UPMC for You is expanding across Pennsylvania in September!
Jun. 2022Important Notices
"We are excited to announce that the Pennsylvania Department of Human Services (PA-DHS) has awarded UPMC for You a Medicaid Managed Care Contract for all five Physical HealthChoices zones across the Commonwealth of Pennsylvania. UPMC for You currently serves the Northwest, Southwest, and Lehigh/Capital HealthChoices zones and will expand into the Northeast and Southeast zones, effective Sept. 1, 2022.*
After June 22, 2022*, your Medicaid patients will receive a letter from PA-DHS to let them know about the Medicaid Managed Care Organizations (MCOs) selected to service their HealthChoices zones. Please look for a provider toolkit arriving in the mail in the coming weeks, explaining various value-added benefits for your patients and a variety of materials to display in your office. You can also review a list of frequently asked questions at upmchp.us/ProviderFAQ.
*Go-live implementation dates and communication timelines are subject to change at discretion of the Pennsylvania Department of Human Services."
After June 22, 2022*, your Medicaid patients will receive a letter from PA-DHS to let them know about the Medicaid Managed Care Organizations (MCOs) selected to service their HealthChoices zones. Please look for a provider toolkit arriving in the mail in the coming weeks, explaining various value-added benefits for your patients and a variety of materials to display in your office. You can also review a list of frequently asked questions at upmchp.us/ProviderFAQ.
*Go-live implementation dates and communication timelines are subject to change at discretion of the Pennsylvania Department of Human Services."
Recent Announcements
Pause in Prior Authorization Policies
On April 1, 2025, we announced that UPMC Health Plan would start requiring prior authorization for certain services. Please note that we are delaying or changing the implementation of prior authorization for some of these services, as described below.May 2025Important Notices
May is Mental Health Awareness Month
“Turn Awareness into Action”Mental Health America founded Mental Health Month in 1949, and since that time, every May has been a time to unite millions of people to promote awareness, provide vital resources, and advocate for everyones mental well-being. 1 in 5 people will experience a mental health condition in any given year¹. Mental health affects us all, and its critical that we move beyond awareness to take meaningful steps for our well-being and that of our community.May 2025Important Notices
Special notice: Important policy changes
Effective June 1, 2025, UPMC Health Plan will be implementing policy changes that will require providers to obtain prior authorizations for services listed in the following policies. For more information, please visit upmchp.us/policiesandprocedures.May 2025Important Notices