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Network and Access

Our provider network includes more than 140 hospitals and more than 29,000 physicians throughout Pennsylvania and parts of Ohio, West Virginia, and Maryland. Across the U.S., the networks include nearly 5,000 hospitals and facilities and more than 900,000 physicians, as well as a broad network of retail pharmacies.

Don’s Story

Don’s employer gave him the option to choose UPMC Health Plan. The network and access to life-saving care made Don glad he did. "I’m very fortunate that I did choose UPMC Health Plan because it allowed me to resolve my situation without worrying."

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Pharmacy Network

Retail

UPMC Health Plan members have access to a broad retail pharmacy network that includes:

  • National chain pharmacies such as CVS, Rite Aid, and Walmart; and regional chain pharmacies such as Giant Eagle, GIANT Food Stores, MARTIN's Food Markets, and Wegmans.
  • An extensive network of independent pharmacies and other regional chain pharmacies.

Mail Order

Long-term maintenance medications are typically available through the Express Scripts mail-order pharmacy.

Specialty medications will generally be dispensed from Accredo Specialty Pharmacy or Chartwell Specialty Pharmacy and may be limited to a one-month supply.

Extended Network

UPMC Health Plan has agreements with multiple extended provider networks. This allows your employees, including their enrolled dependents up to age 26, to receive care while they are away from their primary service area. Employees and their dependents who reside in Ohio can use the SuperMed PPO Network through Medical Mutual of Ohio (MMO). This network includes more than 180 hospitals and over 50,000 health care professionals. Employees residing outside UPMC Health Plan’s Pennsylvania service area and Ohio can access care through the Private Healthcare Systems (PHCS) and MultiPlan networks. Together, these networks offer access to thousands of hospitals and over 900,000 health care professionals.

Global Emergency Assistance Services

Members traveling more than 100 miles from home have access to emergency medical assistance through Assist America.* This service can connect members and their covered family members to doctors, hospitals, and other emergency services—free of charge.

*Assist America is available when members experience a medical emergency while traveling more than 100 miles from their residence, including to another country, for less than 90 days. Assist America is not medical insurance.

UPMC AnywhereCare virtual urgent care visits

With UPMC AnywhereCare,** members and their covered dependents, including children, can access high-quality care 24/7 using their computer or mobile device. UPMC AnywhereCare is best for nonemergency conditions, such as cold and flu symptoms, allergies, or pink eye.

Visit UPMCAnywhereCare.com or download the mobile app to have a virtual visit with a provider. If needed, a provider can send a prescription to a pharmacy near the member.

**UPMC Health Plan members located in Pennsylvania at the time of virtual visit may select a UPMC-employed provider or a provider from Online Care Network II P.C. (OCN), subject to availability and discretion of the provider. Members located outside of Pennsylvania will receive service from OCN. OCN is not an affiliate of UPMC. Limitations may apply for members of ASO plans that have opted out of coverage.

UPMC Children’s AnywhereCare is available only to patients who are in Pennsylvania. In order for a child to have a UPMC Children’s AnywhereCare visit, the child’s parent or legal guardian must be with the child during the video portion of the visit, and the child and parent or legal guardian must be in Pennsylvania during the visit. UPMC Health Plan members located in Pennsylvania at the time of virtual visit may select a UPMC-employed provider or a provider from Online Care Network II P.C. (OCN), subject to availability and discretion of the provider. Members located outside of Pennsylvania will receive service from OCN. OCN is not an affiliate of UPMC. Limitations may apply for members of ASO plans that have opted out of coverage.