Getting the Right Care at the Right Time

UPMC Health Plan members have access to many care options. Knowing all your options can help you quickly get care in a cost-effective way.

Primary care provider

Care by appointment

When you don’t feel well, you should call your primary care provider (PCP).Your PCP coordinates and manages your overall care, knows your health history, and can help you access services to stay healthy. 

PCP’s offer a variety of services, including:

  • Care and advice when you don’t feel well.
  • No-cost well-visits.1
  • Screenings, vaccines, and other preventative services.
  • Care coordination for tests or specialist care.

If you don’t have a PCP, you can select one today!2

Select your PCP

 

LGBTQIA+ Affirming Providers

Our LGBTQIA+ Affirming Providers communicate and validate the LGBTQIA+ patient experience, and they strive to create a safe and welcoming patient-provider relationship with our LGBTQIA+ members. Watch this video on how to find a LGBTQIA+ Affirming Provider.

Highlights:

In-person care
Health & wellness
Low cost

UPMC MyHealth 24/7 Nurse Line

Telephone support for nonemergency health concerns

UPMC nurses are available 24/7 at this no-cost helpline to help you decide if you or your covered dependents can treat your non-emergent symptoms at home or if you need to seek care.3 Call 1-866-918-1591 (TTY: 711) to talk to a nurse or store the number in your phone contacts for the next time you need care advice.

Highlights:

24/7 help by phone
Professional, clinical decision support from UPMC nurses
No cost

UPMC AnywhereCare

Virtual urgent care and much more

You and your child4 can use UPMC AnywhereCare to get treatment for non-emergency conditions like cold and flu symptoms, allergies, or coughs. A provider can assess your condition and send a prescription to your pharmacy if needed. UPMC AnywhereCare also offers pharmacist guidance, personalized health coaching, and behavioral health support. 

Download the UPMC Health Plan app or log in on the member site to access UPMC AnywhereCare!

Download on the App Store Get it on Google Play

Highlights:

24/7
Video visits
Low or no cost

Expert help to manage conditions and make lifestyle changes

Our Health and Wellness Services team of health coaches and care managers, experts with professional degrees or licenses, can help you learn about and manage your condition or make impactful lifestyle changes. They will take the time to understand your needs and listen to your goals.

You can work with a health coach to manage your weight, reduce your stress, improve your nutrition or sleep, and more. You can collaborate with a care manager to help you manage your diabetes symptoms, cardiovascular health, respiratory conditions, and other health conditions.

There are a number of ways to get started, including:

  • Booking an appointment on our appointment calendar (phone or video)
  • Virtual visits through UPMC AnywhereCare
    • Log in or register for an account
    • Once you are logged in, select Health and Wellness Coaching.
  • Calling 1-855-395-8762. TTY users should call 711. Help is available Monday through Friday from 8 a.m. to 6 p.m.

Learn more about our programs and how to connect with a team member.

Highlights:

No cost
Phone or virtual visit
Customized plan to achieve your goals

eDermatology

Expert care when you need it for skin-related concerns

You can use this telehealth service to connect with board-certified, fellowship-trained UPMC dermatologists-no matter where you are in Pennsylvania.6 After you complete a questionnaire and upload photos, you’ll receive medical advice, a treatment plan, and a prescription if appropriate. Providers can treat acne, eczema, rashes, and other nonemergency skin conditions.

To start a visit, go to edermatology.upmc.com.

Highlights:

Easy access to dermatology care 
Low cost7
Diagnosis and treatment plan within 3 days

RxWell app for emotional and physical well-being

Prescription-strength health

Our RxWell® app5 offers programs that can help you improve your physical and emotional health. They’re designed to address stress, anxiety, weight management, depression, physical activity, tobacco cessation, and other wellness topics. You can complete the programs on your own or work with a health coach by messaging them through the app. The coach will provide support, accountability, and education to help you achieve your goals.

Take the first step to improve your mental health. Download RxWell today!

