Understanding the value of value-added benefits

The value of value-added benefits | UPMC Health Plan

There are a lot of things to consider when selecting a health plan — especially its quality of in-network care and cost. But it’s also important to weigh the value of all the additional benefits a plan provides when choosing the one that’s right for you.

In addition to providing affordable access to top-ranked care*, UPMC Health Plan gives members benefits they need to help them live healthy and manage their care. From wellness programs to award-winning customer service**, here’s a closer look at five important benefits that make UPMC Health Plan unlike other plans:


  1. A team of Health Care Concierges
    UPMC Health Plan has a dedicated team of Health Care Concierges who can help you understand your benefits, find a doctor, schedule appointments, coordinate care, and more. Each team member takes pride in going above and beyond to resolve any issue in just one phone call. It’s just one of the reasons why our concierge program continues to win awards for excellence in customer service.
  1. Health coaching
    Perhaps the most potentially life-changing resource included in your membership in UPMC Health Plan is the health coaching program. Whether you’re trying to lose weight, improve your diet, manage stress better, or become more active, you have access to our professional health coaches who will help you set goals and achieve them. They’ll work with you to provide the knowledge, advice, and motivation you need to make a healthy lifestyle change.
  1. MyHealth OnLine
    The award-winning*** MyHealth program is available to all UPMC Health Plan members. It provides a variety of practical tips, tools, and strategies for better health. Our newly designed MyHealth OnLine can help you find a doctor, view your medical history, and manage all of your health information from your computer or phone. You can even connect with a health coach to help you reduce your stress levels, lose weight, quit smoking, eat healthy, exercise more, and improve your emotional health.
  1. Behavioral health services
    UPMC Health Plan offers comprehensive behavioral health coverage. Your membership connects you with a large network of inpatient and outpatient treatment centers as well as a eight-week program called Beating the BluesUS, for those who suffer from depression, anxiety, and/or stress at no cost. We’re 100 percent committed to helping members maintain strong mental health and to supporting recovery in all stages.
  1. Assist America travel coverage
    You deserve easy access to quality health care, no matter where you are in the world. Thanks to UPMC Health Plan’s global emergency travel assistance partner, Assist America, that’s what you get. When you travel more than 100 miles from home, you remain connected to the medical resources you’ll need in case of an emergency. This benefit is included for all UPMC Health Plan members.


Click here for a complete list of member benefits from a plan that truly puts you first.


*UPMC is one of only 15 hospitals nationwide to be named to the U.S. News & World Report Best Hospitals Honor Roll and is ranked #1 in Pittsburgh for clinical excellence. 

**UPMC Health Plan’s Health Care Concierge Contact Center has been recognized by J.D. Power for providing “an outstanding customer service experience” for the live phone channel. UPMC Health Plan’s Member Services Department was named a 2015 Gold Stevie Winner in the Contact Center of the Year Category. The Stevie® Awards — the world’s top sales awards — recognize contact centers, customer service, business development, and sales professionals worldwide.

***The UPMC MyHealth program has received the highest honor — a Platinum Award — from the National Business Group on Health (NBGH). This makes UPMC one of just five employers in the country to win the “Best Employers for Healthy Lifestyles” Platinum Award at least five years in a row. The award goes to companies with established workplace well-being programs that show measurable success and documented outcomes.

Quick guide: UPMC Health Plan’s Pittsburgh network

In network in Pittsburgh | UPMC Health Plan

Pittsburgh has been touted for being a city of successful sports teams, prestigious universities, and pop culture icons — not to mention nationally recognized hospitals and health facilities. Want to know which ones you have access to as a UPMC Health Plan member? We’re breaking down what it means to be in-network in Pittsburgh.


In-Network in Pittsburgh

The UPMC Health Plan network includes more than 125 hospitals and 11,500 physicians in the state of Pennsylvania. Across the nation, UPMC Health Plan is connected to nearly 5,000 facilities and over 500,000 physicians. But what about in Pittsburgh, specifically?

There are more than 10 in-network hospitals in Allegheny County, available to all UPMC Health Plan members, and more than 2,000 in-network physicians.

Not sure which health facilities are available to you? Just a few of the top hospitals and physicians in the Pittsburgh network include:


Children’s Hospital of Pittsburgh – Nationally renowned for its outstanding clinical services, research programs, and medical education, Children’s Hospital of Pittsburgh is one of 10 pediatric hospitals in the United States named to the U.S. News & World Report’s Honor Roll of America’s “Best Children’s Hospitals” for 2014-2015.

