Questions about Health Insurance

For more than 125 years, UPMC Children's Hospital of Pittsburgh has provided high-quality health care to all of the region’s infants, children, teenagers, and young adults regardless of their health insurance coverage or ability to pay.

On June 24, 2019, UPMC announced a new, 10-year agreement between UPMC and Highmark, providing Highmark members with in-network access to all UPMC facilities and physicians in western PA. The agreement also included an extension of the contract between UPMC Children’s Hospital of Pittsburgh and Highmark.

  • All UPMC Children's locations, Children's Express Care, and Children's Community Pediatrics offices and physicians, are in-network for all major insurance providers, including Highmark.
  • Our agreements with the health insurance centers cover all of our services from primary care visits (including Children's Community Pediatrics) to hospitalization, and everything in between. 
  • We continue to provide care for many of our patients well into their 20s and beyond.

If you have questions or concerns about access to Children's doctors or locations, please call us at 412-692-7600 from 8 a.m. to 4 p.m., Monday through Friday. 

Frequently Asked Questions

Q: Are all the services on Children’s campus in Lawrenceville, including imaging, lab, and therapy, considered in-network for all health insurance companies?

A: Yes. All services on the Children's campus in Lawrenceville are in-network for all health insurance products available in western Pennsylvania.

Q: If I live in Uniontown, Pa. can I still take my kids to the local Children's Community Pediatrics office?

A: Yes. All of the Children’s Community Pediatrics office locations are included in all health insurance plans available in western Pennsylvania.

Q: Can I still take my kids to the Children’s Specialty Care Center in Erie if I have Community Blue commercial health insurance?

A: Yes. All of Children’s services and locations are considered in-network for all Highmark products, including Community Blue commercial plans.

Q: We have Highmark insurance and my child is scheduled to have ear tubes put in at the Children’s North Surgery Center in 2019. Will the surgery be covered?

A: Yes. All of the services that Children’s and its physicians provide at all Children's locations are considered in-network for all Highmark products.

Q: Do Children’s and its physicians participate with all of the Medicaid Health Maintenance Organizations (HMOs) in western Pennsylvania?

A: Yes. Children’s Hospital, Children’s Community Pediatrics, and all of its physician specialists are considered in-network providers for all of the Medicaid HMOs.

Q: I have Aetna Insurance and my husband’s new company offers United Healthcare. Does Children’s participate in those health plans?

A: Yes. Children’s and all of its physicians and services are considered in-network providers for all health insurance plans available in western Pennsylvania, including Aetna, Cigna, Health America/Coventry, Highmark, United Healthcare, and UPMC Health Plan.

Q: I am a 47-year-old with congenital heart disease. I have been a patient at Children’s since I was born. Am I still able to be cared for at Children’s even if I have a Highmark insurance product?

A: Yes. Children’s has a special program – the Adult Congenital Heart Disease program – that cares for adult patients who were born with heart disease throughout their lifetime. (Children's offers other adult programs too.)

Q: My son has irritable bowel disease (IBD). He turns 18 next month and has always been cared for by Children’s Hospital gastroenterologists. Can I still bring him to Children’s after he turns 18?

A: Yes. There is no strict cutoff age for our patients. Many of our patients have had their conditions and diseases since childhood, and we may care for them well into their 20s and beyond. Children’s doctors work with patients and their families to help them transition to an adult physician when the time is right. This time may be different for each young adult and family.

Q: If Children’s and its physicians are considered in-network providers, do I still need to pay my deductible, co-insurance, and/or copay?

A: Yes. Depending on your plan’s level of coverage, you are still responsible for those out-of-pocket costs.

Q: If I have a Highmark insurance product and my newborn needs intensive care, can my baby still come to Children’s?

A: Yes. All of the subspecialty services provided by Children’s, including Newborn Medicine, continue to be in-network.

Q: My child sees a pediatric ophthalmologist and optometrist. Are those services considered in-network if I have Highmark insurance?

A: Yes, you can still receive those services, including purchasing eye glasses, at the UPMC Eye Center at Children’s (which has locations in Lawrenceville and at Pine Center in Wexford).