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RXWELL | UPMC HEALTH PLAN Employer Group Services: 1-888-499-6922. TTY: 711. For Members. For Members. As a UPMC Health Plan member, you have access to much more than top-ranked care. Your plan includes online health tools, award-winning customer service, health and wellness programs, travel coverage, and many more benefits and services. PROVIDER TELEHEALTH GUIDELINES Provider Telehealth Guidelines. UPMC Health Plan believes telehealth is an important care delivery option that helps members gain access to care. We are committed to offering industry-leading coverage to our members—subject to federal, state, and local regulations—and to support our network providers in delivering cost-effective, qualitycare.
CLAIMS PROCEDURES
Claims Procedures – Chapter H _____ UPMC Health Plan www.upmchealthplan.com EXPLANATION OF BENEFITS UPMC for Life Complete Care Members. Call us toll-free: 1-800-606-8648 TTY: 711 24 hours a day, 7 days a week EXPLANATION OF BENEFITS UPMC for Life Prospective Members. Call us toll-free: 1-866-400-5077 TTY: 711 Oct. 1 through Dec. 31: seven days a week from 8 a.m. to 8p.m.
NATIONAL SENIOR HEALTH & FITNESS DAY National Senior Health & Fitness Day. Let’s celebrate your health and wellness on Wednesday, May 26, from 10 a.m. to 1 p.m.! UPMC for Life is proud to be the Pennsylvania state sponsor of National Senior Health & Fitness Day for the 14th year in a row! This is the QUALITY HEALTH INSURANCE Employer Group Services: 1-888-499-6922. TTY: 711. For Members. For Members. As a UPMC Health Plan member, you have access to much more than top-ranked care. Your plan includes online health tools, award-winning customer service, health and wellness programs, travel coverage, and many more benefits and services. FOR CURRENT MEMBERS: GENERAL INFORMATION Employer Group Services: 1-888-499-6922. TTY: 711. For Members. For Members. As a UPMC Health Plan member, you have access to much more than top-ranked care. Your plan includes online health tools, award-winning customer service, health and wellness programs, travel coverage, and many more benefits and services. ACCESS MYHEALTH ONLINE With MyHealth OnLine, you can: Complete the MyHealth Questionnaire. It only takes about 20 minutes, and afterward, MyHealth OnLine will be automatically customized.You’ll get a summary of your current health status and get personalized suggestions to manage your health. STAYING IN TOUCH EVENTS Staying in Touch events. We’re here to help you stay connected and informed during this challenging time. Join our Staying in Touch events to hear about how to stay healthy, manage stress, be active, and connect with your community—all from the comfort of your home. Hosted by experts on preventive medicine, mental health, and otherspecialties.
RXWELL | UPMC HEALTH PLAN Employer Group Services: 1-888-499-6922. TTY: 711. For Members. For Members. As a UPMC Health Plan member, you have access to much more than top-ranked care. Your plan includes online health tools, award-winning customer service, health and wellness programs, travel coverage, and many more benefits and services. PROVIDER TELEHEALTH GUIDELINES Provider Telehealth Guidelines. UPMC Health Plan believes telehealth is an important care delivery option that helps members gain access to care. We are committed to offering industry-leading coverage to our members—subject to federal, state, and local regulations—and to support our network providers in delivering cost-effective, qualitycare.
CLAIMS PROCEDURES
Claims Procedures – Chapter H _____ UPMC Health Plan www.upmchealthplan.com EXPLANATION OF BENEFITS UPMC for Life Complete Care Members. Call us toll-free: 1-800-606-8648 TTY: 711 24 hours a day, 7 days a week EXPLANATION OF BENEFITS UPMC for Life Prospective Members. Call us toll-free: 1-866-400-5077 TTY: 711 Oct. 1 through Dec. 31: seven days a week from 8 a.m. to 8p.m.