UPMC Presbyterian & UPMC Montefiore – These two facilities, linked together, both deliver high-quality patient care in Pittsburgh’s Oakland neighborhood. UPMC Presbyterian is one of 41 nationally certified Comprehensive Stroke Centers.

Magee-Womens Hospital of UPMC – Ranked among the top 12 hospitals in the nation for gynecologic care, Magee-Womens Hospital of UPMC is a National Center of Excellence in Women’s Health, one of the first recognized by the U.S. Department of Health and Human Services.

UPMC Shadyside – A 520-bed tertiary care hospital, UPMC Shadyside earned Magnet® status from the American Nurses Credentialing Center — one of the highest achievements a hospital can obtain in professional nursing.

UPMC Mercy – The Mercy Hospital of Pittsburgh, established by the Sisters of Mercy, was the first hospital in Pittsburgh and the first Mercy Hospital in the world. It merged with UPMC in 2008 and continues to deliver quality care. UPMC Mercy is the region’s only combined Level 1 Regional Resource Trauma and Comprehensive Burn Center.


UPMC is one of only 15 hospitals nationwide to be named to the U.S. News & World Report Best Hospitals Honor Roll and is ranked #1 in Pittsburgh for clinical excellence. 


Click here to view a full list of in-network facilities, including hospitals like UPMC East and UPMC St. Margaret. When you’re in need of medical care, you can rest assured that UPMC provides a number of high-quality options, so you can choose the best location and services to meet your needs.

Hospital checklist: Hospitals in your family’s network

Hospitals in your family’s network | UPMC Health Plan

As you consider your options for a health plan, it’s important to be mindful of your network. Do you have in-network access to everything you need to keep your family healthy? Find out using our quick checklist. Here are the top five types of hospitals you should look for in your family’s network:

Children’s hospital
If you have kids, you’ll want in-network access to the very best pediatric care. Children’s Hospital of Pittsburgh of UPMC was designed to provide a warm, family-friendly environment for its patients. And it’s ranked among the top ten pediatric hospitals in the country.* You’ll find the quality compassionate care that all infants, children, and young adults deserve in times of need.

Women’s hospital
Every woman knows the importance of having in-network access to a hospital that specializes in women’s health care. And Pittsburgh is home to one that’s ranked in the top ten nationally for gynecological services.* Magee-Womens Hospital of UPMC is a leading provider of obstetrics, gynecology, gynecological oncology, as well as neonatology, and is committed to treating every woman with the dignity, respect, and care she deserves.

Trauma and burn center
No one plans on needing these types of services, but it’s important to have quality facilities in your network, just in case. It’s why we believe having in-network access to a Level I Trauma and Comprehensive Burn Center is essential. And UPMC Mercy Hospital is the only one in the area, providing care to severe trauma and burn victims through all stages of the healing process.

Psychiatric hospital
Should you or one of your dependents ever need to receive treatment or help for a behavioral health issue, you’ll want a psychiatric hospital in your network and a health plan that covers those services. UPMC Health Plan gives you coverage for behavioral services, as well as in-network access to the Western Psychiatric Institute and Clinic. Western Psychiatric offers research-based care and innovative treatment for mental health and addictive disorders in children, adolescents, adults and seniors at every stage of recovery.

Community hospital
Last but not least, it’s important to have a hospital close to home — so you don’t have to go far to receive care at the times when you need it most. That’s why it’s important to have a network that includes a variety of hospitals. If you work or live near downtown Pittsburgh, maybe that means having access to UPMC Mercy. If you live in Erie, UPMC Hamot is right in your back yard. No matter where you are in western Pennsylvania, UPMC Health Plan gives you in-network access to many community hospitals located throughout the region, so you can get the care you need close to home.


Take a look at your current plan and make sure you have in-network access to all the types of hospitals you need to keep your family healthy. If you don’t, it’s not too late to make a change. For full access to the UPMC doctors and hospitals in your area and the coverage your family deserves, visit: http://www.upmchealthplan.com/coverage today.


*UPMC is one of only 15 hospitals nationwide to be named to the U.S. News & World Report Best Hospitals Honor Roll and is ranked #1 in Pittsburgh for clinical excellence. 

Infographic: Understanding Health Insurance Metallic Levels

When you shop for health coverage on the UPMC Marketplace, you’ll see that plans are grouped into four categories – bronze, silver, gold, and platinum. Check out our infographic below to see what those categories mean and how they work.



To learn more about the coverage offered at each level, visit the UPMC Health Plan Marketplace.

