Documents & Resources for Members
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Please call the UPMC Community HealthChoices Health Care Concierge Team at 1-844-833-0523 (TTY: 711) to request any of these documents in hard copy or alternative format.
- Notice of Privacy Practices
- Out-of-Network Care Claim Form
- Member Authorization to Use/Disclose PHI
- Personal Representative Designation Form
- 2024 Summary of Benefits
- 2024 Participant Handbook
- Prescription Drug Search
- UPMC Community HealthChoices Pharmacy Formulary (Non-PDL) (PDF)
- UPMC Community HealthChoices Pharmacy Formulary (Non-PDL) (JSON)
- Pharmacy Directory
- Provider Directory Search
- UPMC Health Plan member site
- Participant Advisory Committee Application
- Participant Advisory Committee Application (PDF)
- Southwest PA – Participant Advisory Committee Meeting Minutes
- Southeast PA – Participant Advisory Committee Meeting Minutes
- Northwest PA – Participant Advisory Committee Meeting Minutes
- Northeast PA – Participant Advisory Committee Meeting Minutes
- Lehigh/Capital – Participant Advisory Committee Meeting Minutes
- Caring for Your Health newsletter
- Caring for Life newsletter
CHC Member Healthy Lifestyle Articles
- CHC Member Healthy Lifestyle Article – Back Pain
- CHC Member Healthy Lifestyle Article – Heart Disease
- CHC Member Healthy Lifestyle Article – Doctor Visit
- CHC Member Healthy Lifestyle Article – Stress
- CHC Member Healthy Lifestyle Article – Chronic Condition
- CHC Member Healthy Lifestyle Article – Oral Hygiene
- CHC Member Healthy Lifestyle Article – Asthma
- CHC Member Healthy Lifestyle Article – Lifestyle
- CHC Member Healthy Lifestyle Article – Osteoporosis
繁體中文/Mandarin (Chinese):
- 个人代表委托表 – Personal Representative Designation Form
- 福利摘要 – 2024 Summary of Benefits
- 参与者手册 – 2024 Participant Handbook
- UPMC Community HealthChoices 药房指南 – UPMC Community HealthChoices Pharmacy Guide
- 隐私惯例通知 - Notice of Privacy Practices
- 关爱 您的健康 – Caring for Your Health Newsletter
한국어/Korean:
- 개인 대리인 지정 양식 – Personal Representative Designation Form
- 혜택 요약 – 2024 Summary of Benefits
- 참가자 핸드북 – 2024 Participant Handbook
- UPMC Community HealthChoices 약국 가이드 – UPMC Community HealthChoices Pharmacy Guide
- 프 라이버시 관행의 고지 - Notice of Privacy Practices
- 건강 관리 - Caring for Your Health Newsletter
ខ្ខ្មែរ/Mon-Khmer (Cambodian):
- ទម្រង់ចាត្់តំងត្ំណាងផ្ទាល់ខ្លួន – Personal Representative Designation Form
- សងេបអំពីអត្ថម្បសោជន៍ – 2024 Summary of Benefits
- សេៀវសៅណណនំអនក្ចូលរួរ – 2024 Participant Handbook
- ការណែនាំអំពីឱសថស្ថានរបស់គម្រោង UPMC Community HealthChoices – UPMC Community HealthChoices Pharmacy Guide
- Notice of Privacy Practices
- ការថែទាំំសុខភាពរបស់ អ្ននក – Caring for Your Health Newsletter
Tiếng Việt/Vietnamese:
- Mẫu Chỉ định Người đại diện Cá nhân – Personal Representative Designation Form
- Tóm tắt Quyền lợi – 2024 Summary of Benefits
- Sổ tay Người tham gia – 2024 Participant Handbook
- Hướng dẫn về Nhà thuốc của UPMC Community HealthChoices – UPMC Community HealthChoices Pharmacy Guide
- Thông báo Quy định về Quyền riêng tư - Notice of Privacy Practices
- Chăm sóc Sức khỏe của Quý vị – Caring for Your Health Newsletter
Русский/Russian:
- Форма назначения личного представителя – Personal Representative Designation Form
- Краткое описание льгот – 2024 Summary of Benefits
- Справочник участника программы – 2024 Participant Handbook
- Рецептурный справочник UPMC Community HealthChoices – UPMC Community HealthChoices Pharmacy Guide
- Уведомление о порядке использования конфиденциальной информации - Notice of Privacy Practices
- Забота о здоровье - Caring for Your Health Newsletter
عربي/Arabic:
- نموذج تعيين الممثل الشخصي
2024 Personal Representative Designation Form - ملخص المزاي
2024 Summary of Benefits - دليل المشاركين لعام
2024 Participant Handbook - إشعار ممارسات الخصوصية
Notice of Privacy Practices - ینلكعصحتةبا اینلكعصحتةبا ا
Caring for Your Health Newsletter
नेपाली/Nepali:
- व्यक्यनतिगत प्रति निधि नियुक् ति फाराम - Personal Representative Designation Form
- सहभाागीी पुुस्तििकाा - 2024 Participant Handbook
- गोपनीयता अभ्यासहरूको सूचना - Notice of Privacy Practices
- लााभहरूकोो साारांंश - 2024 Summary of Benefits
- तपााईंंकोो स्वाास्थ्यकोो हेेरचााह गर्नेे - Caring for Your Health Newsletter