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Plans

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Your selections:

  • Medicaid
  • Susquehanna
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Co-Pays*

Ambulance
Per trip $0

Dental care $0

Inpatient hospital
Per day $0
Maximum with limits $0

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

Medical equipment
Purchase $0
Rental $0

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

Outpatient hospital
Per visit $0

Prescriptions
Generic $0
Brand name $0

X-rays 
Per visit $0

Coordination of Care

Care Management Support: Care Managers assist with medical and basic needs - housing, food, other social services - plan for appointments, manage conditions, focus on medication adherence, drug disease recommendations, and aid with care coordination.

Care Management Programs

Free Health / Wellness Coaching: By phone or chat - support which focuses on wellness and achieving wellness goals – weight loss, smoking cessation, diabetes prevention, etc. 

Member digital tools

Digital Tools: Mobile and web - Access ID cards, select a PCP, find care, view claims and coverage, chat with a Health Care Concierge.  RxWell App - Support from a dedicated health coach. Programs to manage weight, activity, nutrition, and well-being.

Pregnancy Benefits

Baby Steps Maternity Program: Telephone/in-person support from health coaches during and after pregnancy. Incentive gift for program participation.

Healthy Kids Programs

Pediatric Care Management: Specialty nurses/social workers provide ongoing support, guidance, education, and resources to parents of children from birth to 21.

Vision Benefits

Adult Vision Care: Members over 21 receive a yearly allowance towards a pair of glasses or contacts lenses/fittings.

24 Hour Medical Help Line

UPMC MyHealth 24/7 Nurse Line: Free health care advice from a registered nurse.

UPMC AnywhereCare: Live video visit with a UPMC provider from your digital device.

Urgent Care Benefits

$0 Copay Urgent Care Center Services: Visit an urgent care center or walk-in clinic within network at no cost to you.

Healthy Living and Health Education

Prescription for Wellness: Your doctor writes the prescription - a health coach helps you manage conditions and improve family health.

Other Benefits

Free Transportation: Free fixed route public transportation for non-medical needs.

Free Smartphone: (Eligible members) Generous data, talk, and text benefits.  Apply for the Affordable Connectivity Program for unlimited talk, text, and more.

Preventive Rewards Program: (Eligible members) Gift card rewards for completing certain preventive services.