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UPMC for Life Frequently Asked Questions

Do I need a referral?

No referral is needed by your PCP, or from UPMC Health Plan Behavioral Health Services/UPMC for Life for behavioral health services. However, we strongly encourage you to contact UPMC Health Plan Behavioral Health Services @ 1-888-251-0083 before receiving any behavioral health services. UPMC Health Plan Behavioral Health Services has an experienced team of behavioral health staff who can help you find the right behavioral health provider. We will search for network providers who treat patients like you and who are in a convenient location. We can easily match you up with an experienced professional.

What is my behavioral health co-pay?

Behavioral Health financial questions can be answered by calling UPMC Health Plan Behavioral Health Services Customer Services at 1-888-251-0083 or TTY at 1-877-877-3580. Medical Health financial questions can be answered by calling UPMC for Life member services 1-877-539-3080 or TTY at 1-800-361-2629.

What is my behavioral health deductible?

Behavioral Health financial questions can be answered by calling UPMC Health Plan Behavioral Health Services Customer Services at 1-888-251-0083 or TTY at 1-877-877-3580. Medical Health financial questions can be answered by calling UPMC for Life member services 1-877-539-3080 or TTY at 1-800-361-2629.

Why can't I continue seeing my old provider who is out of network?

Depending on your plan you may have out of network benefits. The HMO plan requires you to choose an in network provider, the PPO plans allow you to go out of network at anytime.

How can I find out who is a network provider?

Contact UPMC Health Plan Behavioral Health Services customer service, 1-888-251-0083 or TTY 1-877-877-3580, and someone will assist you.

How can I get a provider Directory?

Contact member services at UPMC Health Plan at 1-877-539-3080 or TTY 1-800-361-2629 or log onto www.upmchealthplan.com

Is my EOB a bill?

No, it is a statement of services received and unless stated, this is an Explanation Of Benefits for your records.

What if I'm on vacation or living out of the area?

Only emergency services are covered with non-network providers when you are on vacation or living out of the local area if you have a HMO plan. If you have a PPO plan, only emergency services are covered at the highest benefit level. All other non-emergent services are covered at your lower benefit level since you will be using an out of network (non-participating) provider.