UPMC for You Customer Service Phone Number — Expert Guide

Where to find the correct UPMC for You phone number

If you are a UPMC for You (Medicaid) member, the single most reliable place to find the correct customer service phone number is your member ID card. The card lists the dedicated Member Services phone number for your plan, your member identification number, and often a TTY relay number. Because UPMC for You operates in multiple counties and has special lines for behavioral health, transportation, and pharmacy, the exact telephone digits on the card are authoritative for your case.

When you cannot access your ID card, go to the official UPMC Health Plan website (https://www.upmchealthplan.com) and navigate to the “UPMC for You” member section or search “Member Services.” The website provides current contact options, secure messaging through the member portal, and downloadable PDFs of plan materials. If you ever doubt a phone number you find online, cross-check it against the phone printed on your card or call UPMC’s main operator at (412) 647-7000 to verify the correct Member Services line for your county and benefit package.

Direct contact options and typical hours

UPMC for You offers multiple channels: the phone number on your ID card for live Member Services, secure messaging in the member portal, and in some regions a local office for in-person help. Standard Member Services hours are typically Monday–Friday, 8:00 a.m.–5:00 p.m. Eastern Time; however, phone lines for urgent clinical or behavioral health issues can be available 24/7. If you have hearing or speech impairments, use the nationwide relay TTY: 711 to access assistance.

When calling, ask specifically for “UPMC for You Member Services” or the department you need — for example, “Transportation/ NEMT,” “Behavioral Health,” “Pharmacy,” or “Billing.” If you cannot reach a resolution by phone, the member portal allows you to upload documents and receive a written case number; keep that case number for follow-up. For non-emergency administrative matters, expect standard response windows: initial case acknowledgment within 2 business days and resolution or a status update within 15–30 calendar days depending on complexity.

What to prepare before you call

Be organized. Have your member ID number, date of birth, and the last four digits of your Social Security number (if required) ready. Note the exact issue: claim denial, prior authorization, pharmacy coverage, transportation denial, or a billing discrepancy. If the issue involves a claim, have the claim number, date of service, provider name, and billed amount available — typical claims questions are resolved faster when you can cite a claim date and provider Tax ID (EIN).

Record the call details: date and time, the name and employee ID of the representative, a written summary of what was agreed, and the case or confirmation number. If the agent gives you a deadline or next-step timeframe (for example, “you will get a written response in 14 days”), write that down. These documented details are essential if you later need to escalate the issue or file an appeal.

Common reasons members call and what to expect

Common call reasons include: eligibility questions, enrollment changes, behavioral health referrals, pharmacy prior authorizations, denied claims, and arranging Non-Emergency Medical Transportation (NEMT). For pharmacy prior authorizations, expect the representative to give you the prescriber’s phone number and the specific coverage criteria; many approvals are processed within 24–72 hours for urgent requests and up to 14 days for standard requests.

If your call is about a denied service or claim, ask the representative to (1) explain the denial reason code, (2) confirm whether documentation can cure the denial, and (3) tell you the formal appeals process and deadlines. Most managed care plans provide an internal appeal process — document the appeal instructions exactly and ask for a written confirmation by mail or secure message.

• Key numbers and web resources: UPMC main operator (412) 647-7000; TTY for relay 711; official web: https://www.upmchealthplan.com (search “UPMC for You”). Always verify the Member Services number on the back of your member ID card before accepting guidance.
• What to request on the call: written confirmation of decisions, a case or reference number, representative name/ID, a clear timeline for next steps (e.g., 14-day review), and instructions for submitting supporting documents (fax number, secure portal link, or mailing address).

Escalation, appeals, and additional resources

If the phone-level resolution is unsatisfactory, the next step is a written internal appeal. Note typical timelines: many internal appeals require submission within 60 days of the denial receipt, but confirm the exact deadline on your denial letter. If the internal appeal does not resolve the matter, you can request an external or state-level fair hearing — Pennsylvania’s administrative hearing process has distinct deadlines (often up to 120 days to request a hearing), so act promptly and keep proof of submission.

Additional resources include your county assistance office and the Pennsylvania Department of Human Services (DHS). DHS resources and the COMPASS portal (https://www.compass.state.pa.us) provide eligibility and grievance guidance for Medicaid enrollees. For legal help with appeals, community legal aid organizations and certified health navigators in Pennsylvania offer pro bono assistance; search “Medicaid appeals assistance Pennsylvania” or contact 2-1-1 for local referrals.