment becomes diagnostic in nature.

2. 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.

3. Go to upmchealthplan.com/BEST for award information.

4. 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 or Gold HSA $2,900/$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.