UPMC Health Plan Logo
Already a member? Visit our full site.

See All Your Plan Options and Enroll

General FAQ

Do you want to become more fit or quit smoking? Pitt's Wellness for Life program can help. The program offers services and incentives to promote positive lifestyle changes and choices. A healthy lifestyle may reduce your health care costs.
You can choose from different activities and earn incentives by completing them. You must complete these activities during the plan year (July 1 – June 30), to earn incentives.
Only enrolled faculty/staff members and their covered spouse/domestic partner can earn incentive reward dollars. Dependents—even those older than 18 years old—are not eligible to earn reward dollars.
Eligible members will have a personalized list of incentivized healthy activities in MyHealth OnLine. View the complete list of activities. You can also download a short checklist to help monitor your progress.
No, only activities completed in the current plan year are credited. The exception to this is a claim-based activities (e.g., wellness exam). Claim-based activities are credited when the provider is paid for the service.
A biometric screening is a health exam that can tell you your risk for certain health conditions, such as high blood pressure, diabetes, high cholesterol. The screening measures your cholesterol, glucose, blood pressure, and height and weight, and it can help you understand where you should take action to improve your health.
You have three easy options:
  1. Attend a convenient on-campus screening event. On-site biometric screenings will be offered. Please look for upcoming announcements and communications regarding the on-site screenings.
  2. Schedule a screening at a Quest Patient Service Center. Remember to use the code Pitt2021 when scheduling.
  3. If you have a screening performed by your physician, you should ask your physician to complete the Proof of Service lab form and follow the directions to return it.
You are eligible for annual preventive services every plan year starting July 1. You do not have to wait 365 days from your last exam for it to be covered.
Your provider will submit the claim to UPMC Health Plan. Please allow up to six weeks for submission and processing. Once the claim is paid, your credit will appear within a week. If you have questions about receiving credit, please contact Member Services at 1-888-499-6885. The provider must submit the claim as a preventive exam for the claim to be paid at 100 percent (no member cost share). This will allow you to earn the incentive.
For Panther Gold, Plus, and Advocate members, your incentives will be deposited into a health incentive account (HIA) a few days after you complete the eligible activity. The HIA funds are credited to a UPMC Consumer Advantage debit card that you can use to help cover the cost of qualified health care expenses. For Panther Basic members, after the plan year concludes, any earned incentive(s) will be applied to their paycheck after the plan year on the last business day in September for those who receive a monthly paycheck, and the second pay period in September for those receiving a bi-weekly paycheck. You must be actively employed through September (after the plan year) to receive the incentive. Individuals on long-term disability or workers’ compensation as of September (after the plan year), are eligible to participate in this incentive program. Monetary incentives are considered taxable income, according to the IRS.

New members: You can begin earning credits in your HIA effective on your first day of coverage. Once you complete an activity, the credits will be applied within a few days.

Renewing members: You may continue to earn credits, and any unused credits will be carried over into the new plan year up to one times the incentive amount.
MyHealth OnLine is a secure, members-only website that allows you and your family to live chat with Member Services, review your recent claims, and access educational health tools.

Log in to learn more about the healthy activities you can complete to earn HIA credits or check your balance.
Yes. All current faculty and staff subscribers of UPMC Health Plan have single sign-on access from the my.pitt.edu portal to the MyHealth OnLine member website. Just follow these simple instructions:
  • Log in to my.pitt.edu.
  • Follow this path: Browse Categories > Human Resources > MyHealth Access
Enrolled spouses and domestic partners may log in to MyHealth OnLine and create a user name and password. They can then view their Explanations of Benefits (EOBs) and medical and prescription claims history, as well as access health and wellness resources.

If you need assistance logging in or setting up your account, call UPMC Health Plan’s Web Support line 1-800-937-0438.
Once you are logged in to MyHealth OnLine, under Better Health and Wellness select Wellness for Life.
The MyHealth Questionnaire is a confidential health risk assessment that you take online. It asks questions about your current health issues, your medical history, and your lifestyle, including your eating habits and stress level. The questionnaire only takes about 20 minutes to complete. You’ll get a personalized report with tips on how to improve your health.
Yes. Only you have access to the MyHealth Questionnaire report.
Faculty and staff can access the MyHealth Questionnaire by following simple instructions:
  • Log in to my.pitt.edu.
  • Follow this path: Browse Categories > Human Resources > MyHealth Access > Better Health and Wellness > Wellness for Life > MyHealth Questionnaire
You can also access the MyHealth Questionnaire directly.

