Are you turning 26 soon? Here's the plan for a happy birthday!
You can shop for a plan on the ACA Marketplace when you turn 26. This is a great option if you are self-employed, unemployed, or can’t get coverage through your employer. States like Pennsylvania have their own Marketplace. Pennsylvanians can shop for a plan through Pennie®, the state's health insurance marketplace. Some people may qualify for financial savings through Pennie to help lower the cost of their insurance.
Your coverage through your parent or guardian's health insurance coverage may end at the end of your birth month or the calendar year, depending on what type of insurance you have.
When can I enroll with UPMC Health Plan?
If you experience a qualifying life event, you can enroll with UPMC Health Plan even if it is not during Open Enrollment. Turning 26 and aging out of your parents’ health insurance plan is a qualifying life event.
When you enroll with UPMC Health Plan, you’ll be giving yourself the gift of coverage and starting your 26th year with access to outstanding care!
Why choose UPMC Health Plan?
We know efforts to improve or maintain your health happen mostly outside the doctor’s office. That’s why we offer additional benefits and services for an affordable price. Take a look at what it means to be a UPMC Health Plan member.
Get care virtually or in-person with UPMC VirtualCare1
UPMC VirtualCare connects you to convenient, low-cost care your way.
Access to the care you need to get or stay healthy
- $0 preventive care covers many health services for adults and children at 100 percent2
- No-cost preventive medications3
- Access to top-ranked doctors and hospitals and an extended network4,5
Help to take care of your mental and physical health
- Six free counseling sessions through LifeSolutions®6
- Free health coaching to help you make healthy changes in your life
- The RxWell® app to support your total well-being
Support when you need it
- Virtual urgent care 24/7 for treatment that fits your schedule and is covered at 100 percent by most plans7
- The UPMC Health Plan app for easy access to your health insurance information
- Our exceptional Health Care Concierge team, which can help you navigate your benefits with a quick chat or phone call
Contact Us
Questions? Call us toll-free at 1-877-563-0292.
1 Available in the UPMC Partner and Select networks.
2 Preventive care will be covered at 100 percent only when it is received from a participating provider and it is billed as preventive. A separate cost share may apply if additional medical services are received during the same visit or if your preventive care appointment becomes diagnostic in nature.
3 Preventive medications on UPMC Health Plan’s Advantage Choice formulary will be covered with no cost share for members who meet certain criteria in accordance with the Patient Protection and Affordable Care Act of 2010.
4 Go to upmchealthplan.com/BEST for award information.
5 UPMC Health Plan commercial members and their dependents who reside or are traveling in Ohio will continue to access care through the SuperMed PPO Network and, while traveling outside of the state of Ohio, can also use the Cigna Healthcare PPO Network.
6UPMC Health Plan members who are in Pennsylvania at the time of a virtual visit may select a UPMC-employed provider, subject to availability and discretion of the provider. Members located outside of Pennsylvania at the time of service or those who select Talk Therapy or Psychiatry services will receive care from a provider employed or contracted by Online Care Network II PC (OCN), also known as Amwell Medical Group. OCN is not an affiliate of UPMC. Limitations may apply for members of ASO plans that have opted out of coverage. Providers are not available to treat members who are in Puerto Rico.
7Only the virtual visit with the provider will be covered at 100 percent. Prescription drug and other costs related to the visit or recommended by the provider will not be included in the virtual visit coverage and will be your responsibility. If you are enrolled in the UPMC Advantage Silver HSA $4,000/$0, UPMC Advantage Gold HSA $2,500/10%, or UPMC Advantage Catastrophic $9,200/$0 plan, UPMC AnywhereCare virtual visits will be covered at 100 percent after you meet your deductible. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply.