All PlansCoverageMedium impact
UPMC Health Plan medical drug coverage updates
UPMC Health Plan·Provider Announcement
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
UPMC Health Plan has implemented changes to medical drug coverage policies effective January 1, 2025, affecting all lines of business. The announcement directs providers to visit their pharmacy services website for specific details and contact Provider Services with questions.
Action Required
Immediately: Visit upmchp.us/pharm-services-medical to review specific medical drug coverage changes that took effect January 1, 2025. Billing team should identify which medical drugs and procedures are affected and update prior authorization requirements or coverage policies accordingly. Contact UPMC Provider Services at 1-866-918-1595 for clarification on specific coverage changes.