UPMC Standard Network In-Network Hospitals*

UPMC Standard Network ERIE McKEAN WARREN POTTER CRAWFORD The UPMC Health Plan Standard FOREST MAP LEGEND ELK CAMERON VENANGO Network consists of doctors, MERCER JEFFERSON hospitals, and other medical CLARION Home Location LAWRENCE providers located within the 28 BUTLER CLEARFIELD counties in our service area, shown ARMSTRONG BEAVER < 25 at left. You will be covered for 25 – 99 INDIANA Number of 100 – 499 In-Network ALLEGHENY 500 – 2,499 services as outlined in your plan CAMBRIA BLAIR Physicians 2,500 – 3,999 documents when you seek care WESTMORELAND HUNTINGDON WASHINGTON from the participating providers within the Standard Network. SOMERSET BEDFORD FAYETTE GREENE In-network hospitals* Allegheny Select Specialty Hospital – Children’s Hospital of Pittsburgh of Pittsburgh UPMC St. Clair Hospital Eye & Ear Institute The Children’s Home of Pittsburgh Heritage Valley Health System – The Children’s Institute Heritage Valley Sewickley UPMC East Kindred Hospital – Pittsburgh UPMC McKeesport Kindred Hospital – Pittsburgh UPMC Mercy North Shore UPMC Montefiore LifeCare Hospitals of Pittsburgh – UPMC Passavant – McCandless Main UPMC Presbyterian LifeCare Hospitals of Pittsburgh – UPMC St. Margaret Suburban UPMC Shadyside Magee-Womens Hospital of UPMC Western Psychiatric Institute and Ohio Valley Hospital Clinic of UPMC Select Specialty Hospital – McKeesport Armstrong Elk Mercer Armstrong County Memorial Penn Highlands Elk – St. Mary’s Grove City Medical Center Hospital Campus UPMC Horizon – Greenville UPMC Horizon – Shenango Valley Beaver Erie Heritage Valley Health System – Corry Memorial Hospital Potter Heritage Valley Beaver Millcreek Community Hospital Cole Memorial Select Specialty Hospital – Erie Bedford UPMC Hamot Somerset UPMC Bedford Memorial Conemaugh Meyersdale Medical Fayette Center Blair Highlands Hospital Somerset Hospital Nason Hospital Uniontown Hospital Windber Medical Center Tyrone Hospital UPMC Altoona Greene Venango Southwest Regional Medical Center UPMC Northwest Butler Butler Memorial Hospital Huntingdon Warren UPMC Passavant – Cranberry J.C. Blair Memorial Hospital Warren General Hospital Cambria Indiana Washington Conemaugh Memorial Medical Indiana Regional Medical Center Monongahela Valley Hospital Center Washington Hospital Conemaugh Miners Medical Center Jefferson Lee Campus of Conemaugh Penn Highlands Brookville Westmoreland Memorial Medical Center Punxsutawney Area Hospital Excela Frick Hospital Select Specialty Hospital – Excela Latrobe Hospital Johnstown Lawrence Excela Westmoreland Hospital Ellwood City Hospital Select Specialty Hospital – Clarion Jameson Hospital – North Campus Laurel Highlands Clarion Hospital Jameson Hospital – South Campus Clearfield McKean Penn Highlands Clearfield Bradford Regional Medical Center Penn Highlands DuBois Kane Community Hospital Crawford Meadville Medical Center Titusville Area Hospital *Network provider information is current as of January 15, 2015, but is subject to change from time to time. As such, some network providers may have been added or removed from the list since this To search for a participating document was created. UPMC Health Plan recommends that you contact Member Services to provider, please visit confirm that the information is current. www.upmchealthplan.com/find. U.S. Steel Tower, 600 Grant Street Pittsburgh, PA 15219 www.upmchealthplan.com Copyright 2015 UPMC Health Plan Inc. All rights reserved. STNDRD NETWORK INFO SHEET 14SAM0630 (MJA) 2/9/15 10M KP.

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