Preventive Services to Help You Stay Well

At UPMC Health Plan, we believe the disease or condition that’s easiest to treat is the one you never get. That’s why we cover so many preventive services for children and adults at 100 percent—which means you pay nothing.

These services fall into three categories:

  • Screenings1
  • Immunizations
  • Health exams

Common adult screenings include well-visits, breast cancer screenings, cervical cancer screenings, and colorectal cancer screenings. Common adult immunizations include the tetanus, diphtheria, and pertussis (Tdap) vaccine as well as those for the flu and shingles (infection of the nerves).2 If you have children covered under your plan, they are also covered at 100 percent for a variety of developmentally appropriate screenings and immunizations.

During a routine preventive exam, your doctor may find something that requires follow-up care. What then? If your routine preventive service leads to the need for follow-up care, or if you need to be treated for an injury or illness, those additional services will likely be covered—but not at 100 percent.3

For a list of preventive services that your plan covers at no cost to you log in to UPMC Health Plan member site, click on “Coverage and Benefits” at the top of the page, then click “Coverage Overview” from the dropdown menu.

At the bottom of the page, you can choose to review your, “Member Schedule of Benefits,” as well as the “Preventive Services Reference Guide.”  Coverage Overview section documents are specific to your plan, so we encourage you to log in to the member site to ensure that you are reviewing the correct information.

General versions of the Preventive Services Reference Guide (that address both Adults and Children) are available below. 

 

Preventive Guidelines

 Preventive Guidelines. (Includes Breast Cancer Screening coverage under PA Act 52 of 2025. Applicable 7/1/2026 for enrollees in certain group commercial plans).    

 

MyHealthfinder tool

Want personalized recommendations to help you take charge of your health? Use the U.S. Department of Health and Human Services’ MyHealthfinder tool. Enter your information and click on the “Get Results” button to find out which preventive services you should consider having this year.