This page outlines everything you can do 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, here's how to get started:
- Create your MyHealth OnLine account.
It's quick and easy to create an account. Once you sign up, you can use our secure, members-only website to find an in-network provider, get inspiration to make healthy changes, and learn about your UPMC Health Plan benefits.
Already have an account?
After you have registered, you can use the same username and password to access both the UPMC Health Plan mobile app and MyHealth OnLine! Complete the steps below in the app or on MyHealth OnLine to maximize your benefits.
- Understand your coverage.
- Your schedule of benefits is a document that provides a broad list of the medical services covered under your plan, and it details levels of coverage provided for them. Before you seek care from any providers, review your schedule of benefits for detailed information about your copayments, coinsurance amounts, and your
Once you’ve registered for your MyHealth OnLine account, you can log in to view your schedule of benefits.
- Getting the right care at the right time is important. As a UPMC Health Plan member, you have options when you experience an illness or injury.
- 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. You can view your most recent EOBs at MyHealth OnLine.
After your effective date, you are able to:
- 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 will find your MyHealth Questionnaire in the Online Activities section. Once you complete the questionnaire, you will get a confidential overview of your health, a personalized wellness plan, and easy-to-follow advice to help you feel your best.
- Choose your primary care provider.
Make searching for a primary care provider (PCP) a priority. Your PCP’s goal will be to keep you healthy and give you the best possible care. You can designate your PCP on MyHealth OnLine.
- Submit any necessary forms.
- 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 that provider for up to 90 days from the date your UPMC Health Plan coverage begins (your effective date). To get started, electronically complete all the fields on this form to email to your provider. You can also print the form, fill out the fields in black ink, and mail or fax it to your provider. Your provider must return the form to UPMC Health Plan within 30 days of your effective date.
- 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.
- View any other forms regarding your coverage and benefits on MyHealth OnLine.
- Take advantage of our programs and tools to help you live your healthiest life.
- Get the most from your pharmacy benefits.
Find a pharmacy near you, get a personal review of your medications, and be sure your medications are covered with our drug search tool.
Have questions? Call our award-winning Member Services team.
We work hard to make sure you can easily get answers to your health care questions or concerns. You can live chat with Member Services by tapping Contact Us in MyHealth OnLine. If you’d like to speak to a representative, you can call the number on the back of your member ID card. TTY users should call 711. Help is available Monday through Friday from 7 a.m. to 7 p.m. and Saturday from 8 a.m. to 3 p.m. Learn more about our Member Services team.