Download on the App Store Get it on Google Play

Highlights:

Programs to support emotional and physical health 
Dedicated health coach
No cost

Behavioral health support for anxiety and depression

Telephone support from a behavioral health care manager

UPMC licensed social workers and nurses can help you address your behavioral health needs by helping you develop skills to manage your symptoms by connecting you to treatment resources. Get started by calling UPMC Health Plan Behavioral Health Services at 1-888-777-8754 (TTY: 711), Monday through Friday from 8 a.m. to 5 p.m. All services are private and confidential. 

UPMC for You and UPMC Community HealthChoices members are eligible for services through behavioral health managed care organizations (BH-MCOs) that are overseen by the Pennsylvania Department of Human Services’ Office of Mental Health and Substance Abuse Services. Call your Health Care Concierge team by calling the number on your ID card to get contact information for your BH-MCO.

Highlights:

Help by phone
Mental health support
One-on-one

Emergency Care

24/7 care for life-threatening conditions

If you or your child has an emergency health situation, call 911, contact your local ambulance service, or go to the nearest emergency room. 

Find a hospital near you

Highlights:

24/7 access
Care for life-threatening conditions
Trained experts

Accessing care away from home

Nonemergency care

If you are traveling8 outside UPMC Health Plan’s service area and need nonemergency care, please contact the Health Care Concierge team  at the phone number on your ID card or call 1-844-220-4785 (TTY: 711) Monday through Friday from 8 a.m. to 6 p.m. A Health Care Concierge can help you find an urgent care center or participating provider.

If you are traveling more than 100 miles from home—including to another country—you can use Assist America9 to connect to medical services and other resources. 

View care options when you’re away from home

Highlights:

Assistance with care when traveling

1A separate copay may apply if additional medical services are received during these visits or if your screening results in identifying and treating a diagnostic issue.

2UPMC for You members and UPMC Community HealthChoices participants are advised to notify a Health Care Concierge after they change their PCP.

3UPMC nurses who answer calls are licensed to assist members in Pennsylvania, West Virginia, Maryland, New York, and Ohio. Members must be in one of those states when calling the UPMC MyHealth 24/7 Nurse Line. The UPMC My Health 24/7 Nurse Line is not a substitute for medical care. If an emergency arises, please call 911 or your local ambulance service, go to the nearest emergency room, or call or text the Suicide and Crisis Lifeline at 988. Nurses cannot answer plan or benefit questions. For plan or benefit information, please contact Member Services at the phone number on your ID card or call 1-844-220-4785 (TTY: 711) Monday through Friday from 8 a.m. to 6 p.m.

4Members 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. It is at the discretion of OCN providers to choose whether to treat patients ages 0 to 2. OCN is not an affiliate of UPMC. Limitations may apply for members of ASO plans who have opted out of coverage. Talk Therapy or Psychiatry services through AnywhereCare are not covered services for UPMC Community HealthChoices participants, UPMC for You members, or UPMC for Kids members. UPMC Children’s AnywhereCare is not available outside of Pennsylvania. If a member is under the age of 18, the member’s parent or legal guardian must be with the member during the video portion of the visit, and the child and parent or legal guardian must be in Pennsylvania during the visit. Providers are not available to treat members who are in Puerto Rico. 

5RxWell is available at no cost to UPMC Health Plan members who are 14 or older.

6eDermatology services are available only in Pennsylvania.

7eDermatology is available for UPMC for You members at no cost.

8For UPMC for Kids, UPMC Community HealthChoices, and UPMC for You members, coverage of care outside the service area is limited.  For plan or benefit information, please contact the Health Care Concierge team at the phone number on your ID card or call 1-844-220-4785 (TTY: 711) Monday through Friday from 8 a.m. to 6 p.m.

9Assist America’s services are available to members of UPMC Health Plan commercial plans, UPMC for Life and UPMC for Life Complete Care (HMO-SNP). Assist America is not travel or medical insurance, and its services do not replace health coverage while you are away from home. All services must be arranged and provided by Assist America. For travel that will extend beyond 90 days, you can obtain additional Assist America coverage through the Expatriate/Extended Coverage program. Assist America charges a fee for this program.