UPMC Health Plan


Denise Hughes
UPMC Health Plan

UPMC Health Plan to help Medicaid members impacted by end of 'continuous coverage' requirements by 'meeting them where they are'

Eight UPMC Health Plan Connect Center locations and the UPMC Health Plan Neighborhood Center to deliver individualized assistance

Pittsburgh (April 3, 2023) – Utilizing its nine Connect Center retail locations, including the UPMC Health Plan Neighborhood Center in Pittsburgh, UPMC Health Plan today announced a highly personalized, community-driven and data-supported initiative that "meets Medicaid members where they are" to help them update contact information, renew their applications for Medicaid coverage, and understand the availability of alternative health insurance options when the COVID-19-related continuous coverage requirements end in April.

Assistance is available not only to those covered by UPMC for You, a Medicaid managed care plan that is part of a family of insurance and benefit management products offered by UPMC, but any impacted Medicaid recipient, regardless of their coverage plan. Additional avenues for help include County Assistance Offices and COMPASS, Pennsylvania's health and human services website.

"We are taking the best of our award-winning Member Services assets and our health technology infrastructure and combining them with our strong partnerships with community organizations and the state Department of Human Services (DHS) to connect Medicaid members to coverage," said John Lovelace, President, Government Products. "We are taking nothing for granted and leaving no stone unturned to make sure members update their contact information and that they complete and file their Medicaid reenrollment materials or secure alternative coverage if necessary."

During the pandemic, Medicaid members were not required to complete annual renewal paperwork to maintain eligibility. After more than three years, pre-COVID Medicaid eligibility rules will resume, meaning that Medicaid recipients could be disenrolled from coverage if they do not complete their renewal by their assigned due date. The continuous coverage unwinding will occur over a 12-month period starting in April 2023.

UPMC for You is working closely with community-based organizations, providers, and DHS to educate its members about the importance of updating their contact information with DHS and completing renewals on a timely basis. More information about the end of continuous coverage can be found at dhs.pa.gov/phe.

UPMC Health Plan's multi-channel approach focuses on proactively reminding members about their upcoming Medicaid renewal, supporting them with renewal resources, and educating members about alternative health care coverage options if they lose Medicaid eligibility—these options include subsidized Pennie plans, CHIP plans for children aged 19 and under, and employer-based coverage. These connections are generally made to state and other appropriately neutral sites to ensure that members selecting coverage are informed of all coverage options, including, but not limited to, those offered by UPMC Health Plan.

Specific initiatives and supports include:

"Working with our local and state partnerships, UPMC's innovative community-based and data-driven approaches will help us reach as many impacted Medicaid enrollees as possible," said Lovelace. “The redetermination process can be a confusing time, but we hope to provide a helping hand to make any transitions in coverage as smooth as possible, especially with our focus to ‘meet members where they are.'"


About UPMC Insurance Services

UPMC Insurance Services serves nearly 4.5 million members and is owned and operated by UPMC, a world-renowned health care provider and insurer in Pittsburgh, Pennsylvania. UPMC Insurance Services 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.