UPMC Health Plan


Denise Hughes
UPMC Health Plan

UPMC Health Plan Offers Lowest Cost Marketplace Plans in 17 Western PA Counties with Full In-Network Access to UPMC Hospitals and Doctors

New VirtualCare Product Offers Lower Costs, Digital Experience with Mobile App

Pittsburgh (Nov. 1, 2021) – With Open Enrollment for 2022 coverage starting today, UPMC Health Plan announced its continued commitment to providing affordable, in-network access to UPMC hospitals and doctors with Affordable Care Act (ACA) Marketplace options that include a “virtual-first” plan, and the lowest-cost Marketplace plans in 17 Western Pennsylvania counties. The UPMC Health Options Exclusive Provider Organization (EPO) plan received a 5-star Overall Rating from the Centers for Medicare and Medicaid Services (CMS) and is the only 5-star EPO plan on Pennsylvania’s ACA Marketplace, Pennie.

Open Enrollment for plans under Pennie will be held Nov. 1 through Dec. 15 for coverage beginning Jan. 1, 2022.

“As always, UPMC Health Plan remains committed to helping Pennsylvanians access coverage through the State-Based Exchange -- affordability, award-winning member services, and quality remain the cornerstones of our plan choices this year,” said Kim Orth, President, Commercial Products, UPMC Health Plan. “Not only do we have the lowest-cost plans in 17 counties, but American Rescue Plan subsidies also remain in effect, so affordable, high-quality health care is incredibly accessible.”

UPMC Health Plan has more than 114,000 Pennsylvanians currently enrolled.

New “Virtual-First” Product for 2022
Maintaining its ongoing commitment to innovating insurance coverage to meet the changing needs of Pennsylvanians, UPMC Health Plan is offering for the first time UPMC VirtualCare. This new product offers members a $0 copay for virtual visits for selected services, including primary and urgent care, with in-network doctors and a reduced copay for virtual specialist visits -- and the option to see your provider in person at a cost share. UPMC VirtualCare is available in Allegheny, Beaver, Butler, Erie, Fayette, Washington, and Westmoreland counties.

Continued access to World-Class Clinical Care & “Concierge-Style” Member Services
Individuals who choose UPMC Health Plan coverage enjoy award-winning “concierge-style” service with specialized local Member Services representatives who can help schedule appointments, identify specialty providers, and otherwise ensure smooth access to UPMC Health Plan’s provider network. Other innovative services include access to behavioral health support, including social workers and counselors. Members also have access to the UPMC MyHealth 24/7 Nurse Line, which they can call at any time to discuss symptoms with a registered nurse and receive guidance on whether to treat a condition at home or seek professional care.

“UPMC Health Plan is committed to providing our ACA Marketplace members with the best experience possible, from finding a doctor to scheduling an appointment to receiving the best care possible—all at an affordable price,” said Orth.

How to Get More Information & Enroll in a Plan
UPMC Health Plan has a team of licensed agents ready to assist seven days a week from 8 a.m. to 8 p.m. during Open Enrollment. For more information, call 1-877-563-0292 (TTY: 711) or visit upmchealthplan.com/marketplace. UPMC Health Plan Marketplace plans also can be accessed through Pennie. Additionally, UPMC Health Plan has licensed agents available for in-person and virtual appointments at our various retail locations.

“Whether it’s through Pennie or our team of licensed agents, Pennsylvanians have several easy avenues to learn more about how UPMC Health Plan can help them get the coverage they need with full, in-network access to UPMC,” Orth said. She also added that consistent, sustainable plan designs with high-quality networks reinforce our unwavering commitment to the Affordable Care Act Marketplace and to providing affordable health coverage in our communities.

CMS scores qualified health plans (QHPs) offered through the Exchanges using the Quality Rating System (QRS) based on third-party validated clinical measure data and QHP Enrollee Survey responses. CMS calculates ratings yearly on a 5-star scale. Ratings may change from year to year.


About UPMC Insurance Services

Serving more than 4 million members, UPMC Insurance Services is owned and operated by UPMC, a world-renowned health care provider and insurer based in Pittsburgh, Pa. UPMC Insurance Services includes commercial products from UPMC Health Plan for groups as well as individuals. Commercial products also include workers' compensation and employee assistance from nationally known Workpartners®. Government products include Medicare Advantage (UPMC for Life); special needs plans for those eligible for Medicare and Medical Assistance (UPMC for Life Complete Care and UPMC Community HealthChoices); Medical Assistance (UPMC for You); and Children's Health Insurance Program (UPMC for Kids). Community Care Behavioral Health, one of the nation's largest nonprofit managed care behavioral health organizations, offers a full range of services to Commercial and Medical Assistance members. For more information, visit upmchealthplan.com.