How to Access Care as a UPMC Health Plan Member
Get care when and how you want it
Sudden illnesses and injuries are never planned. That’s why we’re ready to help when and where you need care. Let’s look at the many ways you can access care as a UPMC Health Plan member.
Online care
UPMC AnywhereCare
You can have a virtual visit with a health care provider within minutes—right from your smartphone, tablet, or computer.*
With this service, you can get treatment for cold symptoms, pink eye, and other nonemergency conditions 24/7. The provider can even send a prescription to your local pharmacy, if necessary. Sign up for UPMC AnywhereCare today! Read more about the other tools available to members on our digital health tools resources.
Care over the phone
UPMC MyHealth 24/7 Nurse Line
If you are not sure whether you need to see a health care provider, call the UPMC MyHealth 24/7 Nurse Line at 1-866-918-1591 (TTY: 711). You will speak with a registered nurse who can help you determine what care you need—at no cost.**
In-person care
Primary care provider
Not feeling well and looking to see your primary care provider (PCP)? Many practices offer same-day appointments or will work to fit you in.
UPMC urgent care center
You can go to an urgent care center to receive walk-in care for nonemergency conditions. These include flu symptoms, allergies, sore throats, and minor cuts. Some facilities can address sprains and minor fractures. To find a participating facility, visit the UPMC provider directory.
Understanding cost of care
To learn more about your real cost of care, check your member ID card. It lists your copayment amounts for various services. You can also find this information by logging in to MyHealth OnLine. Your Schedule of Benefits (on MyHealth OnLine) also lists many covered services and their costs.
Connect with our team
Do you have a question or concern about your health care coverage? Members of our award-winning Health Care Concierge team are ready to help you. They can help you find a provider, schedule an appointment, and determine the cost of a visit or procedure.
To reach a Health Care Concierge, call the number on your member ID card Monday through Friday from 7 a.m. to 7 p.m. and Saturday from 8 a.m. to 3 p.m. You can also chat with a Health Care Concierge by logging in to MyHealth OnLine.
UPMC for Life members can reach a Health Care Concierge at 1-877-539-3080 (TTY: 711) seven days a week from 8 a.m. to 8 p.m.
*Commercial: UPMC Health Plan members 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 will receive care from a provider employed or contracted by Online Care Network II P.C. (OCN), also known as Amwell Medical Group. OCN is not an affiliate of UPMC. Limitations may apply for members of ASO plans that have opted out of coverage. Providers are not available to treat members who are in Puerto Rico.
Medicare / SNP: UPMC for Life members 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 will receive care from a provider employed or contracted by Online Care Network II P.C. (OCN), also known as Amwell Medical Group. OCN is not an affiliate of UPMC. Providers are not available to treat members who are in Puerto Rico.
Medicaid: UPMC for You members located in Pennsylvania at the time of service will have a virtual visit with a UPMC-employed provider, subject to availability and discretion of the provider. Members located outside of Pennsylvania at the time of service will receive care from a provider employed or contracted by Online Care Network II P.C. (OCN), also known as Amwell Medical Group. OCN is not an affiliate of UPMC. During the COVID-19 emergency declaration, UPMC for You members located outside of Pennsylvania will receive service from OCN. After the COVID-19 emergency declaration, UPMC AnywhereCare virtual visits are not covered services when UPMC for You members are traveling outside of Pennsylvania. Providers are not available to treat members who are in Puerto Rico.
CHIP: In order for a child to have a UPMC AnywhereCare visit, the child’s parent or legal guardian must be with the child during the video portion of the visit. Your child must be in Pennsylvania for UPMC for Kids to cover their virtual visit. You can use UPMC AnywhereCare in other states, but you will have to pay out-of-pocket for the cost of the visit. UPMC for Kids members 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 will receive care from a provider employed or contracted by Online Care Network II P.C. (OCN), also known as Amwell Medical Group. OCN is not an affiliate of UPMC. Providers are not available to treat members who are in Puerto Rico.
Children’s AnywhereCare: UPMC Children’s AnywhereCare is available only to patients who are in Pennsylvania. In order for a child to have a UPMC Children’s AnywhereCare visit, the child’s parent or legal guardian must be with the child during the video portion of the visit, and the child and parent or legal guardian must be in Pennsylvania during the visit. If you are located outside of Pennsylvania at the time of service, you may select the standard UPMC AnywhereCare module and you will receive care from a provider employed or contracted by Online Care Network II PC (OCN), also known as Amwell Medical Group, at the discretion of the provider. OCN is not an affiliate of UPMC. During the COVID-19 emergency declaration, UPMC for You members located outside of Pennsylvania will receive service from OCN. After the COVID-19 emergency declaration, UPMC AnywhereCare virtual visits will not be covered services when UPMC for You members are traveling outside of Pennsylvania. Providers are not available to treat members who are in Puerto Rico.
CHC: UPMC Community HealthChoices participants 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. Participants located outside of Pennsylvania at the time of service will receive care from a provider employed or contracted by Online Care Network II P.C. (OCN), also known as Amwell Medical Group. OCN is not an affiliate of UPMC. During the COVID-19 emergency declaration, UPMC Community HealthChoice participants located outside of Pennsylvania will receive service from OCN. After the COVID-19 emergency declaration, UPMC AnywhereCare virtual visits are not covered services when UPMC Community HealthChoice participants are traveling outside of Pennsylvania. Providers are not available to treat participants who are in Puerto Rico.
**UPMC nurses who answer calls are licensed to assist members located in Pennsylvania, West Virginia, New York, and Ohio. Members must be located in one of those states when calling the UPMC MyHealth 24/7 Nurse Line. The UPMC MyHealth 24/7 Nurse Line is not a substitute for medical care. If an emergency arises, call 911 or go to the nearest emergency department. Nurses cannot answer plan or benefit questions. Please call the Member Services phone number on your member ID card for nonclinical inquiries.
Our hours of operation change twice a year. You can call us Oct. 1 through March 31 seven days a week from 8 a.m. to 8 p.m. From April 1 through Sept. 30, you can call us Monday through Friday from 8 a.m. to 8 p.m. and Saturday from 8 a.m. to 3 p.m.