Top 5 reasons moms should choose UPMC Health Plan

Choose UPMC Health Plan | UPMC Health Plan
Moms have to make a lot of difficult decisions, but choosing a health insurance provider doesn’t have to be one of them. UPMC Health Plan has you covered — from providing access to free preventive services and top-ranked care* to providing the tools you need to help you manage your health and your children’s health. We understand how busy you are and are here to help when you need it most.


Here are just five reasons why moms should choose UPMC Health Plan:


  1. Access to free preventive services for you and your child. You do a lot to protect your children, but you can’t control everything. UPMC Health Plan wants to help where we can, including providing access to free preventive services for you and your child. This includes well-baby visits, screenings, immunizations, and health exams — all free of charge. And because UPMC understands how busy you are, we provide schedules for vaccinations and immunizations, so you don’t have to keep track. Preventive care is the first step in staying healthy.
  1. UPMC for a New Beginning maternity program. UPMC is dedicated to keeping you and your baby healthy, and one way we do that is through the UPMC for a New Beginning maternity program. Through this program, members of UPMC for You, our Medicaid program, could receive an infant car seat or a portable play yard just by enrolling and meeting the following requirements:
  • Visit your maternity provider within 13 weeks of becoming pregnant.
  • Enroll in the UPMC for a New Beginning maternity program before you are 34 weeks pregnant.
  • Keep at least eight prenatal visits.
  • Get all of the routine lab tests ordered by your maternity provider.
  • Keep all of your scheduled telephone calls with the maternity program representative.
  • Return to UPMC for You the consent form signed by you and your maternity provider.
  1. UPMC for Kids health management programs. Moms know better than anyone how important it is for kids to learn good habits early on. This is certainly true for health management, and UMPC Health Plan has programs to help your kids do just that. Members receive access to programs that provide a health coach for your child, so he or she learns healthy habits and strategies for maintaining them.Members also get discounts to the Children’s Museum and the Pittsburgh Zoo, so you can keep your children’s minds healthy, as well.
  1. Access to word-class doctors and Children’s Hospital of Pittsburgh of UPMC. It’s no secret that UPMC offers some of the top-ranked care around, and choosing UPMC Health Plan gets you and your family in-network access. Many of our plans provide coverage across the nation and our network includes more than 125 hospitals and 11,500 physicians in Pennsylvania alone.When it comes to your children’s care, you can rest easy knowing you have in-network access to the Children’s Hospital of Pittsburgh of UPMC, one of the best pediatric hospitals in the nation. In fact, it is one of just 10 pediatric hospitals in the United States named to U.S. News & World Report’s list of best children’s hospitals for 2014-2015. Children’s Hospital has one of the fastest growing, National Institutes of Health-funded pediatric research programs in the country and has been recognized by KLAS, an independent health care research organization, as the number one pediatric hospital in its use of health care information technology. And while all of the accolades are important to moms, Children’s Hospital remains focused on the kids: The hospital campus was designed with input from physicians, nurses, and families to ensure that patients receive care in a comfortable environment that won’t be scary or intimidating for your child.
  1. Stress relief health coaching programs. Moms have been known to worry. UPMC Health Plan can help with that. Health Plan members get free access to a health coaching program and other resources to help you shoulder the stress of everyday life. You can meet with your health coach on a regular basis over the phone. Think of it as your own personal support system. Our health coaches will conduct motivational interviews, a method that helps you focus in on what truly motivates you, to help reduce stress and keep you on track.


With top-ranked doctors and facilities*, health coaching programs for you and your children, free preventive services, and so much more, we’ve got you and your kids covered.


* UPMC is one of only 15 hospitals nationwide to be named to the U.S. News & World Report Best Hospitals Honor Roll and is ranked #1 in Pittsburgh for clinical excellence. 

5 Pittsburgh programs for healthy kids

Pittsburgh programs for healthy kids | UPMC Health Plan

Every day, people in Pittsburgh are making lifestyle changes to become healthier and happier — on their own and in the community. And thanks to the efforts of a few programs and organizations in the region, it’s even easier to participate. UPMC Health Plan makes an effort to collaborate with these local groups to promote positive and healthy change. Take a look at five of our community partner programs that support the health and wellness of young people close to home:


