Complete Care Member Guide

31 1 UPMC nurses who answer calls are licensed to assist members located in in Pennsylvania, West Virginia, Virginia, New York, and Ohio. Members must be located in one of those states when calling the UPMC My Health 24/7 Nurse Line. The UPMC My Health 24/7 Nurse Line is not a substitute for medical care. If an emergency arises, call 911 or go to the emergency department. Nurses cannot answer plan or benefit questions. Please call your Health Care Concierge team at the phone number on the back of your member ID card for nonclinical inquiries. 2 UPMC Health Plan Complete Care members located in Pennsylvania at the time of virtual visit may select a UPMC-employed provider or a provider from Online Care Network II PC (OCN), subject to availability and provider discretion. Members located outside of Pennsylvania will receive service from OCN. OCN is not an affiliate of UPMC. 3 The over-the-counter wellness benefit cannot be used to pay for your Part B or Part D prescription drugs costs. 4 The routine vision allowance does not apply to glasses after cataract surgery. It is excluded from the yearly deductible, if applicable, and does not count toward your annual out-of-pocket maximum. 5 You are responsible for any costs not covered under preventive dental or the comprehensive dental allowance (if covered by your plan). Dental care copays and the dental allowance are excluded from the yearly deductible, if applicable, and do not count toward the annual maximum out-of-pocket. 6 The routine hearing copays and the hearing aid allowance are excluded from the yearly deductible, if applicable, and do not count toward your annual out-of-pocket maximum. 7 UPMC for Life does not install bathroom safety devices or reimburse for costs associated with the installation of bathroom safety devices. UPMC for Life is not liable for improper installation, repairs, or other modifications. Members are responsible for any and all costs associated with installation. 8 Meal services are available when the member is discharged or released to their home from the hospital or skilled nursing facility. This service is not available when the member is discharged to a skilled nursing facility, assisted living facility, nursing home, or shelter. Prior authorization is required to utilize this benefit. Tivity Health and SilverSneakers are registered trademarks or trademarks of Tivity Health Inc. and/or its subsidiaries and/or affiliates in the USA and/or other countries.