UPMC Health Plan Issues Tools for Eligible COVID-19 Test Reimbursement

Pittsburgh (Jan. 14, 2022) – UPMC Health Plan today announced immediate and developing processes to enable members covered by employer or individual plans to seek reimbursement for COVID-19 tests in accordance with recent federal requirements.

“UPMC Health Plan is pleased to offer our commercial members the immediate opportunity to mail in documentation of FDA-authorized tests purchased on or after Jan. 15 for reimbursement,” said Mary Beth Jenkins, Chief Operating and Administrative Officer, UPMC Health Plan. “And we will have an online reimbursement portal up and running in the very near future. At any time, Health Plan members can call their Member Service ‘concierges’ for additional information on this or any other COVID-related coverage and assistance questions.”

Forms and details on the current manual submission process are available at upmchealthplan.com/covid-19/, where up-to-date information regarding vaccines, testing and COVID news are also posted.

“UPMC Health Plan is here to help—implementing these clear, simple processes for the new testing coverage reflects our ongoing commitment to providing accessible, affordable coverage and award-winning member service, especially during this current viral surge,” Jenkins said.

The Biden Administration issued guidance requiring private insurance companies and group health plans to cover the cost of at-home COVID-19 tests, effective Saturday, Jan. 15. Plans are required to cover eight (8) free, over the counter at-home tests per month, per each covered individual. Tests that are ordered or administered by a health care provider following an individualized clinical assessment, including for those who may need them due to underlying medical conditions, will continue to be available to our members as well.

While this mandate does not extend to Medicare members, UPMC for Life Medicare Advantage members already receive full COVID-19 testing coverage when testing is ordered by a physician.

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About UPMC Insurance Services

Serving more than 4 million members, UPMC Insurance Services is owned and operated by UPMC, a world-renowned health care provider and insurer based in Pittsburgh, Pa. UPMC Insurance Services includes commercial products from UPMC Health Plan for groups as well as individuals. Commercial products also include workers' compensation and employee assistance from nationally known Workpartners®. Government products include Medicare Advantage (UPMC for Life); special needs plans for those eligible for Medicare and Medical Assistance (UPMC for Life Complete Care and UPMC Community HealthChoices); Medical Assistance (UPMC for You); and Children's Health Insurance Program (UPMC for Kids). Community Care Behavioral Health, one of the nation's largest nonprofit managed care behavioral health organizations, offers a full range of services to Commercial and Medical Assistance members. For more information, visit upmchealthplan.com.