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Our Health Care Concierge team works hard to make things easy for you when you have questions or concerns. Health Care Concierges will provide personal service when and where you need it, at no cost to you.
Contact them by phone or through a private online chat. Our dedicated Health Care Concierge team will help you:
- Find a doctor or other provider.
- Get answers to benefit questions and explain how your health plan works.
- Check to see if a prescription or over-the-counter drug is covered.
- Schedule important care appointments, and much more.
Call the Health Care Concierge Services team at 1-800-286-4242 (TTY: 711). Representatives are available Monday, Tuesday, Thursday, and Friday from 7 a.m. to 7 p.m.; Wednesday from 7 a.m. to 8 p.m.; and Saturday from 8 a.m. to 3 p.m.
For questions about dental services, call Dental Member Services at 1-888-257-0474, Monday through Friday from 6 a.m. to 8 p.m. TTY users should call toll-free 1-800-201-7165.
For questions about vision services, please call Vision Member Services at 1-866-458-2138 (TTY: 711), Monday through Friday from 8 a.m. to 7 p.m.
UPMC AnywhereCare* lets you access a specially trained UPMC provider via live video from your computer, tablet, or smartphone. You can use this service anytime, day or night. It works well for colds, flu, sore throats, skin rashes, and other nonemergency conditions.
Use UPMC AnywhereCare to take care of minor health problems before they become more serious. It takes less time than a regular doctor visit. And it gives you peace of mind to have this nonemergency care option when you don't feel well.
Doctors are available 24/7 with no long wait, thanks to UPMC AnywhereCare. Register now at www.upmcanywherecare.com!
If you would like more information on UPMC AnywhereCare, please contact the UPMC for You Health Care Concierge Services team at 1-800-286-4242. Representatives are available Monday, Tuesday, Thursday, and Friday from 7 a.m. to 7 p.m.; Wednesday from 7 a.m. to 8 p.m.; and Saturday from 8 a.m. to 3 p.m. TTY users should call toll-free 711.
*UPMC for You members located in Pennsylvania at the time of the virtual visit may select a UPMC-employed provider or a provider from Online Care Network II, P.C. (OCN), subject to availability and discretion of the provider. During the COVID emergency, members located outside of Pennsylvania will receive service from OCN. OCN is not an affiliate of UPMC. After the COVID emergency ends, UPMC AnywhereCare virtual visits are not covered services when UPMC for You members are traveling outside of Pennsylvania.
MyHealth OnLine is our member-only website for tips and tools for better health. You can find a doctor, email a web nurse, view your medical history, and chat with a health coach who can help you manage conditions and meet your goals.
With online tools such as your personal health record, easy-to-use wellness programs, and detailed ways to search for providers, you are just a click away from great health information. Health resources including activity trackers, health coaches, and WebMD® make MyHealth OnLine an interesting place to visit and explore.
In addition, you can access your benefit information (medical, pharmacy, vision, and dental) for the current and past years, and you can see your claims information for medical and pharmacy. You will have access to documents that explain the Notice of Privacy Practices, your rights and responsibilities as a member, and how to file a Complaint or a Grievance or request a Fair Hearing. MyHealth OnLine is available for members age 18 and older.
Access MyHealth OnLine here.
Manage your health care instantly with the UPMC Health Plan mobile app. It’s another safe, speedy, and secure way to stay in touch with us. The app puts all your health information in one place. And you can access your information instantly—anywhere, anytime.
The app makes it easy to explore the benefits you have as a UPMC for You member. Simple icons make it a snap to use. Here are some great ways you can use the app:
- Access your member ID card right when you need it.
- Contact your doctor, pharmacist, and even the UPMC MyHealth 24/7 Nurse Line—instantly.
- Manage your prescriptions in the Pharmacy Center.
- View your personal medical history.
- Live text-chat with Member Services representatives or UPMC Health Plan Maternity Program health coaches.
Download the UPMC Health Plan app today in the iTunes app store or Google Play.
A health management program has health coaches who help you understand your disease or condition. They help you manage your health care and take better care of yourself. Your provider may talk with you about enrolling in one of these programs for better health. However, you can be enrolled in a health management program without a referral from your PCP or other provider.
