UPMC Health Plan Coverage for

17 Plans

Managed Medicaid - HMO - Medicaid

$$$$$
Non-preferred
PA requirements
Quantity Limit

Medicare - MA-PD

$$$$$
Specialty
PA requirements
Step therapies
Quantity Limit

Medicare - PDP

$$$$$
Specialty
PA requirements
Step therapies
Quantity Limit

Commercial - HMO

$$$$$
Specialty
PA requirements
Step therapies
Quantity Limit

Commercial - PPO

$$$$$
Specialty
PA requirements
Step therapies
Quantity Limit

Commercial - Other Insurer

$$$$$
Specialty
PA requirements
Step therapies
Quantity Limit

Commercial - Employer

$$$$$
Specialty
PA requirements
Step therapies
Quantity Limit

Health Exchange - PPO-HIX

$$$$$
Specialty
PA requirements
Step therapies
Quantity Limit

Managed Medicaid - HMO - Medicaid

$$$$$
Non-preferred
PA requirements

Medicare - MA-PD

$$$$$
Specialty
PA requirements

Medicare - PDP

$$$$$
Specialty
PA requirements

Commercial - HMO

$$$$$
Non-preferred
PA requirements
Step therapies

Commercial - PPO

$$$$$
Non-preferred
PA requirements
Step therapies

Commercial - Other Insurer

$$$$$
Non-preferred
PA requirements
Step therapies

Commercial - Employer

$$$$$
Non-preferred
PA requirements
Step therapies

Health Exchange - PPO-HIX

$$$$$
Non-preferred
PA requirements
Step therapies

Managed Medicaid - HMO - Medicaid

$$$$$
Non-preferred
PA requirements
Step therapies
Quantity Limit