View member eligibility and benefits

Health Plans: 

  • UPMC Health Plan

Workflow: 

  • Eligibility and Benefits

View real-time member eligibility and benefits details for UPMC Health Plan members.

  1. Sign in to NaviNet. On the Health Plans menu, click UPMC Health Plan
  2. Under Workflows for this Plan, click Eligibility and Benefits Inquiry. The Patient Search screen appears.
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  3. To find the patient, specify the following search criteria:
    • Member ID and date of birth; or last name, first name, and date of birth. 
    • Date of service. Choose a date up to a year in the past or future.
  4. Click Search. If more than one patient matches your criteria, choose the patient from the list. The Eligibilty and Benefits screen appears for the patient.
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  5. View the patient's coverage details. To view coverage for a specific benefit type, click a benefit on the Benefits panel. If the patient has a Health Reimbursement Account (HRA) balance, view the balance in the top-right corner of the screen. 

For more details about what you can do in this screen, see the Eligibility and Benefits User Guide.

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