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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. 

Emergency Services

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.

Assist America

If you will be traveling 100 miles or more from home or in another contry, and you encounter an emergency, Assist America is a resource available to you.

Coverage for Individuals Temporarily Outside the Network Service Area

Coverage for Individuals Temporarily Outside the Network Service Area
  Panther Gold Panther Premier Panther Plus Panther Basic
Routine Physicals No coverage 60% after deductible 60% after deductible 50% after deductible
Physician Office Visits for Non-Routine Care 100% after $20 copayment.  Must contact PCP for authorization to use a provider outside of UPMC Health Plan Network(1) 90% after deductible(2) 80% after deductible (2) 70% after deductible (2)
Urgent Care Clinic Visits 100% after $30 copayment.  Must contact PCP for authorization to provider outside of UPMC Health Plan Network (1) 90% after deductible(2) 80% after deductible (2) 70% after deductible (2)
Emergency Room Care

100% after $80 copayment for adults and $40 copayment for dependents under 19

(If admitted: 100% after $250 copayment per inpatient stay *Limit of 2 copayments per benefit period)

  90% after deductible 80% after deductible  70% after deductible 
Follow up care for Urgent and Emergency (ie. PT) 100% after applicable copayment/visit  Must contact PCP for authorization to non-network provider (1)   90% after deductible (2) 80% after deductible (2)   70% after deductible(2)
Important Information
 
(1) For Panther Gold members, you must contactyour PCP for authorization to a provider outside of the UPMC Health Plan network
 
(2) For Panther 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.
 
(3) Additional assistance is available through Assist America when traveling 100 miles or more from home.  Please visit the Assist America page for additional details.

Your College Student

A parent's guide to understanding a child's medical insurance while away at school.

Your College Student Brochure (PDF)