UPMC for You wants to help you be as healthy as you can. There are many routine services and tests that are important for children and adults to have on a regular basis to help them stay healthy and to find problems early. For members with ongoing medical conditions such as asthma, diabetes, or heart conditions, routine tests and treatments can help you manage your condition. UPMC for You has programs that can help.
Preventive services can help keep you well. They include more than seeing your primary care provider (PCP) once a year for a checkup. Immunizations/Vaccines, lab tests, and other screenings that can help your provider manage your health needs are all considered preventive care. *
Preventive screenings can help you and your PCP find out early if you have a disease or health condition. Sometimes early treatment can save your life.
*UPMC for You covers certain vaccines when provided by an in-network PCP. If your PCP is unable to give a vaccine, they can refer you to another participating physician’s office. Some local pharmacies provide vaccines, but they may not be covered by UPMC for You. Call our Health Care Concierge team to learn which pharmacies participate in the UPMC for You vaccine program.
Where can I go for preventive services?
You should go to your PCP for preventive services. Women can go to a UPMC for You participating ob-gyn for their Pap test, pelvic exam, and mammogram. Routine physical appointments often take longer to schedule. Call well before the time you would like to schedule an appointment.
Here are some important preventive services you should know about:
Physical examWhen you go for a physical exam, your PCP will ask questions about your medical history and that of your family. This is important because you may have a greater risk of developing a disease if someone in your family has it. Your PCP will also check your height, weight, and blood pressure. How often you see your PCP will vary based on your age and condition, but you should see your PCP at least once a year.
Bloodwork and other testsBased on your age, medical history, and the results of your physical exam, your PCP may order some tests. These might include blood work to check your cholesterol level or blood sugar, an electrocardiogram (EKG) to check your heart, or other tests.
Immunizations/vaccinationsVaccines are given to adults and children to protect them from viruses or diseases. There are vaccines for human papillomavirus (HPV), measles, mumps, pneumonia, the flu, and other illnesses. It is very important for children to get all of their vaccines—even if they feel fine. Some vaccines need to be given only once, and some need to be given at certain times as a child grows. Others work best when they are received each year.
Talk to your PCP to find out which immunizations you and your child may need.
UPMC for You covers certain vaccines when they are provided by an in-network PCP. If your PCP cannot give a vaccine, they can refer you to another participating physician’s office. Some local pharmacies provide vaccines, but they may not be covered by UPMC for You. To learn which pharmacies participate in the UPMC for You vaccine program, call the UPMC for You Health Care Concierge team at 1-800-286-4242 (TTY: 711). Help is available at these days and times:
A health management program has care managers who can help you understand a disease or condition. They can also help you manage your health care, follow your doctor’s orders, and take better care of yourself. Your provider may talk with you about enrolling in one of these programs. However, you don’t have to wait for that talk. You can enroll yourself in a program without a referral from your PCP or other provider. You can also disenroll from a health management program at any time.
UPMC for You has several health management programs. They are:
Care managers will help you make a personalized care plan. They will work with you and your health care providers and check on your progress. Care managers can also:
Call the Health Management Department at 1-866-778-6073 (TTY: 711). Help is available Monday through Friday from 8 a.m. to 6 p.m.
Health coaches help our members make meaningful health changes. The right program can support goals like weight loss, quitting tobacco, healthy eating, increased activity, stress management, or improved emotional health. Together with your coach, you'll develop a personalized plan and work together to achieve your goals.
You can meet with your coach by phone or video until you feel ready to manage on your own. This meeting might be every week or on a schedule that works for you. Being consistent will help you get better results.
If you need more help later, you can resume your coaching sessions. Some programs also offer group sessions. Your coach will help you pick the best program and options for you during your first meeting. If you’re unsure about where to start, your coach will guide you.
Please note that health coaching is not the same as therapy.
You can talk with a clinical navigator to learn more about our services. You can also get started with a health coach right away. You will find both options on our appointment calendar.
You can also call us at 1-855-395-8762 (TTY: 711). Help is available Monday through Friday from 8 a.m. to 6 p.m.
Your provider may talk with you about enrolling in one of these programs for better health. However, you can enroll in health coaching without a referral from your PCP or other provider. You can also disenroll or stop a program at any time.
Your managed care plan may not cover all your health care expenses. Read your member handbook carefully to determine which health care services are covered.