No. We’re happy to say, there’s no change to your current plan.
It doesn’t affect you this year since there’s no change to your 2018 plan. So you can keep going to UPMC, plus the other great doctors and hospitals included in your plan, for the rest of 2018.
Some Western Pennsylvania UPMC facilities will be out of network in 2019. For a listing of these hospitals, please see below.
Yes. You’re always covered when it matters most. When there’s an emergency, your Highmark Medicare plan always covers your care the same as in-network care, no matter where you go. This includes all UPMC facilities.
If your doctor is no longer in-network, you can find a doctor that’s in-network or use the new See Any Provider Benefit for 2019. Visit medicare.highmark.com for an up to date listing of in-network providers or shop for a 2019 Medicare Advantage plan.
We give you three easy ways to find your ideal doctor:
- Call 1-866-871-7710 (TTY users may call 711), 8 a.m. to 8 p.m., seven days a week
- Take our Dr. Match Quiz and get paired up with an in-network doctor that suits your unique needs.
- Stop by your local Highmark Direct health insurance store – To find a store near you, visit HighmarkDirect.com
Depending on your Medicare Advantage plan, you may be able to visit out-of-network doctors, hospitals or facilities as long as their Medicare-approved and agree to the terms of your plan.
Typically, these are the kinds of out-of-network options available to the different plan types:
1Out-of-network/non-contracted providers are under no obligation to treat Medicare Advantage plan members, except in emergency situations.
2HMO-POS plans may not cover all services at the point-of-service level. Cost share when using point-of-service benefits may be greater than at the in-network level.
3Some PFFS plans do not have a network. In those instances, there would be no network restrictions.
4Medigap has no network restrictions as long as the provider is accepting new Medigap patients.
new See Any Provider Benefit for 2019, so you can continue to access any in- or out-of-network doctor. Plus, your plan benefits include set amounts for both in-and out-of-network services, so you always know what you’ll pay.
- UPMC Altoona
- UPMC Bedford
- UPMC Cole
- UPMC Horizon
- UPMC Jameson
- UPMC Kane
- UPMC Northwest
- UPMC Pinnacle Carlisle
- UPMC Pinnacle Community Osteopathic
- UPMC Pinnacle Hanover
- UPMC Pinnacle Health Harrisburg Hospital
- UPMC Pinnacle Lancaster
- UPMC Pinnacle Lititz
- UPMC Pinnacle Memorial
- UPMC Pinnacle West Shore
- UPMC Susquehanna Divine Providence
- UPMC Susquehanna Lock Haven
- UPMC Susquehanna Muncy Valley
- UPMC Susquehanna Soldiers + Sailors
- UPMC Susquehanna Sunbury
- UPMC Susquehanna Williamsport
- UPMC Children’s Hospital of Pittsburgh
- UPMC Western Psychiatric Hospital
- UPMC Magee-Womens Hospital
- UPMC East
- UPMC Hamot
- UPMC McKeesport
- UPMC Mercy
- UPMC Passavant
- UPMC Presbyterian
- UPMC Shadyside
- UPMC St. Margaret