Return to Home








  • Vusion is not included in this formulary. Member pays full cost.

Alternative Drug Information
 


The value of choosing UPMC Health Plan
At UPMC Health Plan, we support our members in focusing on their total well-being. We want to make sure our members have everything you need to be as healthy and happy as possible. We do this by:
Providing access to care to help keep you healthy.
Preventive Care icon
$0 preventive care that covers many health services for adults and children at 100 percent.1
Flat Rate icon
Coverage for high-value generic and no-cost preventive medications.2
Full In Network icon
Access to top-ranked doctors and hospitals and an extended network.3
Taking care of your mental and physical health.
Counseling Icon
Six free counseling sessions through LifeSolutions®.4
Coaching icon
Free health coaching to help you make healthy changes in your life.
RxWell icon
The RxWell® app provides virtual support for your total well-being.
Supporting you when you need it.
My health access icon
24/7 virtual urgent care and connections to pharmacists, health coaches, and behavioral health concierges. Designed to fit your schedule, it's covered at 100 percent by most plans.5
Mobile App icon
The UPMC Health Plan app for easy access to your health insurance information.
Concierge icon
Our exceptional Health Care Concierge team for help navigating your benefits with a quick online chat or phone call.

1Preventive 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.

2Preventive 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.

3Go to www.upmchealthplan.com/BEST for award information.

4Only 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.

5UPMC 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.