NATIONAL SENIOR HEALTH & FITNESS DAY National Senior Health & Fitness Day. Let’s celebrate your health and wellness on Wednesday, May 26, from 10 a.m. to 1 p.m.! UPMC for Life is proud to be the Pennsylvania state sponsor of National Senior Health & Fitness Day for the 14th year in a row! This is theMEMBER INFORMATION
UPMC for Life Complete Care Members. Call us toll-free: 1-800-606-8648 TTY: 711 24 hours a day, 7 days a week MEDICAL PLANS FOR EMPLOYERS Current Clients: 1-800-937-0745. TTY: 711. Plans & Services. UPMC Health Plan offers products, plans, and solutions that make sense for you and your employees. Partnering with us will allow you to manage your health care costs, help your employees live healthy, and save your business time and money. FEDERAL EMPLOYEES HEALTH BENEFITS (FEHB) 1-877-648-9641. TTY: 711. Monday through Friday: 7 a.m. to 7 p.m. ET. Saturday: 8 a.m. to 3 p.m. ET. Plan Options and Rates. With the Federal Employees Health Benefits (FEHB) program, you can choose among two HealthyU options from UPMC Health Plan. Plan Options and Rates.HealthyU Overview.
UPMC HEALTH PLAN
Employer Group Services: 1-888-499-6922. TTY: 711. For Members. For Members. As a UPMC Health Plan member, you have access to much more than top-ranked care. Your plan includes online health tools, award-winning customer service, health and wellness programs, travel coverage, and many more benefits and services. OVER-THE-COUNTER ALLOWANCE Over-the-Counter (OTC) Allowance. Many UPMC for Life plans include a quarterly OTC allowance that can be used to buy covered health care products. Members are sent a mail-order catalog with hundreds of covered products to choose from, including: Face masks and ADDITIONAL MEMBER BENEFITS We will also be there for you after you have your baby. If you have any questions about the maternity program, please call toll-free 1-866-778-6073, Monday through Friday from 7 a.m. to 8 p.m. and Saturday from 8 a.m. to 3 p.m. TTY users should call toll-free 711. PROVIDER TELEHEALTH GUIDELINES Provider Telehealth Guidelines. UPMC Health Plan believes telehealth is an important care delivery option that helps members gain access to care. We are committed to offering industry-leading coverage to our members—subject to federal, state, and local regulations—and to support our network providers in delivering cost-effective, qualitycare.
UPMC HEALTH PLAN PROMOTES GEOFFREY NEIMARK, M.D. TO CHIEF Philadelphia (June 8, 2021) – UPMC Health Plan today announced that Geoffrey Neimark, M.D., has been named Chief Medical Officer for Community Care Behavioral Health Organization (Community Care).In this new role, he will continue to provide leadership for staff physicians, psychologists, and the Quality Management and Pharmacy team serving Community Care, a UPMC-affiliated nonprofitMYHEALTH ONLINE
This secure, easy-to-use website gives you 24/7 access to your child's most current benefit information. The site also allows you to: Review your child’s benefits. Search for doctors and pharmacies. See what drugs are covered by your child's plan. Discover health care resources for infants, children, and teens. COVESTRO TOTAL WELLBEING Covestro Total Wellbeing program has now partnered our wellness program and employee assistance program (EAP) under one roof to bring a holistic approach to your health. QUALITY HEALTH INSURANCE Employer Group Services: 1-888-499-6922. TTY: 711. For Members. For Members. As a UPMC Health Plan member, you have access to much more than top-ranked care. Your plan includes online health tools, award-winning customer service, health and wellness programs, travel coverage, and many more benefits and services. FOR CURRENT MEMBERS: GENERAL INFORMATION Employer Group Services: 1-888-499-6922. TTY: 711. For Members. For Members. As a UPMC Health Plan member, you have access to much more than top-ranked care. Your plan includes online health tools, award-winning customer service, health and wellness programs, travel coverage, and many more benefits and services. ACCESS MYHEALTH ONLINE With MyHealth OnLine, you can: Complete the MyHealth Questionnaire. It only takes about 20 minutes, and afterward, MyHealth OnLine will be automatically customized.You’ll get a summary of your current health status and get personalized suggestions to manage your health.PROVIDER ONLINE
RXWELL | UPMC HEALTH PLAN Employer Group Services: 1-888-499-6922. TTY: 711. For Members. For Members. As a UPMC Health Plan member, you have access to much more than top-ranked care. Your plan includes online health tools, award-winning customer service, health and wellness programs, travel coverage, and many more benefits and services.PROVIDER DIRECTORY
Find care with UPMC Health Plan's Provider Directory. Browse doctors by specialty, procedure, service, or equipment to find the best fitfor you!
