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Plans

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Your selections:

  • Medicaid
  • Adams
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Co-Pays*

Ambulance
Per trip $0

Dental care $0

Inpatient hospital
Per day $3
Maximum with limits $21

Medical centers
Ambulatory surgical center $3
Federal Qualified Health Center / Regional Health Center $0
Independent medical / surgical center $2
Short procedure unit $3

Medical equipment
Purchase $0
Rental $0

Medical visits
Certified nurse practitioner $0
Chiropractor $2 max
Doctor $0
Optometrist $0
Podiatrist $2 max

Outpatient hospital
Per visit $2

Prescriptions
Generic $1
Brand name $3

X-rays 
Per service $1

Coordination of Care

Care Managers Partner with your Providers: Help to ease chronic conditions. Assist with community resources - housing, food security, and other social services. 

Care Management Programs

Free Health Coaching: By phone or online chat - improve your health, manage a condition, and overcome obstacles.

Member digital tools

Mobile App and Member Portal: Access ID card, view claims and coverage, find an in-network provider, chat with a Health Care Concierge. Make healthy choices with online resources found on UPMC MyHealth Online. 

UPMC AnywhereCare: Face-to-face live video conversation with a UPMC provider from your digital device anytime.

Pregnancy Benefits

The UPMC Health Plan Maternity Program: Helps Telephone or in person support for a healthy baby. Complete the program and receive a free gift - infant car seat, stroller or portable crib.

Pediatric First Steps Program: Work with a pediatric health coach throughout your baby’s first 3 years of life. Tips on baby care, safety, development, doctor visits, and immunizations.

Healthy Kids Programs

No extra services.

Vision Benefits

Vision Care for Adults: Services above the basic coverage. All UPMC for You members over 21 receive a yearly allowance for a pair of glasses or contacts/fittings.

24 Hour Medical Help Line

UPMC MyHealth 24/7 Nurse Line: Around-the-clock free health care advice from a registered nurse.  

Urgent Care Benefits

$0 Copay Urgent Care Center Services: Find participating centers using our website, mobile app, or a Health Care Concierge. 

Healthy Living and Health Education

No extra services.

Other Benefits

Prescription for Wellness: Your doctor writes a prescription for a health coach to help you manage conditions, make informed decisions about surgeries; and improve family health.

Peer support groups: Available by phone for programs such as weight management and tobacco cessation.

Free Safelink Smartphone: For qualified members. Comes with 3GB of data, 350 monthly minutes, unlimited texts, voicemail, caller ID, and 3 way calling.


*Co-pays do not apply to the following: members who are pregnant, members under age 18, members age 18 through 20 who are in foster care, emergency services, or certain drugs for specific diseases. The information about the benefits from each plan was current at the time of printing. Please call the plan directly for the most up-to-date information.