Highmark in Western Pennsylvania
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
Member booklet summarizing the consent decree information
Members who have been treated by a UPMC physician for pregnancy in 2015 are eligible to deliver at Magee Hospital in 2016. Please contact myCare Navigator at 1-888-BLUE-428 for more information.
Consent Decree and Transition Plan Information
The Pennsylvania Insurance Department and the Pennsylvania Department of Health have collaborated to create a website to help consumers cut through the confusion and navigate the changes that could occur to health care coverage as a result of the Highmark and UPMC contract termination. View the website: http://www.stayinformed.pa.gov
Pennsylvania Insurance Department finished their review of Highmark’s transition plan. The transition plan is Highmark’s operational details that will be followed in order to insure the objectives of the consent decree are achieved.
Review the Transition Plan Summary
Review the Transition Plan
On June 27, 2014 a consent decree was reached by UPMC and Highmark which provides for transition of care for members in the event that a continuing agreement between the two parties is not reached by December 31, 2014. This document addresses many of the issues concerning members in western Pennsylvania, including oncology services, emergency services, and services provided by certain medical providers in the area of pediatrics and behavioral health.
Review the Consent Decree