Highmark’s Marketplace 2018 plans exclude nearly all UPMC Pinnacle facilities and providers


HARRISBURG — Highmark’s Marketplace plans for 2018 exclude nearly all UPMC Pinnacle’s facilities and providers, according to a press release issued by UPMC Pinnacle.

As a result, some UPMC Pinnacle patients are experiencing confusion and frustration, because only the UPMC Pinnacle Carlisle hospital and AllBetterCare are included in the My Direct Blue EPO network, the release says.

Except for emergency and out-of-area urgent care, Highmark My Direct Blue EPO members will receive no coverage for care received at any other UPMC Pinnacle facility or providers in 2018.

Capital BlueCross considers all UPMC Pinnacle providers and facilities to be in network for its marketplace plans. Those facilities include UPMC Pinnacle Harrisburg, West Shore, Carlisle, Lancaster, Lititz, Memorial, and Hanover.

UPMC Pinnacle patients wanting to continue care with UPMC Pinnacle should consider Capital BlueCross marketplace plans, the press release says.

Marketplace plans are plans that are offered to individuals and families for purchase at healthcare.gov. Some patients who are shopping for plans and checking the provider directories are disappointed to learn that coverage of UPMC Pinnacle providers and facilities is not available for Highmark plans.

Before selecting a plan, UPMC Pinnacle is encouraging its patients who purchase their own individual coverage to carefully check a health plan’s network to ensure their UPMC Pinnacle facility and provider of choice are included.