Important information regarding Highmark Medicare-eligible patients

In a unanimous decision last week, the Pennsylvania Supreme Court confirmed that calendar year 2018 will be the last full year that most UPMC hospitals and physicians in western Pennsylvania will be in-network for Highmark Medicare Advantage members. You can read about the decision here.
 
This ruling provides much-needed clarity to Medicare beneficiaries a full three months prior to the start of the 2019 Annual Election Period. UPMC is grateful the Supreme Court expeditiously reached this decision, allowing Medicare beneficiaries ample time to make the best choices for their health care.
 
Medicare beneficiaries who choose a Highmark Security Blue or Freedom Blue product for 2019 will have in-network access to UPMC in the Greater Pittsburgh and Erie areas through June 30, 2019 only. In-network access to UPMC’s world-class primary and specialty care doctors and hospitals for the entire 2019 plan year and future years will be available to seniors through a multitude of other Medicare Advantage insurers. 
 
Please remember that 2019 Medicare Advantage plans and provider options CANNOT be discussed with Medicare beneficiaries prior to October 1, 2018.
 
Effective July 1, 2019, the following UPMC hospitals will be out-of-network for all Highmark Medicare Advantage products:

• UPMC East
• UPMC Hamot
• UPMC Magee-Womens Hospital
• UPMC McKeesport
• UPMC Mercy
• UPMC Passavant
• UPMC Presbyterian Shadyside (includes UPMC Montefiore and the Eye & Ear Institute, but does not include Western Psychiatric Institute and Clinic of UPMC)
• UPMC St. Margaret

UPMC wants to ensure that Medicare-eligible patients have as much time as possible to prepare for these important changes. As a result, UPMC will be starting the process of letting affected Medicare beneficiaries know about these changes shortly. Frequently Asked Questions and other materials will be available to help you educate your clients. 
 
For more information, please contact your UPMC Health Plan Sales Executive or Account Manager.