UPMC HEALTH PLAN
Wellness for Life. This unique health and wellness program offers resources, tools, and support to help you on your journey to better health. You’ll earn reward dollars in a health incentive account (HIA) when you complete healthy activities during the plan year.*. The HIA dollars you earn are loaded onto a UPMC Consumer Advantage Visadebit
CLAIMS PROCEDURES
Claims Procedures – Chapter H _____ UPMC Health Plan www.upmchealthplan.com EXPLANATION OF BENEFITS UPMC for Life Complete Care Members. Call us toll-free: 1-800-606-8648 TTY: 711 24 hours a day, 7 days a week OVER-THE-COUNTER ALLOWANCE Over-the-Counter (OTC) Allowance. Many UPMC for Life plans include a quarterly OTC allowance that can be used to buy covered health care products. Members are sent a mail-order catalog with hundreds of covered products to choose from, including: Face masks QUALITY HEALTH INSURANCE Employer Group Services: 1-888-499-6922. TTY: 711. For Members. For Members. As a UPMC Health Plan member, you have access to much more than top-ranked care. Your plan includes online health tools, award-winning customer service, health and wellness programs, travel coverage, and many more benefits and services. FOR CURRENT MEMBERS: GENERAL INFORMATION Employer Group Services: 1-888-499-6922. TTY: 711. For Members. For Members. As a UPMC Health Plan member, you have access to much more than top-ranked care. Your plan includes online health tools, award-winning customer service, health and wellness programs, travel coverage, and many more benefits and services. ACCESS MYHEALTH ONLINE With MyHealth OnLine, you can: Complete the MyHealth Questionnaire. It only takes about 20 minutes, and afterward, MyHealth OnLine will be automatically customized.You’ll get a summary of your current health status and get personalized suggestions to manage your health.PROVIDER ONLINE
RXWELL | UPMC HEALTH PLAN Employer Group Services: 1-888-499-6922. TTY: 711. For Members. For Members. As a UPMC Health Plan member, you have access to much more than top-ranked care. Your plan includes online health tools, award-winning customer service, health and wellness programs, travel coverage, and many more benefits and services.PROVIDER DIRECTORY
Find care with UPMC Health Plan's Provider Directory. Browse doctors by specialty, procedure, service, or equipment to find the best fitfor you!
UPMC HEALTH PLAN
Wellness for Life. This unique health and wellness program offers resources, tools, and support to help you on your journey to better health. You’ll earn reward dollars in a health incentive account (HIA) when you complete healthy activities during the plan year.*. The HIA dollars you earn are loaded onto a UPMC Consumer Advantage Visadebit
CLAIMS PROCEDURES
Claims Procedures – Chapter H _____ UPMC Health Plan www.upmchealthplan.com EXPLANATION OF BENEFITS UPMC for Life Complete Care Members. Call us toll-free: 1-800-606-8648 TTY: 711 24 hours a day, 7 days a week OVER-THE-COUNTER ALLOWANCE Over-the-Counter (OTC) Allowance. Many UPMC for Life plans include a quarterly OTC allowance that can be used to buy covered health care products. Members are sent a mail-order catalog with hundreds of covered products to choose from, including: Face masks FOR CURRENT MEMBERS: GENERAL INFORMATION Employer Group Services: 1-888-499-6922. TTY: 711. For Members. For Members. As a UPMC Health Plan member, you have access to much more than top-ranked care. Your plan includes online health tools, award-winning customer service, health and wellness programs, travel coverage, and many more benefits and services.PROVIDER ONLINE
Provider OnLine Account Administrators. A provider office should appoint a staff member to serve as Security Officer. This person will: Serve as the provider practice’s primary contact with UPMC Health Plan regarding Provider OnLine security issues. MEDICAID AND MEDICAL ASSISTANCE PLANS Avoid close contact with people who are sick. Wash your hands for at least 20 seconds. If you're sick, stay home. Information on COVID-19 coverage, testing, and vaccines. UPMC for You Medical Assistance. Learn about our Medicaid plan. STAYING IN TOUCH EVENTS Staying in Touch events. We’re here to help you stay connected and informed during this challenging time. Join our Staying in Touch events to hear about how to stay healthy, manage stress, be active, and connect with your community—all from the comfort of your home. Hosted by experts on preventive medicine, mental health, and otherspecialties.
