About UPMC Health Plan Coverage in Berwick
UPMC Health Plan operates 8 distinct networks in Berwick, PA, with a combined in-network roster of 35 doctors across 15 medical specialties. Among the five largest insurers we track in Berwick, UPMC Health Plan ranks #5 by provider count, the leader is Aetna with 80 in-network doctors. Use this page to confirm a specific provider is in-network, understand which UPMC Health Plan networks have the widest reach in Berwick, and compare coverage against other major insurers before scheduling care.
UPMC Health Plan publishes its Berwick directory at the network level rather than the consumer-plan level. The labels on each row below (for example COUNTY OF CAMBRIA - PPA4X-PPO PLAN) are network identifiers, not the plan names printed on your member ID card. Your specific plan typically maps to one of these networks, but the mapping isn’t exposed in the federal filing. Match the doctor’s name first, then call the office with your member ID to confirm your plan is accepted.
UPMC Health Plan is a Medicare Advantage carrier in Berwick with 3 plans available to seniors, listed below with star ratings and premiums. UPMC Health Plan does not currently sell ACA marketplace plans in PA; commercial coverage shown above comes through employer groups.
Data is sourced from the federally-mandated CMS Transparency in Coverage filings that every insurer must publish monthly. Medicare Advantage plans come from the CMS MA Landscape File. Last refreshed May 29, 2026. Networks change between filings, so even when a doctor appears here we recommend calling their office with your member ID to confirm current network status before your visit.
UPMC Health Plan Networks in Berwick
UPMC Health Plan contracts with doctors at the network level in Berwick. Each network below is a contract; your specific plan (printed on your member ID) maps to one of them.
COUNTY OF CAMBRIA - PPA4X-PPO PLAN
35
EMERGENCY MEDICINE - EPA7S-Advantage Gold EPO
35
Total Advantage EPO - NEP3I
33
UPMC HealthyU HIA HMO - IHF36
31
UPMC HealthyU HRA PPO - UPF52
31
Gold HSA $3,000/$0 - NASH6
17
Gold HSA $3,000/$0 - NASEK
12
UPMC Business Advantage EPO - NEP1W
11
UPMC Health Plan Medicare Advantage Plans in Berwick
3 UPMC Health Plan Medicare Advantage plans available to seniors in Berwick. Each plan combines Medicare Parts A, B and usually D (prescription drugs) into one product, with star ratings and monthly premiums shown.
Star ratings (1-5) reflect overall plan quality measured by CMS. a 4-star plan generally indicates above-average member experience and care coordination. Premiums shown are the monthly cost on top of the standard Medicare Part B premium.
Source: CMS Medicare Advantage Landscape File. Star ratings reflect overall plan performance per CMS quality measures. Premiums shown are monthly Part C+D consolidated.
Top Specialties Accepting UPMC Health Plan
UPMC Health Plan’s Berwick network spans 15 distinct medical specialties. The mix reflects where the insurer has negotiated the deepest physician contracts. primary-care specialties and behavioral health tend to dominate, with surgical and sub-specialty networks typically narrower.
Click any specialty below to see a filtered list of just those in-network providers in Berwick, including ratings, locations, years of experience, and contact information. For specialties with fewer than 10 in-network providers, you’ll likely want to check nearby cities too. the section further down on this page has your geographic options.
Top Hospitals Serving UPMC Health Plan Patients in Berwick
Hospitals with the most UPMC Health Plan-network physicians practicing there. Large affiliation counts indicate that UPMC Health Plan has a durable relationship with the facility, which typically means smoother prior-authorizations for admissions, lab work, and follow-up care coordinated under one roof.
Hospital coverage is a separate contract from physician coverage. your UPMC Health Plan plan may cover a doctor who admits at Hospital X but classify the hospital itself as out-of-network, leaving you with a surprise facility bill. Before scheduling anything inpatient or procedural, call both the doctor’s office and the hospital billing line with your member ID to confirm both sides are in-network for the specific plan you hold.
Geisinger Medical Center
Danville, PA
Lehigh Valley Hospital - Hazleton
Hazleton, PA
Geisinger-bloomsburg Hospital
Bloomsburg, PA
Geisinger Wyoming Valley Medical Center
Wilkes Barre, PA
Wilkes-barre General Hospital
Wilkes-barre, PA
Troy Community Hospital
Troy, PA
Coverage Compared in Berwick
Side-by-side provider counts for the five largest commercial and government insurers tracked in Berwick. These numbers show raw network breadth. they don’t adjust for quality, specialty mix, or your specific plan’s tier structure, but they’re a useful first filter when choosing a carrier at open enrollment.
If UPMC Health Plan’s provider count looks limited for your needs, the alternatives below may fit better. Click any row to open that insurer’s Berwick provider list with the same filters, plan breakdown, and hospital affiliations that you’re seeing here.
Nearby Cities with UPMC Health Plan Coverage
Cities closest to Berwick where UPMC Health Plan has an in-network provider base of meaningful size. Useful if you’re willing to drive a short distance for a hard-to-find specialist, have two offices to choose between, or are planning a move inside the region.