Covered spouses/domestic partners can access the MyHealth Questionnaire by following these simple instructions:
  • Visit upmchealthplan.com/members.
  • Register for a new account, or log in with an existing account.
  • Follow this path: Better Health and Wellness > Wellness for Life > MyHealth Questionnaire
No. Participation is voluntary and will not impact your medical plan or coverage.
No. You do not have to enroll separately in the program as long as you are actively enrolled in University of Pittsburgh-sponsored UPMC Health plan coverage. If you complete the eligible activities, you will automatically receive your incentive.
You can earn rewards up to your plan’s maximum by completing eligible activities from a personalized list on MyHealth OnLine.* You may already complete many of these eligible activities, such as getting a flu shot or having an annual physical. You can earn credit for your HIA throughout the year and receive the credits as they are earned. *The faculty/staff member or covered spouse/domestic partner may only earn half the family incentive reward maximum. For example, if the maximum family incentivereward is $250, then the faculty/staff member may earn up to $125. The covered spouse/domestic partner may earn the remaining $125. Only faculty/staff members and their spouses/domestic partners can earn incentive rewards. Dependents — even those older than 18 years old — are no longer eligible to earn HIA reward dollars. In family contracts that cover one parent plus a child or children, the parent may earn up to the full $250.
This varies based on the activity you complete. For online activities, such as the health risk assessment, the credits are usually available within a few days. Claims-related activities may take longer because the provider must submit a claim for payment. Please contact UPMC Health Plan Member Services at 1-888-499-6885 with specific questions. You can also track your claims and HIA credits using MyHealth OnLine.
You can view your account balance(s) and transactions, file claims, upload receipts, and track your expenses through the UPMC Consumer Advantage member portal. You can also use the UPMC Consumer Advantage mobile app to access your account.

To access the portal through MyHealth OnLine, follow this path:
  • Log in to my.pitt.edu.
  • Select Browse Categories > Human Resources > MyHealth Access > Your Insurance > Health Savings and Spending Accounts
  • Funding: The University of Pittsburgh will fund your HIA after you complete certain wellness activities.
  • Accessing funds: When you incur an eligible health care expense or receive an invoice for an eligible service, you can use your UPMC Consumer Advantage Visa debit card or pay out-of-pocket and request reimbursement online. Always keep your itemized receipts.
  • Requesting reimbursement/substantiating purchases: Log in to your online account and go to File Claims.
    • To request reimbursement, click on File Claim, then follow the instructions to enter the required information and upload your receipts.
    • If the purchase was made using your UPMC Consumer Advantage Visa debit card and substantiation is required, you will receive a notice from UPMC Consumer Advantage to submit your receipt(s).
      • Credit card receipts, nonitemized cash register receipts, and canceled checks cannot be used to substantiate a claim.
  • Reimbursement claims processing: We will promptly process your request and reimburse you either by check or direct deposit (if you sign up for that feature). You will receive your funds sooner if you use direct deposit.
  • Account management: Visit your account regularly to check your account balance and access health education tools.
    Yes. If you have FSA and HIA, your account balances will be maintained on one card. The FSA will pay first. This will protect you from losing any unused FSA funds. HIA funds will apply once your FSA balance is $0.
    HIA funds can be used to pay for eligible health plan expenses, such as your deductible, coinsurance, and pharmacy copayments. Dental and vision expenses are not eligible under the HIA.
    For Panther Gold/Plus members, HIA credits from the previous year will roll over to the new benefit year. The HIA rollover maximum is $125 for an individual and $250 for an employee plus spouse/domestic partner. For the Panther Advocate plan, HIA credits from a previous year will roll over to the new benefit year up to two times the new plan year deductible. There is no limit on how long HIA credits can roll over.
    The University of Pittsburgh’s annual contribution to your HIA is based on the number of wellness activities you complete each year and the award amounts associated with those activities. The maximum HIA contribution you can receive is $125 for single coverage and $250 for family coverage (two or more people).*