FEDERAL EMPLOYEES HEALTH BENEFITS (FEHB) 1-877-648-9641. TTY: 711. Monday through Friday: 7 a.m. to 7 p.m. ET. Saturday: 8 a.m. to 3 p.m. ET. Plan Options and Rates. With the Federal Employees Health Benefits (FEHB) program, you can choose among two HealthyU options from UPMC Health Plan. Plan Options and Rates.HealthyU Overview.
UPMC HEALTH PLAN PROMOTES GEOFFREY NEIMARK, M.D. TO CHIEF Philadelphia (June 8, 2021) – UPMC Health Plan today announced that Geoffrey Neimark, M.D., has been named Chief Medical Officer for Community Care Behavioral Health Organization (Community Care).In this new role, he will continue to provide leadership for staff physicians, psychologists, and the Quality Management and Pharmacy team serving Community Care, a UPMC-affiliated nonprofit PRESCRIPTION FOR WELLNESS 1-800-937-0745. TTY: 711. Plans & Services. UPMC Health Plan offers products, plans, and solutions that make sense for you and your employees. Partnering with us will allow you to manage your health care costs, help your employees live healthy, and save your businesstime
UPMC HEALTH PLAN MARKETPLACE $0 preventive care that can help you and your family stay healthy. Screenings, immunizations/vaccines, and health exams for adults and children are covered at 100 percent. 1 1 UPMC HEALTH PLAN MARKETPLACE Zynrelef At a Glance; Covered: No: Your Cost*: $$$$ Notices?: No * Your cost reflects copayment amount for drug. Individuals with high deductible plans may pay full cost of drug until deductible is met. PROVIDER FRAUD, WASTE & ABUSE TRAINING •FRAUD: An intentional deception or misrepresentation made by a person or entity, with the knowledge that the deception could result in some unauthorized benefit to himself/herself or some other person. QUALITY HEALTH INSURANCE Employer Group Services: 1-888-499-6922. TTY: 711. For Members. For Members. As a UPMC Health Plan member, you have access to much more than top-ranked care. Your plan includes online health tools, award-winning customer service, health and wellness programs, travel coverage, and many more benefits and services.PROVIDER ONLINE
FOR HEALTH CARE PROVIDERS Employer Group Services: 1-888-499-6922. TTY: 711. For Members. For Members. As a UPMC Health Plan member, you have access to much more than top-ranked care. Your plan includes online health tools, award-winning customer service, health and wellness programs, travel coverage, and many more benefits and services. STAYING IN TOUCH EVENTS Staying in Touch events. We’re here to help you stay connected and informed during this challenging time. Join our Staying in Touch events to hear about how to stay healthy, manage stress, be active, and connect with your community—all from the comfort of your home. Hosted by experts on preventive medicine, mental health, and otherspecialties.
RXWELL | UPMC HEALTH PLAN Employer Group Services: 1-888-499-6922. TTY: 711. For Members. For Members. As a UPMC Health Plan member, you have access to much more than top-ranked care. Your plan includes online health tools, award-winning customer service, health and wellness programs, travel coverage, and many more benefits and services.PROVIDER DIRECTORY
Find care with UPMC Health Plan's Provider Directory. Browse doctors by specialty, procedure, service, or equipment to find the best fitfor you!
