Member Resources

Member Handbook

• Member Handbook (PDF)
  
  Manual para Miembros (PDF)
  
  Member Handbook (PDF) - 繁體中文/Mandarin (Chinese)
  
  Member Handbook (PDF) - 한국어/Korean
  
  Member Handbook (PDF) - ខ្ខ្មែរ/Mon-Khmer (Cambodian)
  
  Member Handbook (PDF) - Tiếng Việt/Vietnamese
  
  Member Handbook (PDF) - Русский/Russian
  
  Member Handbook (PDF) - नेपाली/Nepali

Provider Directory

• UPMC for You Provider Directory (PDF)
• Searchable directory

Formulary

• UPMC for You Pharmacy Formulary (Non-PDL) (PDF) | Formulary in JSON format (JSON)
  
  Formulario de Medicamentos con Receta de UPMC for You (PDF) | Formulario en formato JSON (JSON) (en inglés)
  
  UPMC for You Pharmacy Formulary (Non-PDL) - 繁體中文/Mandarin (Chinese)
  
  UPMC for You Pharmacy Formulary (Non-PDL) - 한국어/Korean
  
  UPMC for You Pharmacy Formulary (Non-PDL) - ខ្ខ្មែរ/Mon-Khmer (Cambodian)
  
  UPMC for You Pharmacy Formulary (Non-PDL) - Tiếng Việt/Vietnamese
  
  UPMC for You Pharmacy Formulary (Non-PDL) - Русский/Russian
  
  UPMC for You Pharmacy Formulary (Non-PDL) - नेपाली/Nepali

• Pennsylvania Department of Human Services Preferred Drug List (PDL)
• Searchable Formulary

Important Documents

• Authorization to Release Substance Use Health Information Form (PDF)
• Authorization to Release Physical or Behavioral Health Information Form (PDF)
• Member Rights and Responsibilities (PDF)
• Notice of Privacy Practices (PDF)
• Out-of-Network Care Claim Form (PDF)
• Personal Representative Designation Form (PDF)
  
  Formulario de Designación de Representante Personal
  
  Personal Representative Designation Form - 繁體中文/Mandarin (Chinese)
  
  Personal Representative Designation Form - 한국어/Korean
  
  Personal Representative Designation Form - ខ្ខ្មែរ/Mon-Khmer (Cambodian)
  
  Personal Representative Designation Form - Tiếng Việt/Vietnamese
  
  Personal Representative Designation Form - Русский/Russian
  
  Personal Representative Designation Form - नेपाली/Nepali
• Prescription Reimbursement Claim Form

Domestic Violence Links

• Pennsylvania Department of Human Services
• National Domestic Violence Hotline – 1-800-799-7233

Food and Nutrition Services

• Women, Infants, and Children (WIC)

Managed Care Organizations (BH-MCOs) by County

• Behavioral Health-MCOs

Pennsylvania Head Start Programs

• Head Start

Special Needs Unit

• Learn more about the Special Needs Unit (PDF)

Medical Assistance Transportation Program

• Medical Assistance Transportation Program (MATP)

Safety Net Health Plans Link

• Association for Community Affiliated Plans (ACAP)

National Museum of Dentistry

• Healthy Smiles for Autism (PDF)

Advance Directives

Advance directives can help participants let others know what medical treatments they do or do not want. The resources below can assist with the development of advance directives.

• Living Will (upmc.com)
• Pennsylvania Hospice and Palliative Care Network Next Step in Care

Newsletter

• Read the current Caring for You newsletter (PDF)

This managed care plan may not cover all your health care expenses.

If you have questions about your benefits, call the UPMC for You Health Care Concierge team at 1-800-286-4242 (TTY 711). Representatives are available Monday, Tuesday, Thursday, and Friday from 8 a.m. to 6 p.m.; Wednesday from 8 a.m. to 8 p.m.