Care When You’re Away from Home

Wherever your travels take you, you can rest easy knowing health coverage is coming along on the journey. Here’s what you need to know when traveling.

 

Travel with a Plan

If you are traveling outside UPMC Health Plan’s service area and need nonemergency care, you can:

  1. Call Member Services at 1-844-881-4146. You can also call the phone number on the back of your member ID card. A Health Care Concierge can help you find an urgent care center. The Health Care Concierge team is available Monday through Friday from 7 a.m. to 7 p.m. and Saturday from 7 a.m. to 3 p.m.
  2. Use UPMC AnywhereCare by visiting UPMCAnywhereCare.com or download the mobile app to have a virtual urgent care visit with a provider. He or she can send a prescription to a pharmacy near you, if needed.**
  3. Call the UPMC MyHealth 24/7 Nurse Line at 1-866-918-1591. A UPMC registered nurse can:
    • Answer your health care-related questions.
    • Help you determine the right level of care for your symptoms.
    • Give you general health advice and information.
  4. Use the online provider directory to find an urgent care center in the extended network. To search our directory, visit www.upmchealthplan.com/find.

If you use a nonparticipating provider for nonemergency care, you may be responsible for additional cost sharing. Under an EPO or HMO plan, the services you receive may not be covered.

Emergency care

If you are traveling and suffer from an illness or injury that is life- or limb-threatening, you should go to the nearest emergency department. If the illness or injury is an emergency, the health care services you receive will be paid at the highest level of benefits.

If you are admitted to a facility that is outside UPMC Health Plan’s service area, you or a family member must contact us within 24 hours of admission, or as soon as reasonably possible.

If you do not contact UPMC Health Plan, you may be financially responsible for some or all of the nonemergency care you receive after you are admitted. If you are admitted to a nonparticipating facility after receiving emergency care, you may be required to transfer to a participating facility when it is medically safe for you to do so.

Global emergency travel assistance services

Assist America provides global emergency travel assistance services. You can use this service when you experience a medical emergency while traveling more than 100 miles from home—including to another country—for less than 90 days. Assist America can connect you and your covered family members to doctors, hospitals, pharmacies, and more.

Services include, but are not limited to:

  • Emergency medical evacuation.
  • Medical monitoring and referrals.
  • Medical repatriation.
  • Foreign hospital admission assistance.
  • Prescription assistance.

All services must be arranged and provided by Assist America. You should submit bills for any medical costs you incur to UPMC Health Plan. They will be subject to the policy limits of your health coverage.

To contact Assist America, take these numbers with you when you travel.
Within the United States: 1-800-872-1414
Outside the United States: 1-609-986-1234

To print your Assist America card, visit MyHealth OnLine and click the Self-Service Tools link at the top of the page under your name. Remember to bring the card on your trip — and leave your worries behind.

Assist America also has a free mobile app that is available from the iTunes App Store and Google Play. Assist America is not travel or medical insurance, and its services will not replace your health care coverage while you are away from home.

Dependent members who live outside UPMC Health Plan's service area

Eligible dependent children (up to age 26) who live or attend school outside UPMC Health Plan’s service area must seek care through our extended network. In an emergency, your dependent should seek care from the nearest medical facility.

For more information about benefits for dependents, call the Health Care Concierge team at 1-844-881-4146 to notify us of a dependent’s student status. They’ll be able to provide complete information about your dependent’s coverage and find a participating provider in our extended network. Some services may require prior authorization.

If your dependent is attending school, he or she can also seek care at an on-campus student health center.*

*Coverage at student health centers may not apply to all plans. Check your plan documents to verify your extended network coverage.

Personal representative designation form

Dependents must complete, date, and sign a personal representative designation form to give UPMC Health Plan permission to share their personal health information with their parent, guardian, family member, or other custodian. To access the form, click here.

Out-of-area claims

Some doctors or hospitals that are out of the service area and not in our network may ask you to pay for their services up front. If this happens, notify us of the situation by filling out and submitting an out-of-network care claim form as soon as possible. Keep your original bills and receipts. UPMC Health Plan does not return any paperwork submitted with claims.

Once this information is flagged in UPMC Health Plan’s system, UPMC Health Plan's Claims Department will be alerted to the out-of-area claims that come in and will make sure the claims are processed correctly.

**Members located in Pennsylvania at the time of service will have a virtual visit with a UPMC-employed provider. Service will be delivered by a separate provider group¬—Online Care Group (OCG) — for members anywhere else in the United States.

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