COVESTRO TOTAL WELLBEING Covestro Total Wellbeing program has now partnered our wellness program and employee assistance program (EAP) under one roof to bring a holistic approach to your health.CLAIMS PROCEDURES
Claims Procedures – Chapter H _____ UPMC Health Plan www.upmchealthplan.com UPMC FOR LIFE BATHROOM SAFETY PRODUCTS CATALOG Get access to benefits that can help you live safely and independently at home. View this catalog to see the products available to you. NATIONAL SENIOR HEALTH & FITNESS DAY National Senior Health & Fitness Day. Let’s celebrate your health and wellness on Wednesday, May 26, from 10 a.m. to 1 p.m.! UPMC for Life is proud to be the Pennsylvania state sponsor of National Senior Health & Fitness Day for the 14th year in a row! This is the QUALITY HEALTH INSURANCE Employer Group Services: 1-888-499-6922. TTY: 711. For Members. For Members. As a UPMC Health Plan member, you have access to much more than top-ranked care. Your plan includes online health tools, award-winning customer service, health and wellness programs, travel coverage, and many more benefits and services.PROVIDER ONLINE
FOR HEALTH CARE PROVIDERS Employer Group Services: 1-888-499-6922. TTY: 711. For Members. For Members. As a UPMC Health Plan member, you have access to much more than top-ranked care. Your plan includes online health tools, award-winning customer service, health and wellness programs, travel coverage, and many more benefits and services. STAYING IN TOUCH EVENTS Staying in Touch events. We’re here to help you stay connected and informed during this challenging time. Join our Staying in Touch events to hear about how to stay healthy, manage stress, be active, and connect with your community—all from the comfort of your home. Hosted by experts on preventive medicine, mental health, and otherspecialties.
RXWELL | UPMC HEALTH PLAN Employer Group Services: 1-888-499-6922. TTY: 711. For Members. For Members. As a UPMC Health Plan member, you have access to much more than top-ranked care. Your plan includes online health tools, award-winning customer service, health and wellness programs, travel coverage, and many more benefits and services.PROVIDER DIRECTORY
Find care with UPMC Health Plan's Provider Directory. Browse doctors by specialty, procedure, service, or equipment to find the best fitfor you!
COVESTRO TOTAL WELLBEING Covestro Total Wellbeing program has now partnered our wellness program and employee assistance program (EAP) under one roof to bring a holistic approach to your health.CLAIMS PROCEDURES
Claims Procedures – Chapter H _____ UPMC Health Plan www.upmchealthplan.com UPMC FOR LIFE BATHROOM SAFETY PRODUCTS CATALOG Get access to benefits that can help you live safely and independently at home. View this catalog to see the products available to you. NATIONAL SENIOR HEALTH & FITNESS DAY National Senior Health & Fitness Day. Let’s celebrate your health and wellness on Wednesday, May 26, from 10 a.m. to 1 p.m.! UPMC for Life is proud to be the Pennsylvania state sponsor of National Senior Health & Fitness Day for the 14th year in a row! This is the FOR CURRENT MEMBERS: GENERAL INFORMATION Employer Group Services: 1-888-499-6922. TTY: 711. For Members. For Members. As a UPMC Health Plan member, you have access to much more than top-ranked care. Your plan includes online health tools, award-winning customer service, health and wellness programs, travel coverage, and many more benefits and services. FOR HEALTH CARE PROVIDERS Employer Group Services: 1-888-499-6922. TTY: 711. For Members. For Members. As a UPMC Health Plan member, you have access to much more than top-ranked care. Your plan includes online health tools, award-winning customer service, health and wellness programs, travel coverage, and many more benefits and services. MEDICAID AND MEDICAL ASSISTANCE PLANS Avoid close contact with people who are sick. Wash your hands for at least 20 seconds. If you're sick, stay home. Information on COVID-19 coverage, testing, and vaccines. UPMC for You Medical Assistance. Learn about our Medicaid plan. UPMC CONSUMER ADVANTAGE ǀ UPMC HEALTH PLAN Employer Group Services: 1-888-499-6922. TTY: 711. For Members. For Members. As a UPMC Health Plan member, you have access to much more than top-ranked care. Your plan includes online health tools, award-winning customer service, health and wellness programs, travel coverage, and many more benefits and services.UPMC HEALTH PLAN