    *The faculty/staff member or covered spouse/domestic partner may only earn half the family incentive reward maximum. For example, if the maximum family incentive reward is $250, then the faculty/staff member may earn up to $125. The covered spouse/domestic partner may earn the remaining $125. Only faculty/staff members and their spouses/domestic partners can earn incentive rewards. Dependents — even those older than 18 years old — are no longer eligible to earn HIA reward dollars. In family contracts that cover one parent plus a child or children, the parent may earn up to the full $250.
    This is a special-purpose Visa card that allows you to instantly access the funds in your HIA, health savings account (HSA), and/or flexible spending account (FSA). You can use the card to pay for eligible health care expenses at the point of sale. If you are enrolled in a health care FSA, your FSA funds will automatically be used before your HIA funds. There are two reasons for this:
    1. The health care FSA comes with a “use it or lose it” requirement (except for the $500 health care FSA rollover allowance).
    2. You don’t have to accrue a balance in your health care FSA account before you use the funds. By contrast, you do have to accrue HIA credits before you can use them. For example, if you elect to put $2,000 into your health care FSA, you can use that entire amount at the start of your plan year, if needed, even though you will not have made that amount of deferrals from your paycheck.

Health expense and saving accounts

As long as you keep a designated minimum balance in your HSA, you can shift excess funds into a higher-interest account. For example, you can move your money into a mutual fund that provides tax-free earnings. The UPMC Consumer Advantage HSA offers an integrated investment platform. You can open investments online once your HSA balance reaches $1,000. You can even set up an automatic sweep of available cash into your investment account(s). When you need the investment dollars for health care expenses, they can be returned to your original HSA without penalty.
A health savings account (HSA) is a special tax-advantaged savings account. It is similar to a traditional individual retirement account (IRA), but it is designated for medical expenses. With an HSA, you can pay for current eligible health care expenses and save for future qualified medical and retiree health care expenses on a tax-favored basis.
There are three tax advantages to HSAs: Contributions, investment earnings, and qualified distributions all are exempt from federal income tax, FICA (Social Security and Medicare) tax, and state income taxes (for most states).
Unused HSA dollars roll over from year to year, making HSAs a convenient and easy way to invest and save for future medical expenses. You own your HSA and can take it with you if you change medical plans, change jobs, or retire.
You may be able to invest HSA funds that are not needed for near-term expenses, allowing those funds to increase. Investment options include money market accounts, mutual funds, and more. Check with your bank to find out your options.
  1. To be eligible to contribute to an HSA, you must be covered by a qualified high-deductible health plan (HDHP) and not have first dollar coverage (insurance that provides payment for the full loss, up to the insured amount, with no deductibles).
  2. You may use your HSA to help pay for medical expenses covered under a high-deductible health plan, as well as for other common qualified medical expenses.
  3. Unused HSA funds will remain in your account, and you may be able invest them (as long as your account meets the minimum balance requirement). This allows the funds to increase. Ask your financial institution whether investing is an option for your account.
HSAs work in conjunction with an HDHP. All the money you (or your employer) deposit into your HSA—up to the maximum annual contribution limit—is 100 percent excluded from federal income tax, FICA (Social Security and Medicare) tax, and state income tax (in most states). You can use these tax-free dollars to pay for eligible expenses not covered under your HDHP until you meet your deductible. UPMC Health Plan will pay for covered medical expenses above your deductible, except for any coinsurance. You can pay coinsurance costs with money from your HSA. You can also use your HSA to pay for qualified medical expenses that are not covered by the HDHP, such as dental and vision costs, and alternative medicines.
To have an HSA you must:
  • Be covered by a qualified high-deductible health insurance plan (such as Panther Basic).
  • Not be covered under other health insurance.
  • Not be enrolled in Medicare.
  • Not be another person's dependent.
*Exceptions: Other health insurance does not include coverage for the following: accidents, dental care, disability, long-term care, and vision care. Workers’ compensation, specified disease, and fixed indemnity coverage is permitted.
You cannot have a health care FSA and an HSA. If you are opening an HSA but currently have unused funds in a health care FSA, you may spend down the funds before July 1. Any remaining funds will automatically be transferred to a limited-purpose FSA to pay for eligible dental and vision expenses. You may use limited-purpose FSA funds to reimburse yourself for expenses not covered by your high-deductible health plan, such as:
  • Vision expenses, including glasses, frames, contacts, prescription sunglasses, goggles, vision copayments, optometrists or ophthalmologist fees, and corrective eye surgery.
  • Dental expenses, including dental care, deductibles and copayments, braces, x-rays, fillings, and dentures.
You can have an HSA and a dependent or commuter FSA.
The maximum contribution for an eligible individual with self-only coverage is $3,600. The maximum contribution for an eligible individual with family coverage is $7,200. Under the Last Month Rule, if you are an eligible individual on the first day of the last month of the taxable year (December for most taxpayers), you are considered an eligible individual for the entire year. As such, you can make a full HSA contribution (plus a catch-up contribution, if you will be 55 or older by year’s end). You must remain an eligible individual during a "testing period," which for most taxpayers would run from Dec. 1 through Dec. 31 of the following year.
*Please see "Who can have an HSA?" to learn the requirements for an eligible individual.
  • HSA holders can save up to $3,600 for an individual and $7,200 for a family (HSA holders 55 and older can save an extra $1,000, which means $4,500 for an individual and $8,000 for a family). These contributions are tax-deductible.
  • Minimum annual deductibles are $1,400 for self-only coverage or $2,800 for family coverage.
  • Annual out-of-pocket expenses (deductibles, copayments, and other amounts, but not premiums) cannot exceed $6,900 for self-only coverage and $13,800 for family coverage.
Minimum deductible Maximum out-of-pocket Contribution limit 55+ contribution
Single $1,400 $7,000 $3,600 $1,000
Family $2,800 $14,000 $7,000 $1,000
*Catch-up contributions are allowed for people older than 55 ($1,000). Catch-up contributions can be made at any time during the year in which the HSA participant turns 55.

