Member Resources

On this page you can find electronic copies of many UPMC for You resources, including documents, forms, and more. If you require an alternative format or would like printed copies instead, please call a Health Care Concierge team at 1-800-286-4242 (TTY: 711). Help is available Monday, Tuesday, Thursday, and Friday from 8 a.m. to 6 p.m. and Wednesday from 8 a.m. to 8 p.m.

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

• 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)
• Flu Shot Reimbursement Form (PDF)
• Member Authorization to Use/Disclose PHI (PDF)
• Alternate Address Request 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 (PDF)
• Personal Representative Designation Form (PDF) - 繁體中文/Mandarin (Chinese)
• Personal Representative Designation Form (PDF) - 한국어/Korean
• Personal Representative Designation Form (PDF) - ខ្ខ្មែរ/Mon-Khmer (Cambodian)
• Personal Representative Designation Form (PDF) - Tiếng Việt/Vietnamese
• Personal Representative Designation Form (PDF) - Русский/Russian
• Personal Representative Designation Form (PDF) - नेपाली/Nepali
• Personal Representative Designation Form (PDF) - نموذج تعيين ممثل شخصي/Arabic
• Prescription Reimbursement Claim Form (PDF)

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

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

• 2024 Caring for You newsletter Volume 3 (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.