UPMC Health Plan is part of the Insurance Services Division of University of Pittsburgh Medical Center (UPMC), one of the nation's top-ranked health systems. As part of an integrated health care delivery system, UPMC Health Plan partners with UPMC and community network providers to improve clinical outcomes as well as the health of the greater community.

UPMC Health Plan maintains an "Excellent" rating (the highest available from NCQA) for its commercial HMO/POS, Medicaid HMO and Medicare HMO products. Members have access to the world-class academic, advanced-care, and specialty hospitals of UPMC, as well as renowned community hospitals, cancer centers, physician practices, and long-term care facilities.

UPMC Health System has been recognized as one of “America’s Best Hospitals,” earning the 10th position in U.S. News & World Report’s annual guide for two years in a row.  In addition, UPMC is nationally ranked in 15 adult specialties and among the top 10 hospitals in eight specialties.

UPMC Health Plan provides a dedicated customer service unit comprised of a team of highly trained Health Care Concierges. UPMC Health Plan won the 2012 Global Call Center of the Year award in the large call center category from the International Customer Management Institute (ICMI). ICMI recognizes call centers that make a commitment to superior service and have done the most to deliver a quality customer experience. UPMC Health Plan’s call center ensures excellence for all its members by focusing on one-call resolution, by employing a service-driven and knowledgeable team, and also by utilizing state-of-the-art call center technology.

Highlights and Monthly Costs
Effective: September 1, 2024 – August 31, 2025

Carrier: UPMC Health Plan

Note: The student medical plan meets the current J1 Visa status requirements.

Medical Plan Highlights for In-Network Coverage:

• No pre-existing condition limitations
• No annual benefit maximum
• Primary Care Physician: $30 copayment per visit for illness/injury
• Specialist: $40 copayment per visit
• Urgent care: $40 copayment per visit
• Emergency Room: $75 copayment per visit
• Inpatient hospital stay: Covered 90% after $250 copayment
• Pharmacy: $15 generic/$35 preferred brand/$70 non-preferred brand
• NEW for 2024: Reduced Behavioral Health copay: $10/visit
• Out of network coverage is provided at a lower benefit level
• $250/$500 Family Deductible

For questions regarding the medical plan, contact UPMC Health Plan Member Services at 1-888-499-6885 (option 1, then option 4).

Details of the Plan

Student Plan: Summary of Benefits and Coverage (SBC)     |     Schedule of Benefits (SOB)     |     Certificate of Coverage     |     Prescription Drug Benefits  

Additional Plan and Rider Documents

• Student Plan Policy - General Student Plan
• Student Preventive Services Guide
• Student Benefit Modification Rider - General Student Plan
• Student Benefit Modification Rider - Graduate Student Plan
• Pediatric Dental Care: Schedule of Benefits  |  Certificate of Insurance
• Pediatric Vision Care: Schedule of Benefits  |  Certificate of Insurance
• Creditable Coverage Notice - General Student Plan
• Creditable Coverage Notice - Graduate Student Plan
• How-to guide: Enrolling in Coverage
• How-to guide: Changing Your Benefits

Premiums will differ based on your student type. 

Graduate Students with an Academic Appointment (GSA, GSR, TA, TF) and Pre-Doctoral Fellows and Certificate Trainees (as Defined in University Policy)

Graduate Students without an Academic Appointment, Post-Doctoral Fellows, Health Science Fellows, and Full-time Undergraduate Students

Alternative coverage may be available for your dependents through Pennsylvania's Children's Health Insurance Program (CHIP). CHIP may be able to provide free or reduced-cost coverage for those that qualify.

To learn more, visit the CHIP website. To find a list of health insurance companies that offer CHIP, visit the Find CHIP Coverage page on the CHIP website and select your county from the drop-down menu.

United Concordia Dental is one of the nation’s largest dental insurers, and has been providing exceptional value for more than 40 years.

United Concordia administers dental benefits for more than 8 million members and 26,000 clients, including state and local governments, unions and many of the top 100 Fortune® 500 companies. The Advantage Plus network includes more than 73,600 unique dentists at more than 149,000 access points nationwide. Their network includes both University Dental Health Services and the University of Pittsburgh Dental Medicine Clinic. Both providers are located in Salk Hall.

Highlights and Monthly Costs
Effective: September 1, 2024 – August 31, 2025

Carrier: United Concordia

Graduate Student and Pre/Post-Doctoral Fellow and Certificate Trainee Dental Plan Highlights:

• Concordia Plus DHMO network
• Primary Dental Office selection required
• No deductible
• No annual maximum
• No claims to file
• In-network benefits only
• Benefits available in PA only
• 100% coverage for Exams, Cleaning, and X-Rays
• Reduced member copays and coverage for Crowns, Root Canals, Oral Surgery and Fillings
• Learn more about the Graduate Student DHMO plan in this FAQ.

