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UPMC for You - NW/SW

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1-800-286-4242
TTY: 1-800-361-2629
www.upmchealthplan.com/foryou

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: Working together to create an action plan to help ease chronic conditions. Provide assistance with community resources including housing, food security, and other social services.

Expert Help from an Award-winning Health Care Concierge Team: Our customer service team received the J.D. Power award “#1 in Member Satisfaction”, for the
last 3 consecutive years.

Care Management Programs

Free Health Coaching: Health coaches help improve your health, manage a condition, and overcome obstacles. Coaches are available by phone or online chat.

Member digital tools

Smart Mobile App or UPMC MyHealth OnLine: Access your ID card, contact your doctor, chat with a Health Care Concierge, or contact our 24/7 nurseline, all from your digital device.

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 pregnant women get the support and care needed to have a healthy baby. Complete the program and receive a
free gift; infant car seat, stroller, or portable crib.

Healthy Kids Programs

Health Coaching for Kids: Free health management programs for asthma, diabetes, oral health, and ADHD.

Vision Benefits

Exams, Glasses and Contacts: Above the basic coverage, 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 Urgent Care Centers using our website, mobile app, or by calling your Health Care Concierge team.

Healthy Living and Health Education

No extra services.

Other Benefits

Prescription for Wellness: Your doctor writes a prescription to work with a health coach. Your coach helps you make healthy lifestyle changes, such as losing weight or quitting tobacco.

Free Safelink Smartphone: For qualified members. Comes with 350 free monthly minutes.


*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.