Whether you’re a new member or have chosen to stay with UPMC Health Plan, we're glad you're here.
This page outlines everything you can do over the next few months to get the most out of your coverage. It’s a good idea to bookmark this page for reference.
Once you get your member ID number:
- Create your MyHealth OnLine account.
Create an account. It’s quick and easy. And once you’ve signed up, you’ll have secure, 24/7 access to your health information. This members-only website is where you’ll go to find a doctor, view your medical history, get inspired to make healthy changes, and get information on your Health Plan benefits.
- Understand your coverage.
- Transition of Care (TOC) form: If you joined UPMC Health Plan while receiving ongoing treatment from a nonparticipating provider, you can request to keep receiving care from your current provider for up to 90 days from the date your UPMC Health Plan coverage begins (your effective date). Fill out all the fields on this form to email to your provider or print and fill out all the fields in black ink to mail/fax it to your provider.
- Personal Representative Designation (PRD) form: Your dependents must complete, sign, and date a Personal Representative Designation form to give UPMC Health Plan permission to share their personal health information with you, a guardian, a family member, or another custodian.
- Schedule of Benefits: This document is a broad list of the medical services covered under your plan.
- Prescription Drug Rider: This document lists benefit limits and cost-sharing amounts for prescription drugs. It also tells you if there’s a deductible and lists the copayment or coinsurance you may pay for each prescription.
- Getting the right care at the right time is important. As a UPMC Health Plan member, you have many options depending on the unplanned illness or injury at hand.
- Understand the costs of your plan.
- Enrolled for coverage through your employer? You will pay your share of the cost through a payroll deduction.
- Purchased insurance coverage on your own? Learn how to pay your monthly bill.
- Your Explanations of Benefits (EOBs) are a history of what you and your covered family members have paid during the plan year toward your out-of-pocket maximum.
- Have questions? Call our award-winning Health Care Concierge team.
We work hard to make sure you can easily get answers to your health care questions or concerns. Call 1-855-869-7228 (TTY: 711) Monday through Friday from 7 a.m. to 7 p.m. and Saturday from 8 a.m. to 3 p.m. to speak with a Health Care Concierge. Our Health Care Concierge team is dedicated to helping you navigate the world of health care. Learn more about our Health Care Concierge team here.
After your effective date:
- Take your MyHealth Questionnaire.
Log in to your MyHealth OnLine account and click on Better Health and Wellness. Then go to Resources for Healthier Living. After you click Browse by Resource Type, you can you can take your MyHealth Questionnaire in the Online Activities Section. In just 20 minutes or less you can get a personalized plan to help you feel your best—with easy-to-follow health advice and a completely confidential overview of your health.
- Choose your primary care provider.
Search for a primary care provider (PCP). Your PCP’s goal is to keep you healthy as well as treat you when you are sick or injured. Your PCP knows you and your health history. He or she is the best person to treat you and direct your care.
Call Member Services at 1-855-869-7228 if you need help finding a PCP near you.
- Take advantage of our programs and tools to help you live your healthiest life.