UPMC Health Plan Member Services Update – COVID-19 Vaccines
With vaccines now available to everyone in Pennsylvania aged 12 and up, UPMC Health Plan’s Member Services Team continues to connect our UPMC Health Plan members and those that live in the communities we serve with access to vaccines and other important COVID-related supports.
Each day we work with UPMC and other network providers and pharmacies to help schedule individual vaccine appointments. To date, we have received more than 142,000 calls on our vaccine helplines and made more than 73,000 proactive calls to members to connect them with local vaccination appointments. Our team has also supported multiple regional community vaccine events, including clinics at PPG, Pittsburgh Mills, Hosanna House, Bethany House Ministry, the Jewish Community Center, Langley K-8 School and the Pittsburgh Mercy Southside Clinic
Vaccine Eligibility and Appointments:
UPMC Health Plan can help you schedule an appointment for a vaccine. Call Member Services or schedule it online directly with UPMC.
- All Pennsylvanians age 12+ are now eligible for the vaccine.
- If you are scheduling a Pfizer vaccine for your adolescent or teenage child, our member services team can help you find a clinic vaccinating this age group.
- For individuals with disabilities and their families, please contact us for help with scheduling, transportation or addressing other barriers that might otherwise prevent access to a vaccination clinic.
Commitment to Vaccine Equity
Individuals living and working in underserved communities continue to be a priority for UPMC Health Plan’s vaccination outreach. We are working closely with community organizations and clinics to provide the resources and support needed to make vaccines available to individuals and families at accessible community locations.
We have supported several clinics to help those in predominantly Black communities access the COVID-19 vaccine. These include UPMC’s community events with Hosanna and Bethany House Ministry, as well as multiple clinics developed in coordination with local churches in these neighborhoods.
In late April and May, we participated in community clinics serving the Latino community in Pittsburgh. Our Spanish-speaking Member Services staff provided pre-scheduling and on-site assistance for individuals, resulting in over 200 vaccinations for the first event. Our bi-lingual member services team is standing by to support Spanish-speaking individuals who have questions or are ready to schedule and receive their vaccine.
Reducing Barriers to Vaccine and COVID Treatment Access
UPMC Health Plan continues to support our members physically, emotionally and financially.
UPMC Health Plan will waive all member cost-sharing such as deductibles, copayments and coinsurance through July 20 for a range of in-network COVID-19 treatments, including inpatient hospital services and emerging, proven therapies such as monoclonal antibody infusions offered by UPMC.* According to UPMC clinical leaders, this is the only treatment that has been shown to improve outcomes for mild to moderate COVID-19 cases, and UPMC is providing this treatment to individuals who meet certain guidelines. Speak with your doctor or visit upmc.com/coronavirus/monoclonal-antibodies for more information.
Accessing care Virtually: UPMC Health Plan continues waiving all deductibles, copayments, and coinsurance for in-network telehealth (virtual) visits with a health care provider, including via UPMC AnywhereCare through July 20.*
Members can also access our no-cost RxWell mobile app, which can help you manage stress and anxiety in addition to helping you make and maintain healthy lifestyle changes.
Treatment of Rare Mammography Complications of COVID-19 Vaccination: In addition to supporting vaccine delivery efforts throughout our region, UPMC Health Plan is waiving cost-sharing for members who may need a follow-up to their recommended preventive mammography screening after receiving the vaccine. Because the body’s immune response to vaccination may in some cases cause swollen lymph nodes that lead to abnormal results in a screening mammogram, your health care provider may recommend follow-up screening for further evaluation. Members who experience this result from a preventive screening mammogram shortly after receiving the vaccine can obtain necessary in-network follow-up mammography imaging services at no cost.*
*While almost all our plans include all of these COVID-19 benefit enhancements, self-insured or ASO employer groups may opt out of no-cost coverage of benefits other than federally required coverage for diagnostic testing. For more details about UPMC Health Plan’s COVID-19 benefit enhancements, visit our website at upmchealthplan.com/covid.
If you have additional questions on any of these matters, please call your Member Services representative or visit the UPMC and UPMC Health Plan websites at upmc.com/covid and upmchealthplan.com/covid for more information and resources.
