​​​​​​​​​Welcome to the page for current Annuitant Health Care Program (AHCP) participants. 

 

UPMC Access in 2019 and Beyond

Highmark developed this website (https://faqs.discoverhighmark.com/) to assist members with finding answers to their questions about UPMC providers and facilities after the Consent Decree expires on June 30, 2019. 

Signature 65 Annuitants
Original Medicare (sometimes called traditional Medicare) is administered by the federal government. All UPMC providers and facilities accept original Medicare and will continue to do so after the Consent Decree expires on June 30, 2019. Signature 65 coverage will continue to be accepted by all UPMC providers and facilities.
Please disregard any communications from UPMC providers or facilities regarding your Highmark insurance coverage no longer being accepted after June 30, 2019.​

Under 65 Annuitants​
Many UPMC providers and facilities in the Pittsburgh and Erie areas will be out-of-network after the expiration of the Consent Decree on June 30, 2019. Members with non-emergency out-of-network benefits can still utilize these providers and facilities, but may be subject to higher cost-sharing and out of pocket costs, such as balance billing.  Members with plans that do not include out-of-network non-emergency benefits will be responsible for the full amount charged for services if they choose to utilize out-of-network providers, including UPMC.

In-Network Facilities (including UPMC)
Click here to view an interactive map of facilities that will be in-network for Highmark members after June 30, 2019, subject to your plan and benefit design. The full listing of in-network UPMC facilities can be found further down that webpage.

A few notable UPMC facilities that will be in the network beyond June 30, 2019, are:

  • ​Western Psychiatric Institute and Clinic
  • UPMC Children's Hospital of Pittsburgh
  • UPMC Northwest
  • UPMC Jameson
  • UPMC Horizon
​​For a full listing of facilities and their Highmark 2019 network status after the end of the consent decree, please click here​.

UPMC Cancer Care
Members may continue to receive cancer care from UPMC providers at the UPMC Cancer Care Centers and Joint Venture Cancer Cancers listed here, subject to your plan and benefit design.

UPMC Unique Services
Members will continue to have in-network access for the
following services that are unique to UPMC in Western Pennsylvania: 

  • UPMC Center for Assistive Technology
  • UPMC Center for Excellence for Treatment of Cystic Fibrosis
  • Select transplants, including: live-donor liver, lung, heart-lung, and small bowel

 

Forms

Address Change
 - Form function depends upon web browser/device, send your updated information via email

 

​Additional Information

Note: If enrolled in Signature 65, members submit out of network claims directly to Highmark using the address on ​the back of their ID card and label the claim as a "foreign claim." The claim will be processed against the Major Medical benefit as Medicare would not apply.  


Helpful Links

Medicare          - www.medicare.gov                 1-800-633-4227
Social Security - www.socialsecurity.gov          1-800-772-1213​
 
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