The mileage figures are straight-line distances computed from average practice-address coordinates, not drive-time. Counts reflect each nearby city’s UPMC Health Plan network size. a small count doesn’t mean no coverage, just that your in-Berwick options are likely more plentiful.
Frequently Asked Questions
Common questions about UPMC Health Plan coverage in Berwick
How do I find an UPMC Health Plan in-network doctor in Berwick, PA?
UPMC Health Plan has 35 in-network providers across 15 medical specialties in Berwick. This list is compiled from federally-mandated CMS Transparency in Coverage filings, last verified May 29, 2026. Filter by specialty, plan type, gender, telehealth or experience above to narrow your search, then click any provider for full credentials and contact details. Always confirm coverage with your specific plan before scheduling.
Does UPMC Health Plan offer Medicare Advantage in Berwick?
Yes. UPMC Health Plan offers 3 Medicare Advantage plans in Berwick for 2026, with plan types including HMO, PPO, HMO D-SNP. The average CMS star rating across these plans is 4.3 of 5. Medicare Advantage (Part C) bundles Parts A and B with usually Part D prescription drug coverage, often adding dental, vision, and wellness benefits. Enrollment is open during the annual election period each fall.
What's the highest-rated UPMC Health Plan Medicare Advantage plan in Berwick?
UPMC for Life HMO No Rx (HMO) (HMO) holds UPMC Health Plan's top CMS star rating in Berwick at 4.5 of 5. Star ratings reflect overall plan quality based on member experience, customer service, drug pricing, and clinical care measures. Plans rated 4 or higher generally indicate above-average performance.
Which hospitals in Berwick accept UPMC Health Plan?
Hospitals where UPMC Health Plan doctors most commonly practice in Berwick include GEISINGER MEDICAL CENTER, LEHIGH VALLEY HOSPITAL - HAZLETON, GEISINGER-BLOOMSBURG HOSPITAL, GEISINGER WYOMING VALLEY MEDICAL CENTER. This is inferred from physician affiliations rather than direct insurer-hospital contracts, so confirm hospital network status separately with both your UPMC Health Plan plan and the hospital's billing department before scheduling any inpatient or surgical procedure. Even when a doctor is in-network, the hospital where they admit may not be.
Which medical specialties have the most UPMC Health Plan providers in Berwick?
UPMC Health Plan's Berwick network is largest in Optometry (9), Physician Assistant (5), Certified Registered Nurse Anesthetist (crna) (4). Primary care, behavioral health, and physical therapy tend to dominate insurer networks because high patient volumes drive deeper provider contracts. Surgical sub-specialties typically have narrower networks. Click any specialty in the section above to see a filtered list of those in-network providers.
How does UPMC Health Plan compare to other insurers in Berwick?
UPMC Health Plan ranks #5 of 6 major insurers tracked in Berwick by provider count, with 35 doctors. Aetna leads at 80 providers. Larger network size means more provider choice but doesn't guarantee that your specific doctor is in-network with any insurer. The Coverage Compared section above shows side-by-side counts for the top five carriers in Berwick.
Why don't I see specific UPMC Health Plan plan names like Bronze or Silver?
UPMC Health Plan files its Berwick provider directory at the network level rather than by consumer plan name. The labels above (such as COUNTY OF CAMBRIA - PPA4X-PPO PLAN) are the network identifiers UPMC Health Plan uses internally. Your specific plan, whether commercial group, Medicare, or Medicaid, maps to one of these networks but the federal filing format doesn't expose which plan goes with which network. To verify your exact plan covers a specific doctor, call the provider with your member ID handy.
How do I verify a doctor is in-network with UPMC Health Plan?
Three steps: first match the doctor's name against this list, second call the provider's office with your member ID to confirm they currently accept your specific UPMC Health Plan plan, and third check UPMC Health Plan's own member portal for the most authoritative real-time status. Networks change between monthly federal filings; our data was last refreshed May 29, 2026.
What if my doctor isn't listed here?
This list reflects UPMC Health Plan's submitted network data as of the last federal filing on May 29, 2026. Doctors join and leave networks between filings, so a current in-network provider may be missing if they joined recently. Call the doctor's office to ask whether they currently accept UPMC Health Plan, then check UPMC Health Plan's own member portal for confirmation.
When was this UPMC Health Plan data last updated?
The UPMC Health Plan Berwick provider list was last refreshed May 29, 2026. Doctor and network data come from the federally-mandated CMS Transparency in Coverage filings that every insurer must publish monthly. Medicare Advantage plans come from the CMS MA Landscape File. Refresh cadence: monthly for provider data, annually for marketplace and Medicare plans.
Related healthcare resources
Patient resources for Berwick UPMC Health Plan members.
Common health topics
Common medications
Common procedure costs
Data freshness
Last verified May 29, 2026 · Source: CMS Transparency in Coverage federal filings · Refresh cadence: monthly