Preventive Services to Help You Stay Well

At UPMC Health Plan, we believe the disease or condition that’s easiest to treat is the one you never get. That’s why we cover so many preventive services for children and adults at 100 percent—which means you pay nothing.

These services fall into three categories:

  • Screenings1
  • Immunizations/Vaccines
  • Health exams

Common adult screenings include well-visits, breast cancer screenings, cervical cancer screenings, and colorectal cancer screenings. Common adult immunizations include the tetanus, diphtheria, and pertussis (Tdap) vaccine as well as those for the flu and shingles (infection of the nerves).2 If you have children covered under your plan, they are also covered at 100 percent for a variety of developmentally appropriate screenings and immunizations.

During a routine preventive exam, your doctor may find something that requires follow-up care. What then? If your routine preventive service leads to the need for follow-up care, or if you need to be treated for an injury or illness, those additional services will likely be covered—but not at 100 percent.3

For a list of preventive services that your plan covers at no cost to you, log in to UPMC Health Plan member site, click on Your Insurance, and go to Plans and Coverage. Once here, choose a type of coverage (medical, vision, or dental) to view your Schedule of Benefits.

Getting the flu shot is free and easy

Even if you’re healthy, you can still get the flu and spread the virus to others. That’s why the Centers for Disease Control and Prevention (CDC) urges everyone over 6 months old to get an annual flu shot. (The CDC recommends that children ages 6 months to 8 years who are getting the flu shot for the first time receive two doses four weeks apart.4)

Getting the vaccine could help prevent millions of people from getting sick and/or having to seek treatment from a doctor for flu-related issues.5

Watch our videos to learn what’s in the flu shot, why it’s every year instead of once in a lifetime, if you have to schedule at the pharmacy, and a lot more.

Flu shots are available at your doctors' offices, participating urgent care centers, or local pharmacies, including Giant Eagle, Martin's, CVS, Giant, and many independent pharmacies. When you show your health care member ID card, your shot will be free.

If you have to pay for your shot, we will reimburse you. All you have to do is complete the digital flu shot reimbursement form on the UPMC Health Plan member site (login required) or fill out and submit the flu shot reimbursement form.

MyHealthfinder tool

Want personalized recommendations to help you take charge of your health? Use the U.S. Department of Health and Human Services’ MyHealthfinder tool. Enter your information and click on the “Get Results” button to find out which preventive services you should consider having this year.

1This is the medical term for testing to find a disease before it causes symptoms.

2If you have a UPMC for Life plan, the shingles vaccine is covered under your Part D plan benefits. To check whether your plan has Part D prescription drug coverage, see your Summary of Benefits.

3For additional information and/or help finding an in-network provider, please contact a Health Care Concierge at the phone number on your ID card or call 1-844-220-4785 (TTY: 711) Monday through Friday from 8 a.m. to 6 p.m.

4 Centers for Disease Control and Prevention. Flu and Children. Reviewed Sept. 5, 2024. Accessed Sept. 10, 2025. Flu and Children | Influenza (Flu) | CDC

5Source: Centers for Disease Control and Prevention

UPMC Health Plan's use of this material does not imply or constitute endorsement or recommendation by the Centers of Disease Control and Prevention, Agency for Toxic Substances and Disease Registry, Department of Health and Human Services, or the U.S. government of UPMC Health Plan, its affiliates, or their respective services.