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Highmark in Western Pennsylvania
 
UPMC No Longer Accept Highmark Medicare Advantage Plans Starting June 30, 2019
State System retirees enrolled in Signature 65 Medicare complement coverage are not impacted with this recent court decision. This only impacts Highmark Medicare Advantage members enrolled in plans like Security Blue, Freedom Blue, or Community Blue. The State System does not offer coverage in any Medicare Advantage plans.
 
Extension Agreements for Certain UPMC Facilities for Highmark Members
In anticipation of the conclusion of the consent decrees that guide the relationship between UPMC and Highmark, Governor Tom Wolf
announced in January 2018 a landmark agreement between UPMC and Highmark that creates terms to provide access to critical, unique
services and to certain hospitals in the commonwealth. The following community hospitals and oncology facilities will be in-network for
Highmark members through the dates listed.
 
Community Hospital County Contract Through Date
  Carlisle Regional   Cumberland 6/30/2025
  Heart of Lancaster   Lancaster 6/30/2025
  Lancaster Regional   Lancaster 6/30/2025
  UPMC Altoona   Blair 6/30/2024
  UPMC Bedford    Bedford 6/30/2024
  UPMC Kane   McKean 6/30/2024
  UPMC Northwest   Venango 6/30/2024
  UPMC Pinnacle - Hanover   York 6/30/2024
  UPMC Pinnacle - Memorial   York 6/30/2025
  UPMC Susquehanna - Lock Haven   Clinton 12/31/2024
  UPMC Susquehanna - Divine Providence Hospital   Lycoming 6/30/2024
  UPMC Susquehanna - Muncy Valley Hosptial    Lycoming 6/30/2024
​  UPMC Susquehanna - Williamsport Hospital   Lycoming 6/30/2024
​  UPMC Susquehanna - Divine Providence Hospital ​  Tioga 6/30/2024
  UPMC Susquehanna - Sunbury   Northumberland 6/30/2024
  Western Psychiatric Institute and Clinic   Allegheny 6/30/2024
 
Oncology Access Through June 30, 2021
Facility Name Location
  Arnold Palmer Cancer Center   Greensburg
  Arnold Palmer Medical Oncology   Mt. Pleasant
  Arnold Palmer Medical Oncology   North Huntingdon
  Butler Health System Medical and Radiation Oncology   Butler
  Heritage Valley Cancer CenterHeritage Valley Cancer Center    Beaver
  Heritage Valley Cancer Center  At UPMC West   Moon Township
  UPMC Cancer Center Medical Oncology   Beaver
  UPMC Cancer Center Medical Oncology   Washington
  UPMC/St. Clair Hospital Cancer Center   Mt. Lebanon
  Washington Health System Radiation Oncology   Washington
 
Oncology Access Through June 30, 2024
Facility Name Location 
  Children's Hospital of Pittsburgh   Pittsburgh
  Grove City Medical Oncology (limited oncology services)   Grove City
  Jameson Radiation Oncology   New Castle
  John P. Murtha Regional Cancer Center   Somerset
  Uniontown Hospital Radiation Oncology Robert E. Eberly Pavilion   Uniontown
  UPMC Cancer Center @ UPMC Altoona   Altoona
  UPMC Cancer Center @ UPMC Horizon   Greenville, Farrell
  UPMC Cancer Center @ UPMC Northwest   Seneca
  UPMC Cancer Center Medical Oncology    Johnstown
  UPMC Cancer Center Medical Oncology   Uniontown
  UPMC Cancer Center Medical Oncology   Greenville
  UPMC Cancer Center Medical Oncology   Windber
 
Facilities and Provider Networks in Western PA and Nationwide
 
Additional Resources for Employees

Highmark/UPMC Employee Presentation 

 

Videos summarizing Consent Decree

This video was created in 2015 by Highmark and although some information may no longer be relevant, the majority of the information still pertains

to the current Highmark/UPMC situation in western PA.

·          Click Here to view the video

 

myCare Navigator Information click here to view

Representatives that can assist with your questions regarding:

·      Finding a provider

·      Transferring medical records

·      Making an appointment

·      Assist with health care concerns

 
Consent Decree and Transition Plan Information
Refer to the Pennsylvania insurance department website for more information on the consent decree and transition plan.