StayInformed


The contract between Highmark and UPMC expires 12/31/14. This is a confusing time for many consumers who are affected.

 

Note: Questions regarding access to a specific provider/facility or continuity of care for an ongoing medical condition should be directed to Highmark member services and/or your provider.  For other questions, please see the resources below.

 

Consumer Resources: 

 

Points of Contact:

 

 

Pennsylvania Insurance Department

Email When submitting an email, please include your first and last name, address and phone number.

Call toll-free: 1-877-881-6388

  • Help consumers understand the agreements (consent decrees), how the agreements may affect them and that change is coming.
  • Offer questions to consider when choosing health insurance.
  • Assist with filing complaints.
  • For general health questions, visit www.PAHealthOptions.com.

 

 

Department of Health, Bureau of Managed Care

Email When submitting an email, please include your first and last name, address and phone number.

Call toll-free: 1-717-787-5193

 

  • Assist with continuing care concerns when a member is in an ongoing course of treatment.
  • Discuss local provider access when a UPMC provider is the only available provider in the area for a particular service.
  • Ensure one-year Safety Net provision of consent decree is being properly applied to patient care (i.e., if a Highmark covered individual saw a UPMC physician during calendar year 2014, and is unable to find a Highmark participating physician in their locality, then that individual can remain with the UPMC physician during calendar year 2015. DOH will investigate inquiries involving the safety net provision.)
  • Answer questions regarding access to Children’s Hospital, Western Psychiatric Institute and Clinic of UPMC, and UPMC hospitals outside of Allegheny County and its adjacent counties (the Exception Hospitals).

 

 

Office of the Attorney General

Email When submitting an email, please include your first and last name, address and phone mumber.

Call toll-free: 1-877-888-4877

  • Assist with filing complaints and other legal matters related to the consent decrees. 

 

 

APPRISE Program

Call toll-free: 1-800-783-7067

Visit www.aging.pa.gov

  • Provide free, health insurance counseling fo older Pennsylvanians with Medicare.
  • Answer questions about Medicare and provide objective, easy-to-understand information about Medicare, Medigap Insurance, Medicaid, and Long-Term Care Insurance.

 

 

MEDICARE

Call Toll-free: 1-800-MEDICARE (or 1-800-633-4227)

Visit www.medicare.gov

  • Provide information on Medicare, including comparisons of Medicare and Medigap plans.

 

 

Highmark

Current Members: 1-800-345-3806 or call the number on the back of your ID card

  • Provide information on access to a specific provider or facility.
  • Answer questions on continuity of care for an ongoing medical condition.
  • Answer benefit questions about your health insurance coverage.

 

 

UPMC

Current Members: 1-800-646-8762

  • Provide information on access to a specific provider or facility.
  • Answer questions on continuity of care for an ongoing medical condition.
  • Answer benefit questions about your health insurance coverage.

 

(Page updated 11/18/14)