Preventive services

Preventive services can help spot health problems early so you can get the care you need right away!

It’s important to talk to your doctor about the preventive care that’s right for you based on your health care needs. Most preventive services are available at no cost when you see an in-network doctor.* Plus, you can earn rewards for completing certain preventive care and taking steps to maintain your best health.

Preventive care reward program

The UPMC for Life preventive care reward program allows members to earn reward dollars for completing certain preventive screenings by Dec. 31 each year. We'll let you know which preventive screenings you are eligible for in 2025.

  • Annual wellness visit – $30 reward
    Here are some important topics and questions you should discuss with your doctor
  • Diabetic retinal eye exam – $25 reward
  • Breast cancer screening – $50 reward
  • Colorectal cancer screening – $60 reward
  • New! At-home checkup –  $25 reward
    UPMC Health Plan is working with Matrix Medical Network to bring your next checkup right to your home. A Matrix Nurse Practitioner will come to your home to complete a comprehensive assessment of your overall health as well as go over your medications with you. You may even qualify for a virtual visit – this type of visit will also earn you a $25 reward! This next-level care is designed to complement your regular doctor visits and help you stay up to date on important health services. Schedule online or by phone: 1-888-568-5612 (TTY: 711) Monday through Friday from 8 a.m. to  8 p.m. and Saturday from 8 a.m. to 5 p.m.

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Earning reward dollars

If your plan includes the UPMC for Life Flex Spend Card or UPMC for Life Complete Care Shop Healthy Card, you should have already received your card in the mail with instructions on how to use it. After you complete eligible preventive care screenings and we process the claim from your doctor, reward dollars will be automatically added to this card. If your plan does not include this benefit, after you complete your first screening, we will mail a card to you pre-loaded with your reward dollars.

As you complete additional preventive care screening(s), we will add reward dollars onto your card. We will let you know when new rewards are added. You can also check your card balance in the UPMC Health Plan member site or through the UPMC Health Plan app.

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Using your reward dollars

All UPMC for Life members can use preventive care reward dollars to buy healthy foods at participating stores like Giant Eagle, Kroger, Rite Aid, Walgreens, and Walmart! Choose from a variety of healthy foods like fruits and vegetables, meats and seafood, healthy grains, and pantry staples. To take advantage of your reward dollars, you must shop in-store. Reward dollars will not be accepted on participating retailer websites or apps.

Your preventive care reward dollars can only be used to buy healthy foods. If your plan also includes the Flex Spend or Shop Healthy allowance, you can use your card towards healthy foods and over-the-counter (OTC) products. Here’s how:

  • If your plan includes a Flex Spend Card allowance, you can use your card towards both OTC products and toward healthy foods. To do this, you would swipe your card like you normally would at check out. Your preventive care reward dollars will go towards the healthy foods, and the OTC amount will be deducted from your Flex Spend allowance. Any remaining healthy food amount not covered with your preventive care reward dollars, will require another form of payment. You cannot use your Flex Spend allowance to buy healthy foods.
  • If your plan includes a Shop Healthy Card allowance, you can use your card towards both OTC products and healthy foods. To do this, you would swipe your card like you normally would at check out. Your preventive care reward dollars will go towards your healthy foods. Any remaining amount for OTC and healthy foods will be deducted from your Shop Healthy allowance.
  • If your plan does not include the Flex Spend or Shop Healthy Card allowance, you can only use your card towards healthy foods.

You have until Dec. 31, 2025, to use your reward dollars earned for preventive care screenings completed in 2024. You have until Dec. 31, 2026, to use reward dollars earned for preventive care screenings completed in 2025. This date is different for your Flex Spend and Shop Healthy Card allowance. See your Evidence of Coverage for details.

Here are the types of healthy foods you can buy with your preventive care reward dollars:

  • Beverages
  • Water (includes sparkling and enhanced water)
  • Juice
  • Coffee and tea
  • Isotonic sports drink
  • Breads and healthy grains
  • Bread
  • Rolls
  • Tortillas
  • Rice
  • Hot and cold cereals
  • Cereal and muesli bars
  • Dairy and dairy substitutes
  • Milk
  • Cheese
  • Eggs
  • Butter
  • Yogurt
  • Fruit and vegetables
  • Prepared fruits and vegetables
  • Fresh fruits and vegetables
  • Meat and seafood
  • Prepared meats and seafood
  • Fresh meats and seafood
  • Nuts and seeds
  • Prepared nuts and seeds
  • Fresh nuts and seeds
  • Trail mix
  • Other prepared preserved foods
  • Dairy and egg-based products
  • Dough-based products
  • Grain-based products
  • Vegetable-based products
  • Meat substitutes
  • Pasta and noodles
  • Prepared soups
  • Sandwiches, filled rolls, and wraps
  • Pickles, relishes, chutneys, and olives
  • Pantry staples
  • Flour
  • Spreads (peanut butter, jelly, honey)
  • Baking and cooking supplies
  • Seasonings, preservatives, and extracts
  • Herbs and spices
  • Sauces, spreads, and condiments
  • Vinegars and cooking wines

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Scheduling a preventive care appointment

You can schedule an appointment with your doctor’s office directly or you can call your Health Care Concierge team at the number on your member ID card.

We also have a direct scheduling line for diabetic retinal eye exams. Call toll-free 1-833-779-6824 (TTY: 711) Monday through Friday from 7 a.m. to 7 p.m. and Saturday from 8 a.m. to 3 p.m.

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Measures in place to keep you safe

Your providers should have safety measures in place so that you can get the in-person care you need without worry. Check with your doctor or provider directly. You can also visit our Medical Care and Advice page.

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*These preventive care reward opportunities listed are valid for 2024 and 2025. A separate copay may apply if additional medical services are received during the same visit or if the member’s screening becomes diagnostic in nature. Members may have a copay for telehealth video visits. For information about coverage of preventive services, members should see their Evidence of Coverage. 
This information is not a complete description of benefits. Call 1-866-400-5077 (TTY: 711) for more information. Out-of-network/Noncontracted providers are under no obligation to treat UPMC for Life members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost sharing that applies to out-of-network services. Other physicians/providers are available in the UPMC for Life network.

This information is available for free in other languages. Please call our customer service number at 1-877-539-3080 (TTY: 711).

UPMC for Life has a contract with Medicare to provide HMO, HMO D-SNP, and PPO plans. The HMO D-SNP plans have a contract with the PA State Medical Assistance program. Enrollment in UPMC for Life depends on contract renewal. UPMC for Life is a product of and operated by UPMC Health Plan Inc., UPMC Health Network Inc., UPMC Health Benefits Inc., UPMC for You Inc., and UPMC Health Coverage Inc.

SilverSneakers is a registered trademark of Tivity Health Inc. SilverSneakers GO is a trademark of Tivity Health Inc. © 2024 Tivity Health Inc. All rights reserved.

UPMC for Life Members
Call us toll-free: 1-877-539-3080
TTY: 711

Oct. 1 – March 31:
Seven days a week from 8 a.m. to 8 p.m.

April 1 – Sept. 30:
Monday through Friday from 8 a.m. to 8 p.m.

UPMC for Life Prospective Members
Call us toll-free: 1-866-400-5077
TTY: 711

Oct. 1 – March 31:
Seven days a week from 8 a.m. to 8 p.m.

April 1 – Sept. 30:
Monday through Friday from 8 a.m. to 8 p.m. Saturday from 9 a.m. to 3 p.m.

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Last Updated: 10/01/2024