Pittsburgh

Pittsburgh (Plan 106)

DO YOU HAVE A PRIMARY CARE PROVIDER (PCP)?

Our Health Fund

Care Coordinators:
(866) 686-0003

Phone Hours:
Monday-Friday
8:30am-10:00pm Eastern Time

Care Coordinators

Your Care Coordinators are here to help with your benefit and healthcare questions. We can help you find a provider, submit enrollment forms and claims, update your information and much more.

And when your Primary Care Provider (PCP) calls us before your specialist visit, you pay a lower copay.

Call us with ALL your questions: (866) 686-0003 

 

View claims, manage your health and more here.

UNITE HERE HEALTH—Our Health Fund

What does it mean to have our own health fund?

Find a Doctor

Don’t go out of network! It costs too much money!

Find a Primary Care Provider (PCP) and your nearest Urgent Care Center (UCC) here.
If you need help finding any kind of doctor, just call (866) 686-0003 or use BCBS Blue Access for Members.

 

Pharmacy

Hospitality Rx now manages your pharmacy benefits! Please view their website for more details.

Copays

  What you pay
When you use a nework or mail order pharmacy
Generic drugs $3 copay
Preferred brand name drugs $12 copay
Non-preferred brand name drugs $27 copay

Benefits

The Pittsburgh Plan (106) has three classifications: I, II, III.  If you’re not sure what classification you have, just call us: (866) 686-0003.

Download a copy of your “Benefits at a Glance.” It is an overview of your benefits, but some information may have changed.

Call us to double-check what class you’re in and to make sure what you’re looking for hasn’t changed: (866) 686-0003

 

Benefits at a Glance, Class I

Benefits at a Glance, Class II

Benefits at a Glance, Class III

 

View your SPD here: Pittsburgh

After each SPD is published, certain changes may have been made to your benefits. These changes are reflected in a Summary of Material Modifications (SMM) that are mailed to each member. View these SMMs on our library page. (Click your plan button under "Atlantic City Region".)

1-2-3 Program

Three easy steps will take you closer to better health.  We promise it’s worth your time.

Call us (866-686-0003) and tell us:

     Your Primary Doctor (we can help you find one and schedule an appointment)
     Your Basic Blood Work – click here for details
     A bit of your health history – English or Spanish

If you’re good at using the web, you can go ahead and submit this information through your member account here.

Prior Authorization and Forms

Certain types of care require “prior authorization” or approval. This helps us to keep quality high and costs low and forces doctors and nurses to talk better to each other about the care you receive.

  • Save money on specialist copays by getting a referral from your primary care provider (PCP). When your PCP calls us BEFORE your specialist visit, your copay gets lowered by HALF.
  • Have your doctor call us before you get a service listed on the back of your ID card.

Get prior authorization
Call: (877) 266-9991

Forms

Here are some forms you may want to print and fill out.

Call us if you need help understanding these forms: (888) 437-3480

Coordination of BenefitsDisability

Life Insurance BeneficiaryVision Reimbursement Form

Enrollment Biometrics

Specialist Referral and Pre-notification Form

Health/Care Profile - English / Español
 

Pharmacy forms

Appeal FormMail Order Form

Prior Authorization Initiation FormReimbursement Claim Form