UPMC Health Plan


Denise Hughes
UPMC Health Plan

UPMC for Kids CHIP Plan Adds 7 PA Counties to its Service Area

New expansion increases service area to 64 out of 67 Pennsylvania counties

Pittsburgh (Jan. 23, 2023) – UPMC for Kids, Pennsylvania's Children's Health Insurance Program (CHIP) plan with the highest number of enrolled children and teenagers, announced its expansion into seven additional counties. With this expansion, UPMC for Kids will offer plans in 64 of Pennsylvania's 67 counties and hopes to add to the nearly 29,000 members it currently serves.

Specifically, UPMC for Kids will now offer coverage for eligible children and teenagers in Bucks, Delaware, Montgomery and Philadelphia Counties in Southeastern Pennsylvania and Carbon, Columbia, and Monroe counties in northeastern Pennsylvania.

"UPMC for Kids is excited to expand its ability to offer affordable access to high quality health care, including plans with some of the lowest premiums in the state," said John Lovelace, President of Government Programs, for UPMC. "In addition to affordable coverage, our whole-person approach to care also offers ways for kids to stay healthy."

UPMC for Kids recently achieved its National Committee for Quality Assurance (NCQA) 4-Star Health Plan Rating in NCQA's Medicaid Health Plan Ratings 2022. UPMC for Kids is one of four health plans offering CHIP coverage in Pennsylvania that have earned this high-quality rating.

UPMC for Kids coverage includes access to UPMC's in-network hospitals, as well as support from UPMC Health Plan's award-winning Member Service "concierges." Members may also utilize the 24-hour UPMC MyHealth Nurse Line and virtual provider visits through UPMC AnywhereCare.

Additional enhanced benefits are also available for all UPMC for Kids members, including Health Management Programs to help monitor conditions such as asthma, diabetes, and ADHD; MyHealth Online, the secure website that includes members' most current benefit information along with online tools for related health topics; and access to UPMC Children's AnywhereCare, where children up to age 17 can have virtual visits with UPMC Children's Hospital of Pittsburgh providers over live video.

Throughout the year, UPMC for Kids offers a range of wellness events at UPMC Health Plan Connect Center retail spaces across the commonwealth. Wellness events cover a wide range of topics, including weight management, healthy eating, smoking cessation, heart disease, mental health, and much more. A complete listing of wellness events is available at upmchealthplan.com/connect-centers/.

Parents or guardians can apply for CHIP coverage for their children/child dependents by calling UPMC for Kids at 1-800-978-8762 or the Department of Human Services' CHIP Help Line at 1-800-986-KIDS; applying online at compass.state.pa.us; submitting a paper application directly to UPMC for Kids; or requesting a transfer to UPMC for Kids from another CHIP managed care organization.

CHIP was established in the 1990s to provide health coverage to families with incomes above Medicaid eligibility thresholds but who cannot afford or do not have access to private coverage. CHIP has a rolling enrollment period, unlike other plans such as Medicare, Marketplace plans, or many commercial plans that have open enrollment periods. Families must renew coverage every year and will qualify for one of three levels of CHIP, including free, low-cost, and full-cost CHIP. There is no income limit for CHIP availability.


About UPMC Insurance Services

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