  1. Let’s Move Pittsburgh
    This program is a national campaign led by First Lady Michelle Obama with a simple goal: to improve the health of children and teens in America. We teamed up with Phipps Conservatory and Botanical Gardens to start our own version of Let’s Move! here in Pittsburgh. Community partners ranging from corporations and nonprofits to parents and caregivers have come together to help Pittsburgh families increase their physical activity, reduce screen time, improve nutrition, and live more environmentally friendly.
  1. HEALTHY Armstrong
    HEALTHY stands for Healthy Eating and Active Lifestyles Together Helping Youth, which is exactly what this program has been working to promote in Armstrong County since 2005. As a founding partner of HEALTHY Armstrong, UPMC Health Plan is dedicated to its efforts to combat childhood obesity in Armstrong County by educating children and their families on how to engage in healthful habits and behavior.
  1. We Can!
    We Can! Pittsburgh is a local arm of another national campaign: We Can! (Ways to Enhance Children’s Activity and Nutrition), which is a science-based education program designed to help children ages 8 to 13 improve their food choices, increase their physical activity, and reduce their screen time. UPMC Health Plan contributes its health care resources, leadership, and expertise to help community partners start regional programs, and empower families to work together to lead healthier lives.
  1. Parks Are Free
    We believe that getting outside is a great way to stay active and brighten your spirits. It’s why we’re so proud to sponsor the Pittsburgh Parks Conservatory and its efforts to encourage people of western Pennsylvania to step outside and explore our region’s beautiful parks. We are especially excited about their new mobile app, MyPGH Parks, developed to connect people in the area with local parks with updated maps, information, and upcoming events.
  1. Dining Smart Community
    Developed by our very own doctors and dietitians, this program works to encourage a habit and culture of healthy eating in the workplace and in the community. UPMC Health Plan collaborates with Dining Smart Community partners to provide healthy menu items at participating locations, including the Children’s Museum of Pittsburgh. There, parents can pick up materials on nutrition and children can participate in events that support physical activity and good nutrition.


To get involved or to learn more about these exciting community programs to improve the health and wellness of children and families close to home, please visit https://www.upmchealthplan.com/about/community/.

Health insurance checklist for the first-time buyer

Are you buying health insurance for the first time this year? Are you wondering where to start? With this simple checklist, you should have a better idea of what type of health insurance plan may be right for you.

Buying health insurance for the first time | UPMC Health Plan


Looking for an even easier way to get a handle on health insurance? Simply visit the UPMC Health Plan Marketplace. We can help you make sure you’re getting everything you need from your plan.

Have a question about how Medicare works?


We’re your personal connection for help with Medicare

Do you have a question about how Medicare works? Do you need more information about UPMC for Life Medicare Advantage plan options?

Join us for a special Medicare Annual Enrollment Event!

When: Wednesday, December 2, 2015, anytime from 10 a.m. – 3 p.m.

Where: UPMC Health Plan Connect Service and Sales Center at:

  • Century III Mall (first floor in front of Macy’s)
  • Millcreek Mall (near Best Buy Mobile)
  • Monroeville Mall (second floor in front of Macy’s)
  • Ross Park Mall (first floor next to Starbucks)
  • South Hills Village (first floor near J.Crew)

The Medicare Annual Enrollment period for 2016 benefits will be ending Dec. 7. Most Medicare beneficiaries can only make changes to their Medicare Advantage coverage during this time. There are only 5 days left to enroll, so let us help you today!

We’ll have licensed representatives on-site to answer your questions and help you choose the best plan for you. We can even help you apply for enrollment.


A sales person will be present with information and applications. UPMC for Life has a contract with Medicare to provide HMO and PPO plans. Enrollment in UPMC for Life depends on contract renewal. UPMC for Life is a product of and operated by UPMC Health Plan Inc., UPMC Health Network Inc., and UPMC Health Benefits Inc.

For accommodation of persons with special needs at sales meetings, call toll-free 1-877-539-3080 seven days a week from 8 a.m. to 8 p.m. TTY users call 1-800-361-2629.


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Copyright 2015 UPMC Health Plan Inc. All rights reserved.

The top 5 things your Health Care Concierge can do for you

Health Care Concierge | UPMC Health Plan

When it comes to health insurance, you probably have a lot of questions. It can be overwhelming to try to understand benefits, claims, and how to make the most of your insurance. That’s why we have a team of Health Care Concierges dedicated to helping you understand your UPMC Health Plan health insurance and take advantage of your benefits.

