UPMC Children’s Hospital of Pittsburgh Access

Can my kids go to UPMC Children’s Hospital of Pittsburgh after June 30, 2019?
Yes. Highmark is currently in a long-term contract with UPMC Children’s Hospital of Pittsburgh, which provides in-network access to both UPMC Children’s Hospital of Pittsburgh and its affiliated pediatricians and pediatric specialists until at least 2022. Highmark has every intention to renew this contract. Members will have access to the services provided by UPMC Children’s Hospital of Pittsburgh and the physicians who practice there.

Can I continue to access UPMC Children’s Hospital of Pittsburgh and Children’s Community Pediatrics after June 30, 2019?
Access to UPMC Children’s Hospital of Pittsburgh, including pediatric specialists that are part of Children’s Hospital, Children’s Community Pediatrics, and neighborhood locations of Children’s Hospital, is not affected by the end of the Consent Decrees and will remain in-network after June 30, 2019.

Can my kids utilize all services at UPMC Children’s Hospital of Pittsburgh’s Lawrenceville location, including imaging, lab, and therapy, on a network basis after June 30, 2019?
All pediatric services, including imaging, lab and therapy on the Children’s campus in Lawrenceville and Children’s community pediatric locations can be used on a network basis.

Can my kids go to UPMC facilities that will be out-of-network after June 30, 2019 on an in-network basis for lab, imaging and therapy?
These services will be considered out-of-network if provided at out-of-network UPMC facilities. These services will be in-network if provided at Children’s Hospital of Pittsburgh or Children’s community pediatric locations.

Can I take my kid to Children’s Express Care Centers on a network basis after June 30, 2019?
Yes, all Children’s Express Care Centers will remain in-network after June 30, 2019.

Can I take my kid to a UPMC pediatric specialist after June 30, 2019?
Yes, all UPMC pediatric specialists will remain in-network after June 30, 2019. This includes ophthalmology, cardiology, oncology, pulmonology, neurology, gastroenterology, endocrinology, sports medicine, newborn medicine and other pediatric specialties.

*This answer is applicable to Commercial and ACA plans only. For questions about how the end of the Consent Decree impacts Medicare Advantage plans, please call the number on the back of your member identification card.

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