For more detailed information on HSAs and taxes, visit the U.S. Department of Treasury website at ustreas.gov or talk with your tax advisor.
With a high-deductible health plan (HDHP), you have the security of comprehensive health care coverage. Like a traditional plan, you are responsible for paying for your qualified medical expenses up to the in-network deductible. However, the deductible will be higher, and you can use HSA funds to pay for these expenses.
After the annual deductible is met, you are responsible for a portion of your medical expenses through coinsurance or copayments, just as with a traditional health plan. The minimum HDHP deductible is $1,400 for individuals and $2,800 for families.
Maximum out-of-pocket expenses (including deductible and copayments, but not including premiums) cannot exceed $7,000 for individuals and $13,800 for families.
The deductible and maximum out-of-pocket expenses are indexed annually for inflation by the IRS and U.S. Department of Treasury.
Panther Basic’s in-network deductible is $1,500 for individuals and $3,000 for families. The maximum out-of-pocket in-network is $5,000 for an individual and $10,000 for a family. Panther Basic is an HDHP while the Panther Advocate, Panther Plus, PA Child Welfare Resource Center OOA, Panther Gold, and Gold Advantage plans are not.
Both HSAs and FSAs allow you to pay for qualified medical expenses with pre-tax dollars. One key difference is that HSA balances can roll over from year to year. Only $500 from an FSA can roll over to the following plan year.
Triple tax savings:
  • Contributions are tax-free.
  • Earnings are tax-free.
  • Withdrawals are tax-free when made for eligible medical expenses.
Three kinds of tax-favored contributions:
  • Employee contributions are deductible over the line. This means they are deductible even by those who don't itemize their taxes.
  • Employer contributions are excluded from income and employment taxes.
  • Salary reduction contributions are made through a section 125 cafeteria plan.
All three forms of contributions are exempt from federal income taxes. Employer and salary reduction contributions (section 125 cafeteria plan) are also exempt from FICA and the federal unemployment tax (FUTA) as well.
Yes. You may have more than one HSA and contribute to them all as long as you are enrolled in an HDHP. However, having more than one HSA does not provide any additional tax advantages. The total contributions to your accounts cannot exceed the annual maximum contribution limit. Contributions from your employer, family members, or any other person must be included in the total.
You are only allowed to have home, auto, dental, vision, disability, or long-term care insurance at the same time as an HDHP. You may have coverage for a specific disease or illness as long as that coverage pays a specific dollar amount when the policy is triggered.
No. This would be a nonmedical withdrawal and would be subject to taxes and a penalty. There are some exceptions. You would not have to pay a penalty or taxes if the money in your HSA was withdrawn to pay premiums for:
  • Qualified long-term care insurance.
  • Health insurance while you are receiving federal or state unemployment compensation.
  • Continuation of coverage plans, such as COBRA.
  • Medicare.
Generally, yes. Qualified medical expenses include unreimbursed medical expenses for you, your spouse, or your dependents.
A qualified medical expense is one for medical care as defined by Internal Revenue Code Section 213(d). The expenses must be primarily to improve or prevent a physical or mental defect or illness, including dental and vision.* Most expenses for medical care will fall under IRC Section 213(d); however, some expenses do not qualify. Here are few examples:
  • Surgery for cosmetic reasons
  • Health club dues
  • Illegal operations or treatment
  • Maternity clothes
  • Toothpaste, toiletries, and cosmetics
HSA money cannot generally be used to pay your insurance premiums. *See IRS Publications 502 (“Medical and Dental Expenses”) and 969 (“Health Savings Accounts and Other Tax-Favored Health Plans”) for more information.
