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.

Graduate students without academic appointments or Fellows are eligible to choose between the graduate plan (below) and the General Student Medical Plan.

UPMC Panther Blue - Graduate Student Medical Plan
Highlights and Monthly Costs
Effective: September 1, 2020 – August 31, 2021

Carrier: UPMC Health Plan

Available to:

• Graduate Students with an Academic Appointment (GSA, GSR, TA, TF)
• Graduate Students without an Academic Appointment
• Health Sciences Fellows, Pre-Doctoral Fellows, Post-Doctoral Fellows (Dental Residents), Certificate Trainees

Graduate Student Medical Plan Highlights for In-Network Coverage:

• No annual deductible
• No pre-existing condition limitations
• No annual benefit maximum
• Plan pays 100% of covered services after applicable copayment
• Primary care physician: $5 copayment per visit for illness/injury
• Specialist: $10 copayment per visit
• Urgent care: $10 copayment per visit
• Emergency room: $25 copayment per visit
• Inpatient hospital stay: Covered 100%
• Mental health outpatient (e.g., therapy): $5 copay per visit with participating provider; 20% after deductible with non-participating provider
• University Pharmacy: $5 generic/$15 preferred brand/$35 non-preferred brand
• Other Retail Pharmacies: $10 generic/$20 preferred brand/$40 non-preferred brand
• Out of network coverage is provided at a lower benefit level

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

Summary of Benefits     |     Schedule of Benefits     |     Prescription Drug Benefits

Additional Plan and Rider Documents

• Student Plan Policy
• Student Preventive Services Guide
• Student Benefit Modification Rider
• Pediatric Dental Care: Schedule of Benefits  |  Certificate of Insurance
• Pediatric Vision Care: Schedule of Benefits  |  Certificate of Insurance
• Enrolling in Coverage
• Changing Your Benefits

There are three schedules of premiums, based on your student type. The details of the Graduate Student Plan remain the same, regardless of the schedule in which the student participates.

Schedule 1: Graduate Students with an Academic Appointment (GSA, GSR, TA, TF)

Schedule 2: Graduate Students without an Academic Appointment

Schedule 3: Health Science Fellows, Pre-Doctoral Fellows, Post-Doctoral Fellows (Dental Residents), Certificate Trainees

Important Information about Rate Schedules

In order to keep coverage affordable for families with children in the 2020-21 plan, the University is providing subsidies to offset the total cost of the monthly child, children, and family premium for graduate students with an academic appointment. The subsidies are reflected in the premium charts in the Student Health Insurance Summary Guide and on the OHR website.

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.

United Concordia Plus DHMO Premier - Graduate Student Dental Plan
Highlights and Monthly Costs
Effective: September 1, 2020 – August 31, 2021

Carrier: United Concordia

Available to:

• Graduate Students with or without an Academic Appointment
• Health Sciences Fellows, Pre-Doctoral Fellows, Post-Doctoral Fellows (Dental Residents), Certificate Trainees

Graduate Student 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

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     |     Certificate of Coverage

Manage Your Dental Benefits
College Tuition Benefit

Davis Vision 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 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’s is one of a select few vision care programs in the country with NCQA’s Certification in Credentialing, maintained since 2004. Davis Vision’s labs and Customer Service Center are the only ones in managed vision care to be certified to ISO 9001:2008 standards. Davis Vision 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 labs.

Davis Vision – Student Vision Plan
Highlights and Monthly Costs    
Effective: September 1, 2020 – August 31, 2021

Carrier: Davis Vision

Available to:

• Graduate Students with and without an Academic Appointment
• Health Sciences Fellows, Pre-Doctoral Fellows, Post-Doctoral Fellows (Dental Residents), Certificate Trainees
• Full-time undergraduate students

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

For questions regarding the Vision plan, contact Davis Vision at 1-877-923-2847 and enter Client Control Number 4382 when prompted.

Details of the Plan

Review the Details of the Student Vision Plan for additional information

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.

Graduate students without academic appointments or Fellows are eligible to choose between the graduate plan (below) and the General Student Medical Plan.

