Health insurance guide for the first-time buyer

Are you buying health insurance for the first time this year? Are you wondering where to start? This simple guide can help you find the perfect UPMC Health Plan, Individual and Family plan.

Do you already have providers that you know and trust?

• Yes: Review those doctors and hospitals against the plans you’re considering make sure the providers you trust will be covered. Use our provider search tool to help you determine which doctors and hospitals are in our different networks.
• No. Make a list of providers or types of providers that you would like to access. Use our provider search tool to help you determine which network those doctors and hospitals are in.

How often do you expect to need care in the upcoming year?

• Often. You may want to consider choosing a plan with a higher monthly premium and a lower deductible, so you won’t have to worry about high out-of-pocket costs each time you visit a doctor.
• Not often. If you don’t think you’ll use your health insurance coverage that much, you may want to consider a plan with a lower monthly premium and a higher deductible. Remember, though, coverage needs can change unexpectedly. Make sure you’re prepared for whatever life throws at you.

Do you take any prescription drugs?

• Yes. You’ll want to make sure they are included in our formulary (a list of prescription drugs covered by a plan). Note whether there are any special limits or coverage requirements.
• No. It’s still a good idea to check out the formulary of any plan you consider. You’ll want to make sure you understand which drugs your plan covers and how commonly they are prescribed.

We hope this simple guide has given you a better idea of what type of health plan may be right for you. The next step? Beginning Nov. 1, sign up to get health insurance from the UPMC Health Plan Marketplace. You’ll need to enroll by Dec. 15 to have coverage that begins on Jan. 1, 2025.

Have questions? Get in touch. You can call 1-877-563-0292 (TTY: 711) to chat with one of our knowledgeable UPMC Health Plan representatives today. We can help you make sure you’re getting everything you need to start the year off right!