Continuous coverage unwinding
Jun. 2023Important Notices
The continuous coverage unwinding period began on April 1. Medicaid recipients may have questions about their Medicaid eligibility determination.
We developed this FAQ to help you educate patients who have already submitted their renewal.
The goal of this material is to:
We developed this FAQ to help you educate patients who have already submitted their renewal.
The goal of this material is to:
- Help patients understand the Medicaid renewal process and have them keep an eye out for mail from DHS.
- Provide guidance to patients who did not return required verification documents.
- Provide guidance to patients who received a coverage termination letter.
- UPMC for You Continuous Coverage Postcard
- UPMC for You Continuous Coverage Postcard Spanish
- UPMC Community HealthChoices Participant Postcard
- UPMC Community HealthChoices Participant Postcard Spanish
In addition to the FAQ, the items below may be distributed to your UPMC for You patients and UPMC Community HealthChoices participants. These materials can be ordered through MarketingExpress, which is available via Provider OnLine.
Instructions on how to use MarketingExpress are also available. If you have any questions, please contact your physician account executive or call Provider Services at 1-866-918-1595.
Recent Announcements
Important announcement – Telehealth submissions
As of October 1, 2025, UPMC Health Plan continues to accept the submission of telehealth claims. Providers may conduct telehealth visits for UPMC Health Plan members in all UPMC Insurance products. UPMC Insurance products include UPMC Advantage group and individual products, UPMC for Life Medicare Advantage plans, UPMC for Kids CHIP plans, UPMC Community HealthChoices, and UPMC for You Medical Assistance plans.Sep. 2025Important Notices
October 2025 UPMC for You and UPMC Community HealthChoices Formulary Update
Effective October 1st, 2025, Xifaxan and Retin-A (cream, gel) will no longer be covered by UPMC for You and UPMC Community HealthChoices due to non-participation in the Medicaid Drug Rebate Program.Sep. 2025Pharmacy Updates
Biosimilar Medication Formulary Updates
Updates to formulary biosimilar medications for denosumab, eculizumab, and ustekinumab productsSep. 2025Pharmacy Updates