UPMC Panther Blue - Graduate Student Medical Plan
Highlights and Monthly Costs
Effective: September 1, 2019 – August 31, 2020

Carrier: UPMC Health Plan

Available to:

• Graduate Students with an Academic Appointment (GSA, GSR, TA, TF)
• Graduate Students without an Academic Appointment
• Health Sciences Fellows, Pre-Doctoral Fellows, Post-Doctoral Fellows (Dental Residents), Certificate Trainees

Graduate Student Medical Plan Highlights for In-Network Coverage:

• No annual deductible
• No pre-existing condition limitations
• No annual benefit maximum
• Plan pays 100% of covered services after applicable copayment
• Primary care physician: $5 copayment per visit for illness/injury
• Specialist: $10 copayment per visit
• Urgent care: $10 copayment per visit
• Emergency room: $25 copayment per visit
• Inpatient hospital stay: Covered 100%
• University Pharmacy: $5 generic/$15 preferred brand/$35 non-preferred brand
• Other Retail Pharmacies: $10 generic/$20 preferred brand/$40 non-preferred brand
• Out of network coverage is provided at a lower benefit level

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

Summary of Benefits     |     Schedule of Benefits     |     Prescription Drug Benefits

Additional Plan and Rider Documents

• Student Plan Policy
• Enrolling in Coverage
• Changing Your Benefits

There are three schedules of premiums, based on your student type. The details of the Graduate Student Plan remain the same, regardless of the schedule in which the student participates.

Schedule 1: Graduate Students with an Academic Appointment (GSA, GSR, TA, TF)

*4th child under age 21 is free

Schedule 2: Graduate Students without an Academic Appointment

*4th child under age 21 is free

Schedule 3: Health Science Fellows, Pre-Doctoral Fellows, Post-Doctoral Fellows (Dental Residents), Certificate Trainees

*4th child under age 21 is free

Important Information about Rate Schedules

The 2019-2020 Student Health Insurance Rate Filing Guidance issued by the Pennsylvania Insurance Department has mandated how fully-insured student health insurance plans can develop family premiums in 2019. This change requires that the individual premium rate applies to each person on the family plan equally, including the student subscriber, spouse, and each dependent child. Prior to this year, the University was able to rate dependent children premiums in a way that was reflective of their total health care costs, and therefore lower than the subscribers and spouses.

In order to keep coverage affordable for families with children in the 2019-2020 plan, the University is providing subsidies to offset the total cost of the monthly child, children, and family premium for graduate students with an academic appointment. The subsidies are reflected in the premium charts in the Student Health Insurance Summary Guide and on the OHR website. For more information, please visit the insurance.pa.gov website.

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.

United Concordia Plus DHMO Premier - Graduate Student Dental Plan
Highlights and Monthly Costs
Effective: September 1, 2019 – August 31, 2020

Carrier: United Concordia

Available to:

• Graduate Students with or without an Academic Appointment
• Health Sciences Fellows, Pre-Doctoral Fellows, Post-Doctoral Fellows (Dental Residents), Certificate Trainees

Graduate Student 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

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     |     Certificate of Coverage

Davis Vision 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 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’s is one of a select few vision care programs in the country with NCQA’s Certification in Credentialing, maintained since 2004. Davis Vision’s labs and Customer Service Center are the only ones in managed vision care to be certified to ISO 9001:2008 standards. Davis Vision 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 labs.

Davis Vision – Student Vision Plan
Highlights and Monthly Costs    
Effective: September 1, 2019 – August 31, 2020

Carrier: Davis Vision

Available to:

• Graduate Students with and without an Academic Appointment
• Health Sciences Fellows, Pre-Doctoral Fellows, Post-Doctoral Fellows (Dental Residents), Certificate Trainees
• Full-time undergraduate students

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

For questions regarding the Vision plan, contact Davis Vision at 1-877-923-2847 and enter Client Control Number 4382 when prompted.

Details of the Plan

Review the Details of the Student Vision Plan for additional information