Coverage While Away from Home
Persons covered by a University of Pittsburgh medical plan are covered 100 percent for urgent medical care and emergency services when traveling outside of the UPMC Health Plan service area.
Your existing coverage through the University continues while you are traveling for business or pleasure. You remain responsible for your portion of the insurance premium while you or your dependents are out of the UPMC Health Plan service area.
Under all plans, if you have a life threatening emergency, you have the comfort of knowing you are covered worldwide. In medical emergency situations:
- Seek care immediately from the nearest emergency facility
- If you are close to home, notify your PCP (if applicable) or contact UPMC Health Plan University of Pittsburgh Member Services at 1-888-499-6885 within 24 to 48 hours.
- If you are away from home, contact the dedicated University of Pittsburgh Member Services line at UPMC at 1-888-499-6885 within 24 to 48 hours.
- If admitted to an out-of-network facility, please contact the dedicated University of Pittsburgh Member Services line at UPMC at 1-888-499-6885.
- Have claims processed through UMPC Health Plan before making payment to providers outside the network.
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. It also includes assistance with pre-trip preparation such as advisement on required immunizations and location of medical facilities at your destination. You can search for information at www.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”
For business travel, contact the Office of Risk Management at 412-624-0621. You may also be referred to the UPMC Corporate Health Program for recommended vaccinations. The UPMC Corporate Health Program can be contacted by calling 412-560-8765. The website is http://www.upmc.com/services/corporate-health/services/pages/default.aspx. You can also contact the Allegheny County Health Department to schedule vaccinations at 412-687-ACHD. Further detailed travel-related health information may be found through the Centers for Disease Control at http://wwwnc.cdc.gov/travel. For personal travel, all of the previous resources may be used; however, there is no need to contact Pitt’s Employee Health Department.
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.
COVERAGE FOR INDIVIDUALS TEMPORARILY OUTSIDE THE NETWORK SERVICE AREA
|Panther Gold||Panther Advocate||Panther Premier||Panther Plus||Panther Basic|
|Routine Physicals||No Coverage||70% after deductible||70% after deductible||60% after deductible||50% after deductible|
|Physician Office visit for non-routine care||No Coverage||70% after deductible||70% after deductible||60% after deductible||50% after deductible|
|Urgent Care Clinic Visit||100% after $60 copayment. Must contact PCP for authorization to provider outside of UPMC Health Plan Network (1)||70% after deductible||70% after deductible||60% after deductible||50% after deductible|
|Emergency Room Care||
100% after $125 copayment for adults and $75 copayment for dependents under 19.
(If admitted: 100% after $500 copayment per inpatient stay. *Limit of 2 copayments per benefit period.)
|90% after deductible||90% after deductible||80% after deductible||70% after deductible|
|Follow up care for Urgent and Emergency (i.e. PT)||100% after applicable copayment/visit. Must contact PCP for authorization to non-network provider (1)||90% after deductible||90% after deductible||80% after deductible||70% after deductible|
(1) For Panther Gold members, you must contact your PCP for authorization to a provider outside of the UPMC Health Plan network
(2) For Panther Advocate, Premier, Plus, and Basic members, when receiving care outside of the UPMC Health Plan network, please select a Multiplan/PHCS provider to receive the highest level of benefits. If a non-Multiplan/PHCS provider is utilized benefits will be paid at the out of network rate.
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