For questions regarding the dental plan, contact United Concordia’s Member Services at 1-877-215-3616. Representatives are available from 8 a.m. to 8 p.m. EST Monday - Friday.

Details of the Plan

Summary of Benefits and Coverage (SBC)     |     Certificate of Coverage

Manage Your Dental Benefits
College Tuition Benefit

Highlights and Monthly Costs
Effective: September 1, 2024 – August 31, 2025

Carrier: United Concordia

Full-time Undergraduate Student Dental Plan Highlights:

• Annual deductible: $50
• Plan maximum: $500
• 100% coverage for Exams, Cleaning, and X-Rays
• 50% coverage for Root Canals, Oral Surgery and Fillings
• National Dental Provider Network - Concordia AdvantagePlus
• Freedom to see any participating licensed dentist
• No referrals needed for specialty dental care
• Utilizing network providers saves you money

For questions regarding the dental plan, contact United Concordia’s Member Services at 1-877-215-3616. Representatives are available from 8 a.m. to 8 p.m. EST Monday - Friday.

Details of the Plan

Summary of Benefits and Coverage (SBC)     |     Certificate of Coverage

Manage Your Dental Benefits
College Tuition Benefit

Davis Vision by MetLife provides vision benefits, eye care and eyewear to over 55 million members and a seamless member experience with unparalleled ease of use and value. Davis Vision by MetLife has a National provider network of ophthalmologists, optometrists and retailers at more than 35,000 points of access, in both private practice and retail settings.

Davis Vision by MetLife is one of a select few vision care programs in the country with NCQA’s Certification in Credentialing, maintained since 2004. Davis Vision by MetLife's labs and Customer Service Center are the only ones in managed vision care to be certified to ISO 9001:2008 standards. Davis Vision by MetLife also has the Cooperative Ophthalmic Lens Testing Service, Inc.’s (COLTS) Certification for Prescription Accuracy and FDA Conformance (impact-resistance). This provides third party certification and validation of prescription accuracy and quality from Davis Vision by MetLife labs.

Davis Vision by MetLife – Student Vision Plan
Highlights and Monthly Costs    
Effective: September 1, 2024 – August 31, 2025

Carrier: Davis Vision by MetLife

Student Vision Plan Highlights:

• 100% coverage for eye exam every 12 months
• Covered-in-full for eyeglasses from Davis Vision’s Collection or receive a:
  • $60 frame allowance towards frame of your choice, or
  • $75 contact lens allowance
• Additional lens options available at discounted member prices
• One-year breakage warranty on plan eyewear 

If you have questions about vision coverage contact Davis Vision by MetLife at 1-833-393-5433.

Plan Documents

• Vision Plan Summary of Benefits
• Group Vision Insurance Policy
• Vision Insurance Certificate for Paid Research Assistants
• Vision Insurance Certificate for all students excluding Paid Research Assistants

LifeSolutions is the University of Pittsburgh's Assistance Program that provides a broad range of services to assist University students and their household members to balance school and the stresses of daily life. This includes a specialized program for students like you! LifeSolutions offers personalized care services, 24-hour support, online resources and tools, and more, all at no cost to you. The LifeSolutions Assistance Program services include:

• Personalized Life Referrals
• Online Life Resources
• Crisis 24/7 Contact Information
• Counseling and Coaching Services
• And more!

You can speak with a LifeSolutions specialist in-person, through video, or by telephone. To speak with a specialist, or to schedule an in-person appointment, call 1 833-223-5754 (TTY: 711). To access the LifeSolutions website, select "Get Started" and input the "STUDENT" as the University Code.

Through UPMC Health Insurance, University travelers are automatically eligible for Assist America services. Assist America services include emergency medical services such as help with hospital admissions, referrals to qualified physicians, and emergency medical evacuation. In addition, it also provides assistance with trip preparation such as advisement on required immunizations and location of medical facilities at your destination. You can search for information at assistamerica.com before or during your trip for help. 

If you are traveling to an area where there are health concerns, you should contact Assist America at 1-800-872-1414 prior to your departure.

You will need to take the following steps to obtain the University of Pittsburgh’s Assist America Identification Card with the Reference Number:

Log onto my.pitt.edu and enter your username and password
From the "My Resources" drop down menu, select "UPMC Health Plan"
Select “My Health” located in the upper right-hand side of the portal page
After authentication takes place in approximately 15 seconds, you will land on the UPMC My Health Online homepage
From the homepage, click on “Self-Service Tools”
Click on “I want to print…”
Click on “An Assist America ID card for an upcoming trip”

NOTE: Eligibility for Assist America is for UPMC Health Plan policyholders traveling more than 100 miles from home for less than 90 days. Expatriate coverage is available for purchase for trips exceeding 90 days. Contact Assist America for the enrollment form.