Some COVID-19-related benefits will be extended through Dec. 31 with $0 cost share for UPMC for You members

Sep. 2024Important Notices

As previously communicated, UPMC Health Plan will retire Appendix A – COVID-19 Special Coverage and Payment Policy for all lines of business on Sept. 30, 2024. However, UPMC Health Plan will extend the $0 cost share until Dec. 31 for the following services for UPMC for You members when the services are clinically indicated and consistent with generally accepted practice guidelines based on an individual assessment by the member’s attending provider:

  • COVID-19 diagnostic lab testing
  • Over-the-counter (OTC) COVID-19 testing1
  • Evaluation for a COVID-19 diagnosis
  • Treatment for COVID-19-related diagnosis

COVID-19 vaccines (FDA-authorized agents) are covered with $0 member cost sharing for vaccine administration at all licensed providers and pharmacies. Note: When the government provides COVID-19 vaccines at no cost, providers should bill only for vaccine administration.

If you have any questions, please contact your physician account executive or call Provider Services at 1-866-918-1595.

1For Medicaid: Coverage includes up to 8 FDA-authorized OTC rapid tests every 28 days per covered individual when the tests purchased directly from a retail store or retailer website through 12/31/24. When purchasing through a participating pharmacy, coverage is limited to 2 COVID-19 OTC tests per 7 days for up to 8 tests in a 28-day time period. Members are eligible to purchase rapid at-home OTC COVID-19 tests for $0 through participating pharmacies or submit for reimbursement after purchasing from retailers.

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Community Care Behavioral Health is excited to announce this free upcoming web-based training opportunity:

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May 2026Education/Webinars

Bridging Smiles and Systems: Collaborative Care for Children with Chronic Conditions

Please join us for a live, CME-accredited and CEU-accredited webinar on May 13 from noon to 1p.m., that will explore the critical connection between oral health and pediatric chronic conditions such as diabetes, asthma, congenital heart disease, and ADHD.
Apr. 2026Education/Webinars