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:

  • Screenings
  • 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, pertussis (Tdap) vaccine and those for the flu and shingles. If you have children covered under your plan, they’ll be covered at 100 percent for a variety of screenings and immunizations.

During a routine exam covered at 100 percent, your doctor may find something requiring follow-up care. What then? Here’s a good rule of thumb: (1) If your routine preventive service leads to the need for follow-up care, or (2) if you’re being treated for injury or illness, those services will likely be covered, but not at 100 percent.

For a list of preventive services your plan covers at no cost to you, log in to MyHealth OnLine and click on the Plan Documents tab or review your Schedule of Benefits.

View Preventive Guidelines for Adults and Children


Get the Flu Shot

According to the Centers for Disease Control and Prevention (CDC), the flu virus causes around 200,000 hospitalizations in the United States each year. Getting the flu shot is the first and most important way to protect yourself and your family during flu season.

Go to your doctor’s office, Giant Eagle, or Rite Aid* for your flu shot. As a UPMC Health Plan member, you can get a flu shot free of charge when you show your member ID card.

If you get your flu shot at another location, we will reimburse you if you are required to pay for it up-front. All you have you have to do is fill out and submit the reimbursement form.

*Only applies to pharmacy locations in Pennsylvania. Pharmacies, by state law, are not permitted to administer vaccines to children younger than age 10.

Lung Cancer Testing for People at High Risk

Lung cancer is the leading cause of cancer death for both men and women in the United States. Low-dose computerized tomography (CT) is a new screening* test that can improve lung cancer survival rates by finding signs of the disease at an earlier stage. Finding cancer early makes it easier to cure. Doctors use a low-dose CT scan of the lungs to look for signs of lung cancer.

Older adults who have smoked for a long time should get this test. Learn more about the screening and see if you should be tested.

*The medical term for testing to find a disease before it causes symptoms.

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 below. Enter your information and click on the “get started” button to find out what preventive services you should consider this year.

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