Employer Group Services: 1-888-499-6922. TTY: 711. For Members. For Members. As a UPMC Health Plan member, you have access to much more than top-ranked care. Your plan includes online health tools, award-winning customer service, health and wellness programs, travel coverage, and many more benefits and services. OVER-THE-COUNTER ALLOWANCE Over-the-Counter (OTC) Allowance. Many UPMC for Life plans include a quarterly OTC allowance that can be used to buy covered health care products. Members are sent a mail-order catalog with hundreds of covered products to choose from, including: Face masksPREVENTIVE SERVICES
In addition to the annual wellness visit, eligible UPMC for Life members may also earn rewards for completing other preventive screenings, including: Colorectal cancer screening—earn $60. Mammogram—earn $50. Diabetic retinal eye exam—earn $25. There is no cost to members for preventive services. Once you become a member,we’ll let you
CARE MANAGEMENT
UPMC for Life Complete Care Members. Call us toll-free: 1-800-606-8648 TTY: 711 24 hours a day, 7 days a week UPMC HEALTH PLAN MARKETPLACE 1 Preventive care will be covered at 100 percent only when it is received from a participating provider and it is billed as preventive. A separate cost may apply if additional medical services are received during the same visit or if your preventive care appointment becomes diagnostic in nature. NATIONAL SENIOR HEALTH & FITNESS DAY National Senior Health & Fitness Day. Let’s celebrate your health and wellness on Wednesday, May 26, from 10 a.m. to 1 p.m.! UPMC for Life is proud to be the Pennsylvania state sponsor of National Senior Health & Fitness Day for the 14th year in a row! This is the Skip to main contentUPMC Health Plan
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WELCOME TO UPMC HEALTH PLANSIMONE
As a mom and a business owner, Simone knows a thing or two about making decisions. When the time came to buy health insurance, the choice was simple. She found the perfect plan for her and her family with UPMC Health Plan. Whether you’re purchasing for your family or for your family business, we’ve got you covered. Get the Most from Your Health Plan -------------------------*
UPMC _FOR KIDS_
DEIJAH & DAYONNIA
We are proud to support the healthy growth of our members. UPMC _for Kids_ has grown to become the largest CHIP plan in Pennsylvania. That's a lot of happy, healthy kids! Learn About UPMC _for Kids_ -------------------------*
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DENTON & CATHIE
Denton and Cathie enrolled in a UPMC Health Plan health coaching program to eat healthier, but the changes they made went far beyond their kitchen. As the couple shed pounds, they gained energy and got more active outdoors. Get Connected to a Health Coach -------------------------*
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CHRISTIAN & MANDY
For Christian and Mandy, every day is an adventure—from biking around Pittsburgh to traveling internationally. But near or far, they’re covered with UPMC Health Plan and Assist America.® Whether you’re traveling around the block or around the world, bring peaceof mind with you.
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WELCOME TO UPMC HEALTH PLANSIMONE
As a mom and a business owner, Simone knows a thing or two about making decisions. When the time came to buy health insurance, the choice was simple. She found the perfect plan for her and her family with UPMC Health Plan. Whether you’re purchasing for your family or for your family business, we’ve got you covered. Get the Most from Your Health Plan -------------------------*
UPMC _FOR KIDS_
DEIJAH & DAYONNIA
We are proud to support the healthy growth of our members. UPMC _for Kids_ has grown to become the largest CHIP plan in Pennsylvania. That's a lot of happy, healthy kids! Learn About UPMC _for Kids_ -------------------------1
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View All News & Media UPMC Health Plan Non-Discrimination Statement UPMC Health Plan Extends Members’ No-cost Access to TelehealthServices
UPMC Health Plan Again Offers Lowest Cost Marketplace Plans with Full In-Network Access to UPMC UPMC Health Plan Helps Members Through the Coronavirus Pandemic NEW IDEAS FOR BETTER HEALTH CARE View All Thought Leadership As a provider-led health plan, we’ve created a unique laboratory to align incentives, deliver better care, and improve the health of our members. Read about our latest innovations that control costs and improve health outcomes. Centers of Excellence: Innovating access tohigh-quality care
Integrated Delivery and Finance Systems: Pittsburgh is Blazing the Path New Research on Physician Satisfaction_MY_HEALTH MATTERS
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