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  • Upmc Health Plan Member Application

Get Upmc Health Plan Member Application

Instruction Sheet MEMBER APPLICATION AND CHANGE FORM The attached application form will enable you to enroll in a UPMC Health Plan product or to make certain changes if you are already a member. Please.

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How much do UPMC Medicare Advantage plans cost? UPMC for Life HMO Premier RxUPMC for Life PPO High Deductible RxMonthly premium$0$35Annual health deductible$0$1,250Out-of-pocket maximum$7,550 in network$11,300 in and out of network, $7,550 in network onlyPrimary care copayment$0$101 more row

Apply for enrollment. We offer two different ways to apply: Call us toll-free at 1-866-400-5077 (TTY: 711) to apply for enrollment over the phone. Apply online using our secure enrollment website.

By app: Download the PA Enrollment Services app. By phone: Call PA Enrollment Services at 1-800-440-3989 to enroll in UPMC for You. TTY users should call 1-800-618-4225. Help is available Monday through Friday from 8 a.m. to 6 p.m. Customer service is offered in multiple languages.

UPMC for You, affiliate of UPMC Health Plan, offers high-quality care to eligible Medical Assistance recipients in 40 counties in the Commonwealth of Pennsylvania. This care is achieved by combining the benefits of a managed care organization with all the services covered by Medical Assistance.

UPMC for You covers services that are medically necessary. Some of the services may have limits, copayments, or need a referral from your PCP or require prior authorization by UPMC for You. For more information, please see the UPMC for You Member Handbook or contact the Health Care Concierge team.

UPMC for You is one of five Medicaid plans in Pennsylvania to earn an overall rating of 4 out of 5 Stars in NCQA's Medicaid Health Insurance Plan Ratings for 2021-2022.

free unlimited gym memberships One free personal training session per year at a participating fitness facility. Support from trained instructors. Exercise classes, some designed specifically for older adults. Access to dance studios, yoga studios, and swimming pools.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232