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Plans

Main Content

Your selections:

  • Medicaid
  • Clarion
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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 visit $1

Coordination of Care

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

Care Management Programs

Free Health / Wellness Coaching: By phone or online chat - improve health, manage conditions, overcome obstacles.

Free tobacco cessation support by phone, including nicotine replacement medication benefits.

Member digital tools

Mobile App and Member Portal: Access ID cards, select a PCP, find an in-network healthcare provider, view claims and coverage, live chat with a Health Care Concierge.

Pregnancy Benefits

UPMC Health Plan Maternity Program: Telephone or in-person support for a healthy baby. Incentive gift for participation - infant car seat, stroller or portable crib. Breast pump after delivery.

Healthy Kids Programs

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

Vision Benefits

Adult Vision Care: Services above basic coverage. 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: 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: Find participating centers using our website, mobile app, or a Health Care Concierge.

Healthy Living and Health Education

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.

Other Benefits

RxWell App: Helps members get healthier with support from a dedicated health coach. Offers programs to manage weight, become more active, eat healthy foods, or overcome negative thoughts or feelings.  

Free Safelink Smartphone: Smartphone (Qualified members).  3GB of data, 350 monthly minutes, unlimited texts, voicemail, caller ID, and 3-way calling. Contact a health care concierge without using minutes by calling 1-888-222-9877.