Here are just five things your Health Care Concierge can do for you:

  1. Answer questions about your benefits and explain how your health plan works. Want an estimate on how much a procedure would cost? Want to learn more about your network? A Health Care Concierge can explain all of this and more to you in just one phone call. They can check to see if a prescription will be covered under your plan, or recommend the nearest health facilities in your network.
  1. Find a network provider and schedule a doctor’s appointment. If you’ve recently switched your health insurance, or if you need to see a certain type of doctor for the first time, a Health Care Concierge can help you identify an available doctor or specialist in your network and schedule an appointment for you. A Health Care Concierge can also help you schedule a preventive service appointment, such as a vaccination, screening, or general health exam.
  1. Resolve claim questions. A claim is the bill that your health provider turns in to your health insurance after you’ve had an appointment, procedure, or consultation. Your bill or Explanation of Benefits (EOB) tells you how much of that claim you have to pay (your copayment, coinsurance, and/or deductible) and how much is covered by your health plan. Sometimes it can be confusing. If you have any questions or just want to walk through your coverage and the claim process one more time, a Health Care Concierge can help.
  1. Notify you of special events and benefits. Did you know that your UPMC Health Plan insurance entitles you to discounts at gyms and health facilities? Or that we offer a variety of health-related events throughout the year? Ask your Health Care Concierge about MyHealth Community member benefits, discounts, and events — and get involved! Enjoy a family trip to the zoo, become a member of a local gym to kick-start your New Year’s resolution, and take advantage of the various benefits of being a member of UPMC Health Plan.
  1. Serve as your personal contact and resource at UPMC Health Plan. We try to make all of the information we have online easy to find and easy to understand, but sometimes it’s just nice to have an actual person explain everything to you — especially for something as complicated as health insurance. With UPMC Health Plan, we’ve got you covered. Health Care Concierges are available over the phone and via live chat during extended business hours, and they go above and beyond to be your personal resource at UPMC Health Plan. 



As an exclusive member benefit of UPMC Health Plan, Health Care Concierges are fast, efficient, and helpful. Ready to speak with a Health Care Concierge? Log in to your MyHealth OnLine account to get started.


Not a member of UPMC Health Plan? Browse our plans to find a health insurance plan that’s right for you, or give us a call at 1-855-394-2107.

The top 5 benefits you probably didn’t know you had

Health Insurance Benefits | UPMC Health Plan

Did you know that you can get discount tickets to the zoo with your UPMC Health Plan insurance? How about free health coaching to help you manage your weight or stop smoking? Health insurance with UPMC Health Plan gives you more than just medical health coverage.


Here are five benefits that you may not have realized you have:


  1. Care while traveling with Assist America®When UPMC Health Plan members have an emergency 100 miles or more from home, they still have access to doctors, hospitals, and more through Assist America®. Coverage through Assist America comes at no additional cost, but gives UPMC Health Plan members peace of mind that they can receive emergency care when away from home — even if they’re out of the country.
  1. MyHealth Community discounts – Treat yourself to a day at the museum, or become a member of that gym you always walk past. UPMC Health Plan members are eligible for discounts for gym memberships (and sometimes even waived initiation fees), discounts on fitness products such as bike rentals, admission discounts at local museums such as the Children’s Museum of Pittsburgh and the Pittsburgh Zoo and PPG Aquarium, and more! Find discounts near you at www.upmchealthplan.com/MyHealthCommunity/.
  1. MyHealth OnLine – UPMC Health Plan members can manage their prescriptions, find doctors in their network, schedule appointments, review their medical records, and more with MyHealth OnLine. This benefit is also available through the UPMC Health Plan mobile app. You’ll never have to worry if you forgot your insurance card at home, or if you don’t remember what one of your prescriptions is called — you can access all of this information with just a few clicks using your smartphone or tablet.Can’t find what you need? Have a question about your benefits? UPMC Health Plan members can speak with a Health Care Concierge through MyHealth OnLine, as well. Health Care Concierges are available to answer all of your questions, make appointments for you, and share information on upcoming community events and member programs.
  1. Preventive Care Covered at 100% – Screenings, vaccinations, well visits — are you putting them off because you don’t want to pay? As part of the Affordable Care Act (ACA), most health insurance plans, including UPMC Health Plan, now offer certain preventive care services at no additional cost. Take a look at our preventive services reference guide to learn more about the services covered, and the recommended age/time for each service.
  1. Free Health Coaching From Local Health Experts – Most of us are aware of a few things that we could do to improve our health, but we just need someone to encourage us to do them. UPMC Health Plan members have access to health coaches who are trained in a particular subject area. A health coach can help you lose weight, quit smoking, or simply develop a healthier lifestyle. Health coaches speak with members over the phone, via live chat, and sometimes attend health and fitness events in the community. Whether you just need a little encouragement, or an entire fitness and exercise plan, UPMC Health Plan health coaches are here to help.


Now that you know, make sure to take advantage of these FREE benefits by logging in to your MyHealth OnLine account here.


Not a UPMC Health Plan member? Click here to start shopping on the UPMC Health Plan Marketplace.