Additional Participant Benefits

Manage your health care instantly with the UPMC Health Plan mobile app. It’s another safe, speedy, and secure way to stay in touch with us. The app puts all your health information in one place. And you can access your information instantly—anywhere, anytime.

The app makes it easy to explore the benefits you have as a UPMC Community HealthChoices participant. Simple icons make it a snap to use. Here are some great ways you can use the app:

• Access your member ID card right when you need it.
• Contact your UPMC Community HealthChoices doctor, pharmacist, and even the UPMC MyHealth 24/7 Nurse Line—instantly.
• View your personal medical history.
• Live text-chat with a Health Care Concierge.

Download the UPMC Health Plan app today in the iTunes App Store or Google Play.

 

UPMC Health Plan Tech Guides

This service provides in-person or over-the-phone support to help participants use the free digital health care tools UPMC Health Plan offers. This includes tools such as the UPMC Health Plan member site, UPMC AnywhereCare, and the Find Care tool (online provider search). Tech Guides can work with participants to make sure each tool is set up to meet their needs and teach how to use them. The Tech Guides can also help participants with basic troubleshooting on your personal devices, with tasks such as downloading apps, setting up email, setting up the computer camera, or making a video call.

Health Management Programs

A health management program has health coaches who help you understand your disease or condition. They help you manage your health care and take better care of yourself. Your provider may talk with you about enrolling in one of these programs for better health. However, you can be enrolled in a health management program without a referral from your PCP or other provider.

UPMC Community HealthChoices has several health management programs:

• Asthma
• Heart disease (coronary artery disease, atrial fibrillation, and congestive heart failure)
• Chronic obstructive pulmonary disease (COPD for short, a lung disease)
• Diabetes
• Maternity
• Hypertension (high blood pressure)
• Hyperlipidemia (high cholesterol)
• Low back pain
• Chronic kidney disease

Thanks to an innovative program called UPMC Prescription for Wellness, your UPMC Community HealthChoices doctor can now write you a prescription to work one-on-one with a UPMC Heath Plan health coach. Whether you are already working on making healthy changes or want to set a new goal, a coach can support you. The coach will let your doctor know how you are doing with your health goals, so everyone stays in the loop. Ask your UPMC Community HealthChoices doctor about writing a UPMC Prescription for Wellness today. Or call 1-855-395-8762 to speak with a health coach and get started.

To learn more about health management programs, call the Health Management Department at 1-866-778-6073 (TTY: 711) Monday through Friday from 7 a.m. to 8 p.m. and Saturday 8 a.m. to 3 p.m.

UPMC MyHealth 24/7 Nurse Line 

Immediate access to health care advice is available around the clock through the UPMC MyHealth 24/7 Nurse Line. Whether you are seeking general health advice or need help with a medical issue, experienced registered nurses are available to provide you with prompt and efficient services. Call the UPMC MyHealth 24/7 Nurse Line at 1-866-918-1591 (TTY: 711).

Note: The UPMC MyHealth 24/7 Nurse Line is not a substitute for medical care. If you need emergency care, go to the nearest emergency room, or call 911 or the local ambulance service.

UPMC nurses who answer calls are licensed to assist UPMC Community HealthChoices participants. Nurses cannot answer plan or benefit questions. Please call the Health Care Concierge team at the phone number on your member ID card for nonclinical inquiries.

Extended Coverage of Personal Assistance Services and Home Delivered Meals

This service provides a limited amount of personal assistance services and home delivered meals to eligible participants who are waiting for an LTSS eligibility decision to be made by the Independent Enrollment Broker (IEB). The initial amount of services received is based on a service coordinator’s assessment.

$500 Dental Allowance

This yearly allowance can be used toward certain dental procedures after a benefit limit has been reached.

$100 Vision Allowance

This allowance can be used toward purchasing new glasses (one frame and two lenses) or contact lenses and a fitting every 12 months.

Enhanced Community Transition Services

This service offers an allowance of up to $5,000 to assist participants who are transitioning from a nursing facility to the community. This is $1,000 more than the Office of Long-Term Living waiver program limit of $4,000. The allowance can be used on a variety of items, such as household supplies, essential furniture, general moving expenses, security deposits, and other items associated with personal and environmental health and safety assurances.
UPMC Community HealthChoices administers this benefit in conjunction with a nursing home transition team, led by the participant, which develops a budget for distributing these funds to support the facility-to-community transition. This benefit also includes six in-person or telephonic visits by a nursing home transition coordinator in collaboration with a participant’s service coordinator. This will provide extra support for the participant’s community living plan and goals. Funding is per lifetime.

Caregiver Support Program

This service offers individualized coaching support for caregivers through in-person home visits and a user-friendly technology platform. Eligible caregivers may receive a daily stipend based on the participant’s level of need.

In-home Palliative Care

This service is available to participants who receive long-term services and supports in the community and do not have Medicare. This service requires prior authorization and medical necessity review.

To learn more about these and other member benefits, view the UPMC Community HealthChoices Handbook.