COVID-19 vaccines; No cost share for members
Jan. 2022Important Notices
"UPMC Health Plan believes that vaccination is important, helps protect our communities, and saves lives. We advocate that all who can be vaccinated should be vaccinated. Since the first Emergency Use Authorizations were granted, the COVID-19 vaccine has been covered as a preventive service at no cost for UPMC Health Plan members. This applies to all of our comprehensive medical coverage products, including UPMC for Life, UPMC for Life Complete Care, UPMC for You, UPMC for Kids, UPMC Community HealthChoices, and all UPMC commercial group and individual (Pennie/Marketplace) products.
CMS has provided billing guidance and vaccine toolkits that can be found at cms.gov/COVIDvax. As of Jan. 1, 2022, vaccination claims for members with UPMC for Life (Medicare Advantage) should go to UPMC Health Plan, not Medicare Fee-For-Service. To learn more, visit our provider FAQ and Appendix A for more information."
CMS has provided billing guidance and vaccine toolkits that can be found at cms.gov/COVIDvax. As of Jan. 1, 2022, vaccination claims for members with UPMC for Life (Medicare Advantage) should go to UPMC Health Plan, not Medicare Fee-For-Service. To learn more, visit our provider FAQ and Appendix A for more information."
Recent Announcements
Pause in Prior Authorization Policies
On April 1, 2025, we announced that UPMC Health Plan would start requiring prior authorization for certain services. Please note that we are delaying or changing the implementation of prior authorization for some of these services, as described below.May 2025Important Notices
May is Mental Health Awareness Month
“Turn Awareness into Action”Mental Health America founded Mental Health Month in 1949, and since that time, every May has been a time to unite millions of people to promote awareness, provide vital resources, and advocate for everyones mental well-being. 1 in 5 people will experience a mental health condition in any given year¹. Mental health affects us all, and its critical that we move beyond awareness to take meaningful steps for our well-being and that of our community.May 2025Important Notices
Special notice: Important policy changes
Effective June 1, 2025, UPMC Health Plan will be implementing policy changes that will require providers to obtain prior authorizations for services listed in the following policies. For more information, please visit upmchp.us/policiesandprocedures.May 2025Important Notices