COVID-19 vaccines; No cost share for members
Jan. 2022Important Notices
"UPMC Health Plan believes that vaccination is important, helps protect our communities, and saves lives. We advocate that all who can be vaccinated should be vaccinated. Since the first Emergency Use Authorizations were granted, the COVID-19 vaccine has been covered as a preventive service at no cost for UPMC Health Plan members. This applies to all of our comprehensive medical coverage products, including UPMC for Life, UPMC for Life Complete Care, UPMC for You, UPMC for Kids, UPMC Community HealthChoices, and all UPMC commercial group and individual (Pennie/Marketplace) products.
CMS has provided billing guidance and vaccine toolkits that can be found at cms.gov/COVIDvax. As of Jan. 1, 2022, vaccination claims for members with UPMC for Life (Medicare Advantage) should go to UPMC Health Plan, not Medicare Fee-For-Service. To learn more, visit our provider FAQ and Appendix A for more information."
CMS has provided billing guidance and vaccine toolkits that can be found at cms.gov/COVIDvax. As of Jan. 1, 2022, vaccination claims for members with UPMC for Life (Medicare Advantage) should go to UPMC Health Plan, not Medicare Fee-For-Service. To learn more, visit our provider FAQ and Appendix A for more information."
Recent Announcements
CME Webinar Series: Introducing Physicians and their teams to Value-Based Health Care
Please join us for a new CME-accredited webinar series on value-based care. This series is designed to introduce practicing physicians and their teams to value-based health care. Over the course of six sessions, we will define the components of value and identify the tools necessary to deliver high-value care for a population.Feb. 2026Education/Webinars
Bridging Smiles and Systems: Collaborative Care for Children with Chronic Conditions
Please join us for a live, CME-accredited and CEU-accredited webinar on May 13 from noon to 1p.m., that will explore the critical connection between oral health and pediatric chronic conditions such as diabetes, asthma, congenital heart disease, and ADHD.Feb. 2026Education/Webinars
February 2026 UPMC for You and UPMC Community HealthChoices formulary update
Pulmicort Flexhaler has a new distributor, Rubicon Holding. National Drug Codes (NDCs) for Pulmicort Flexhaler from Rubicon Holding are not included in the Medicaid Drug Rebate program and are not covered under the Medicaid Prescription Drug Program. Pulmicort Flexhaler NDCs from the previous manufacturer, H2 Pharma, have been discontinued but may be billed/dispensed until supplies are exhausted.Feb. 2026Pharmacy Updates