Western PA/Susquehanna Member Guide

11 Access to care when you need it All UPMC for Life participating medical providers have agreed to see you in a timely manner: • Routine care: Within 10 business days of your request. • Urgent care: Within 24 hours of your request. All UPMC for Life participating behavioral health providers have agreed to see you in a timely manner, depending on the care you need: • Routine office visit: Within 10 business days of your request. • Urgent visit: Within 48 hours of your request. • Non-life-threatening emergency: Within six hours of your request. • Emergency: Referred to an emergency room. On-call coverage Primary care practices must provide 24-hour on-call coverage. In addition, they must be available seven days a week and offer at least 20 hours of service a week. If your doctor has another doctor covering for them, that doctor must participate in the UPMC for Life network and be available 24 hours a day, 7 days a week. If you have a disability All providers’ offices are accessible to members with disabilities. Providers’ offices are considered places of public accommodation. They must be accessible to individuals with disabilities. Providers’ offices are required to follow the Americans with Disabilities Act (ADA) guidelines, Section 504 of the Rehabilitation Act of 1973, and other applicable laws. Extended leave coverage If your participating medical or behavioral health provider goes on extended leave, they must arrange for coverage by another UPMC for Life participating doctor. Having trouble? If you are having trouble making an appointment with a doctor in the UPMC for Life network, we can help. Call your Health Care Concierge team at the phone number on the back of your member ID card.