Highmark and UPMC agreement keeps providers in-network

July 11, 2019

A new agreement between Highmark Blue Cross Blue Shield and UPMC allows Medical Plan members to continue using UPMC providers on an in-network basis.

Highmark Blue Cross Blue Shield and UPMC have entered into a new 10-year agreement, brokered by the Pennsylvania Attorney General. As a result, members in western Pennsylvania with Highmark medical coverage through the Board of Pensions may continue using UPMC providers on an in-network basis. Many UPMC hospitals and doctors in Allegheny County, as well as UPMC Hamot in Erie, were expected to become out-of-network providers under the Medical Plan, when their current agreement with Highmark expired June 30.

What this means to you

If you’re covered under the PPO, EPO, or HDHP option and receive care through the national Blue Cross Blue Shield network, this agreement means that you will continue to have access to all UPMC hospitals, doctors, and facilities, subject to standard Medical Plan network copays and plan provisions. Receiving care in-network generally means you pay lower out-of-pocket costs.

If you’re covered under the PPO, EPO, or HDHP option and receive care through the Board's Aetna network option, this agreement will not affect you because all UPMC providers continue to remain in-network for Aetna members.

What you can do

Check the network status of your provider before you go to the doctor, urgent care center, or any healthcare provider, to avoid surprise bills and higher out-of-pocket costs.

  • National Blue Cross Blue Shield network — Visit Highmark’s website and select Find a Doctor or Rx, then click on Find a Doctor, Hospital or other Medical Provider. Under Pick a plan, select BCBS PPO; then type name, hospital, clinic, specialty, or condition, along with location and distance, and click Search. Or, call a dedicated Highmark BCBS service, My Care Navigator, at 866-263-2583 Monday through Friday, from 8 a.m. to 8 p.m. ET.
  • Aetna network — Use the provider search tool; for Select a Plan, under Aetna Open Access Plans choose either Aetna Choice POS II (Open Access) if you are enrolled in the PPO or Aetna Select (Open Access) if you are enrolled in the EPO or HDHP. You can also search by provider type, conditions, and procedures. Or, call Aetna at 800-541-0429 Monday through Friday, 8 a.m. to 5 p.m. ET.

For more information about the new agreement between Highmark Blue Cross Blue Shield and UPMC, visit askHighmark.com. If you have questions about your Medical Plan benefits, call the Board at 800-773-7752 (800-PRESPLAN).