Your HSA is portable. This means that you can take your HSA with you when you leave and continue to use the funds you have accumulated. Funds left in your account will continue to grow, tax-free. If you are covered by a qualified HDHP, you can continue to make tax-free contributions to your HSA. Distributions from your HSA that are used to pay for qualified expenses for you, your spouse, or your dependents are excluded from your gross income. Your HSA funds can be used for qualified expenses even if you are not currently eligible to make contributions to your HSA.
You may make a withdrawal (also known as a distribution) at any time. Distributions are tax-free when they are for qualified medical expenses that are not covered by the high-deductible health plan. You can request a distribution through your online account. If you are disabled, 65 or older, or you die during the year, you must pay income taxes—plus an additional percentage (determined by the IRS)—on any amount that is not used for qualified medical expenses. If you are disabled or 65 or older, you can receive nonmedical distributions without facing penalty but you must report the distributions as taxable income. You can find additional information on health savings accounts by visiting the U.S. Department of Treasury — home.treasury.gov and searching for health savings accounts (HSAs).
Even if you are no longer eligible to contribute to your HSA, distributions for qualified medical expenses will continue to be excluded from federal and state taxes (for most states) and your gross income.
Your funds will still be available to pay for qualified medical expenses. You may use your HSA to pay certain insurance premiums, such as Medicare Parts A and B, Medicare HMO, or your share of retiree medical coverage offered by a former employer. However, funds cannot be used tax free to purchase Medigap or Medicare supplemental policies. If you use your funds for qualified medical expenses, the distributions from your account will remain tax-free. If you use the funds for nonqualified expenses, the distributions will be taxable but exempt from the 20-percent penalty. If you enroll in Medicare, you will no longer be eligible to contribute to your HSA. If you have reached age 65 or become disabled, you may still contribute to your HSA if you have not enrolled in Medicare.
You will not pay a monthly maintenance fee while you are actively working for the University of Pittsburgh and enrolled in Panther Basic. Please see the grid below for more information on what fees apply and when.
Fee Description Schedule Amount While with University of Pittsburgh? Stand-alone HSA under UPMC Consumer Advantage? If your available balance is less than the fee amount
HSA Closure Fee Closure of your HSA account Upon events $25 Yes Yes Adjust fee amount to equal current available balance
HSA Returned Item Fee Distribution transactions that need to be returned due to insufficient funds Upon events $25 Yes Yes Apply pending fee to available balance once funds are available
HSA Setup Fee Service fee if you leave the University of Pittsburgh but maintain your HSA under UPMC Consumer Advantage Monthly $3.50 No Yes Apply pending fee to available balance once funds are available
Debit Card Issuance Fee Debit cards issued for the member and/or spouse Upon event, after three issued cards $5 Yes Yes Apply pending fee to available balance once funds are available
The out-of-pocket maximum is embedded. This complies with federal regulations that limit a person’s out-of-pocket (OOP) maximum to not exceed $7,000. The family deductible is aggregate. This means that one or more family members can contribute toward and meet the family’s total deductible. The family out-of-pocket limit will be satisfied in one of two ways, whichever comes first:
  • When an individual within a family reaches his or her individual out-of-pocket limit – At this point, only that person will have benefits covered at 100 percent for the remainder of the benefit period; OR
  • When a combination of family members’ expenses reaches the family out-of-pocket limit – At this point, all covered family members are considered to have met the out-of-pocket limit and will have benefits covered at 100 percent for the remainder of the benefit period. Any combination of one or more family members can contribute toward and meet the family’s total maximum.