Welcome to UPMC Health Plan

This page shows you how to get the most out of your coverage. It’s a good idea to bookmark it.

After you have your member ID number, you can:

• Access the UPMC Health Plan member site and the UPMC Health Plan app.
  New to UPMC Health Plan? Register for a UPMC Health Plan Login to access the UPMC Health Plan member site, the UPMC Health Plan app, RxWell®, and more!
  
  Register for a UPMC Health Plan Login Now
  
  Already have a UPMC Health Plan Login?

After you register, complete the steps below using the website or app to make the most of your benefits:

• Review your coverage.
  
  • Your Schedule of Benefits lists the medical services that are covered under your plan. It also details the levels of coverage provided for those services. Before you seek care from any providers, review your Schedule of Benefits for details on your copayments, coinsurance amounts, and out-of-pocket maximum. After you register for your UPMC Health Plan Login, you can sign in to MyHealth OnLine to view your Schedule of Benefits.
  • Getting the right care at the right time is important. As a UPMC Health Plan member, you have options to address an illness or injury.
• Understand the costs of your plan.
  
  • Did you enroll for coverage through your employer? You will pay your share of the cost through a payroll deduction.
  • Did you purchase insurance coverage on your own? Learn how to pay your monthly bill.
  • Your Explanations of Benefits (EOBs) provide you details about health care you and your covered family members have paid during the plan year toward your out-of-pocket maximum. You can view your most recent EOBs on MyHealth OnLine.

After your effective date, you can:

• Complete your MyHealth Questionnaire.
  Sign in to the UPMC Health Plan member site and click on Better Health and Wellness, then Resources for Healthier Living. After you click Browse by Resource Type, you will find the well-being assessment in the Online Activities section. Once you complete it, you will get a confidential overview of your health, a personalized wellness plan, and advice to help you improve or maintain your health.
• Choose your primary care provider.
  Make searching for a primary care provider (PCP) a priority. Your PCP’s goal is to keep you healthy and give you the best possible care. You can choose a PCP on the UPMC Health Plan member site.
• Review your member guide.
  Whether you are a new or returning member, it’s important to take a few minutes to review your member guide. We update this guide each year, and the information it contains will help you take control of your health and your health care expenses. There are two ways you can access your member guide:
  • Sign in to the UPMC Health Plan app, tap Plan Details, then select Member Guide.
  • Sign in to the UPMC Health Plan member site and follow this path: Menu > Forms and Guides > under Plans and Coverage, select Member Guide.
• Submit any necessary forms.
  • Transition of Care (TOC) form (PDF): If you join UPMC Health Plan while receiving ongoing treatment from a nonparticipating provider, you can request to keep receiving care from that provider for up to 90 days from the date your UPMC Health Plan coverage begins (your effective date). To get started, complete this form and email it to your provider. You can also print the form, fill out the fields in black ink, and mail or fax it to your provider. Your provider must return the form and any applicable documentation to UPMC Health Plan within 30 days of your effective date.
  • Personal Representative Designation (PRD) form (PDF): Your dependents over the age of 13 must complete, sign, and date a PRD form to give UPMC Health Plan permission to share the dependent's personal health information with you, a guardian, a family member, or another custodian.
  • View any other forms about your coverage and benefits on MyHealth OnLine.
• Use our programs and tools to help you live your healthiest life.
  • Find doctors, hospitals, and pharmacy information with our provider directory search tool.
  • Access preventive services that can help you stay well.
  • Sign up for one-on-one health coaching for help making healthy lifestyle changes.
  • Use digital health tools, such as the UPMC Health Plan app, to take your wellness resources with you.
  • Access women’s health benefits, such as breast cancer and cervical cancer screenings and our maternity health coaching program, Baby Steps.
  • Learn about behavioral health programs that can help you improve or maintain your mental health.
• Get the most from your pharmacy benefits.
  Find a pharmacy near you, get a personal review of your medications, and ensure your medications are covered with our drug search tool.

Have questions? Call our award-winning Health Care Concierge team.¹

We work hard to make sure you can easily get answers to your health care questions. You can live chat with a Health Care Concierge by clicking Contact Us on the UPMC Health Plan member site. If you want to speak to a representative, you can call the number on your member ID card. TTY users should call 711. Help is available Monday through Friday from 7 a.m. to 7 p.m. and Saturday from 8 a.m. to 3 p.m. Learn more about our Health Care Concierge team.

¹UPMC Health Plan earned 10 Stevie® Awards in 2024, including a prestigious Grand Stevie Award. The Stevie Awards are among the world’s top honors for customer service, contact center, business development, and sales professionals across multiple businesses and industries.