To see specific plan details, enter the deductible and out-of-pocket maximum for your selected plan. Find this information on the federal government’s Marketplace website (see screenshots below).
Plan Information
Please note: If you wish to see information for another plan, return to the Marketplace website and click on the Details button.
Select the type of Coverage.
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Where to find needed information

Benefits:
Coverage
In Network Co-Insurance
Annual Deductible Individual
Annual Deductible Individual
The fixed amount that members with Individual Coverage must pay for covered medical services before UPMC Health Plan will pay benefits that are subject to the Deductible.
Annual Deductible Family
Annual Deductible Family
The fixed amount that members with Family Coverage must pay for covered medical services before UPMC Health Plan will pay benefits that are subject to the Deductible.
Annual Out Of Pocket Limit Individual
Annual Out Of Pocket Limit Individual
The most a member with Individual Coverage will pay for covered benefits in the plan year. All cost sharing (deductibles, copayments and coinsurance) for Medical, Pharmacy as well as Pediatric Dental and Vision count towards your Annual Out-of-Pocket limit.
Annual Out Of Pocket Limit Family
Annual Out Of Pocket Limit Family
The most members with Family Coverage will pay for covered benefits in the plan year. All cost sharing (deductibles, copayments and coinsurance) for Medical, Pharmacy as well as Pediatric Dental and Vision count towards your Annual Out-of-Pocket limit.
Health Incentive Account Individual
Health Incentive Account Individual
Goals plan members may complete healthy activities to earn funds in a health incentive account (HIA). Individuals can earn up to $400 per year, and families can earn up to $800 per year. These HIA funds can be used toward medical expenses such as deductibles, prescriptions, and coinsurance. If the funds are not used during the current plan year, they roll over to the next plan year up to one time the deductible.
Designed for people who want to be rewarded for taking care of their health!
Health Incentive Account Family
Plan Payment Level
PCP Office Visit
Specialist Office Visit
Virtual Visit-Level 1, non-specialist
Virtual Visit-Level 2, specialist
Emergency Care Coverage
Inpatient
Pharmacy Benefits:
Retail Generic
Retail Preferred
Retail Non Preferred
Specialty
Do you have questions? Contact us.