UPMC for You has several health management programs:
- Heart disease (coronary artery disease, atrial fibrillation, and congestive heart failure)
- Chronic obstructive pulmonary disease (COPD for short, a lung disease)
- Hypertension (high blood pressure)
- Hyperlipidemia (high cholesterol)
- Low back pain
- Chronic kidney disease
Thanks to an innovative program called Prescription for Wellness, your doctor can now write you a prescription to work one-on-one with a UPMC Heath Plan coach. Whether you are already working on making healthy changes or want to set a new goal, a health coach can support you. The coach will let your doctor know how you are doing with your health goals, so everyone stays in the loop. Ask your doctor about writing a Prescription for Wellness today. Or call 1-855-395-8762 to speak directly to a health coach to get started.
To learn more about health management programs, call the Health Management Department at 1-866-778-6073 Monday through Friday from 7 a.m. to 8 p.m. and Saturday 8 a.m. to 3 p.m. TTY users should call toll-free 711.
Moms are important. We care about you and your children. Our maternity program can help keep you and your baby healthy. If you meet program requirements, you may be eligible to receive a baby gift. To meet the program terms and conditions, you will need to:
- Visit your maternity provider within 13 weeks of becoming pregnant.
- Enroll in the maternity program before you are 34 weeks pregnant.
- Keep at least 10 prenatal visits.
- Get all of the routine lab tests ordered by your maternity provider.
- Keep all of your scheduled telephone calls with the maternity program representative.
- Return to UPMC for You the consent form signed by you and your maternity provider.
We will help you find maternity providers close to your home. We will also be there for you after you have your baby.
If you have any questions about the maternity program, please call toll-free 1-866-778-6073, Monday through Friday from 7 a.m. to 8 p.m. and Saturday from 8 a.m. to 3 p.m. TTY users should call toll-free 711.
What is a special need?
A special need is when a UPMC for You member needs some extra help. This may be because you have:
- Physical health problems.
- Trouble getting health care services.
- Special communication needs (you might need visual or hearing aids or translation services).
- A need for services in your community.
- Physical or intellectual disabilities.
- Behavioral health problems. (UPMC for You does not manage your behavioral health services. Your behavioral health services are managed by a Behavioral Health Managed Care Organization.)
What services does the Special Needs Unit provide?
The Special Needs Unit helps UPMC for You members understand how to get covered services. They also help find services in the community that may help you and your family.
The Special Needs Unit can:
- Help you access the benefits you have and the health care services for which you are eligible as a UPMC for You member.
- Connect you with UPMC for You participating providers, including specialists.
- Tell you which UPMC for You participating providers speak languages other than English and whether a provider’s office is wheelchair-accessible.
The text4baby program is available to pregnant women and new moms. You can get free tips on your cell phone to help you through your pregnancy and your baby’s first year.
Registration is easy. You can register online or from your cell phone. Your tips are timed to your due date or your baby’s birth date.
If you have service with one of the carriers listed below, text4baby is free. Even mothers without a text messaging plan can get these messages for free. If you have limited texts per month, text4baby won't reduce that limit.
- Assurance Wireless
- Bluegrass Cellular
- Boost Mobile
- Cellular South
- Centennial Cellular
- Cincinnati Bell
- Metro PCS
- Nex-Tech Wireless
- Sprint Nextel
- U.S. Cellular
- Verizon Wireless
- Virgin Mobile USA
If you have questions about text4baby, please call 1-866-778-6073, Monday through Friday from 8 a.m. to 4:30 p.m. TTY users should call toll-free 711.
Immediate access to health care advice is available around the clock through the UPMC MyHealth 24/7 Nurse Line. Whether you are seeking general health advice or need help with a medical issue, experienced registered nurses are available to provide you with prompt and efficient services. Call the UPMC MyHealth 24/7 Nurse Line at 1-866-918-1591. TTY users should call toll-free 711.
Note: The UPMC MyHealth 24/7 Nurse Line is not a substitute for medical care. If you need emergency care, go to the nearest emergency room, or call 911 or the local ambulance service.
UPMC nurses who answer calls are licensed to assist UPMC for You members. Nurses cannot answer plan or benefit questions. Please call the Health Care Concierge team at the phone number on the back of your member ID card for nonclinical inquiries.
To learn more about these and other member benefits, view the UPMC for You Member Handbook.