Provider Search – Medicare Advantage Plans

To locate a network provider nearest to you, select the type of provider you would like to see.

  1. Provider Search – Search for primary care providers and specialists in your area.
  2. Hospital Search – Search for hospitals in your area.
  3. Facility Search – Search for ancillary providers in your area, including audiology, dialysis, durable medical equipment, physical therapy, and more.
  4. Pharmacy Search– Search for pharmacies that participate with the plan. If you need to locate a pharmacy outside of Michigan’s Upper Peninsula please click here. (Clicking this link will take you away from UPHP’s website.) (Scroll down for additional Pharmacy information.)
  5. Dentist Search – Search for dentists that participate with the plan.
    (Clicking this link will take you away from UPHP’s website.)
  6. Live Fit Fitness Center Search – Search for a participating fitness center near you.

This searchable directory provides a list of Upper Peninsula Health Plan ‘s (UPHP) network providers.

This directory is for all counties of the Upper Peninsula of Michigan, including: Alger, Baraga, Chippewa, Delta, Dickinson, Gogebic, Houghton, Iron, Keweenaw, Luce, Mackinac, Marquette, Menominee, Ontonagon, and Schoolcraft counties.

This searchable directory is updated daily. We do not guarantee that each provider is still accepting new members. To get the most up-to-date information about UPHP’s network providers in your area, you can call UPHP Customer Service at 1-877-349-9324 (TTY: 711), Monday through Friday from 8 a.m. to 9 p.m. Eastern time, with weekend hours Oct. 1 through March 31.  The call is free.

This information is available in a printed document and may be available in an alternate format such as Braille, larger print or audio. To request alternate formats call UPHP Customer Service at 1-877-349-9324 (TTY: 711), Monday through Friday from 8 a.m. to 9 p.m. Eastern time, with weekend hours Oct. 1 through March 31. The call is free.

This searchable directory provides a list of UPHP’s network providers. To get detailed information about your health care coverage, please see your UPHP Evidence of Coverage.

You will have to choose one of our network providers that are listed in this directory to be your primary care provider (PCP). Generally, you must get your health care coverage from your PCP. A PCP is the provider you see first for your medical care. Your PCP will refer you to other providers when necessary.

The “network providers” in this directory have agreed to provide you with your health care and vision coverage. You may go to any of our network providers in this directory; however, some services may require a referral. If you have been going to one network provider, you are not required to continue going to that same provider. In some cases, you may get covered services from non-network providers.

If you see a provider that is not part of our network for any reason and you receive a bill, you should not pay that bill. Instead, send the bill to UPHP. We will review the bill to determine if your care is covered by UPHP. If it is, we will pay your bill for you. We will contact you in writing if we determine that you are responsible for any part of the bill.

You must use providers in our network for your medical care. If you wish to see a doctor that is not part of our network, in most cases you will need a referral from your PCP and prior approval from UPHP. There are some circumstances in which a referral and prior approval is not required. These circumstances include emergency and urgent care. If you are traveling outside of the Upper Peninsula of Michigan and have an emergency or urgent situation, go to the nearest hospital or urgent care facility. The hospital or urgent care facility must contact UPHP if you are admitted or if you need further out of area care.

Emergency care can always be obtained in or out of the service area from the nearest available provider. When in the service area you must use plan providers for urgent care. When out of the service area, urgent care may be obtained from the first available provider. If you obtain routine care from out-of -network providers, neither Medicare nor UPHP will be responsible for the costs.

You must use plan providers except in emergency or urgent care situations or for out-of -area renal dialysis. If you obtain routine care from out-of -network providers, neither Medicare nor UPHP will be responsible for the costs.

What is the service area for UPHP?

The service area for this plan includes all counties in the Upper Peninsula of Michigan: Alger, Baraga, Chippewa, Delta, Dickinson, Gogebic, Houghton, Iron, Keweenaw, Luce, Mackinac, Marquette, Menominee, Ontonagon, and Schoolcraft counties in Michigan.

How do you find UPHP providers in your area?

To locate a network provider nearest you in this searchable directory, first locate the type of provider you would like to see and then look for the state, county and city nearest you. All of the providers in this directory accept Medicare and Medicaid members of UPHP.

If you have questions about UPHP or require assistance in selecting a PCP, please call UPHP Customer Service at 1-877-349-9324 (TTY: 711), Monday through Friday from 8 a.m. to 9 p.m. Eastern time, with weekend hours Oct. 1 through March 31.

UPHP has contracts with pharmacies that equal or exceed requirements of the Centers for Medicare and Medicaid Services (CMS) for pharmacy access in your area. UPHP has contracts with many pharmacies in the service area.

We generally cover drugs filled at an out-of-network pharmacy only when you are not able to use a network pharmacy. Here are the circumstances when we would cover prescriptions filled at an out-of-network pharmacy.

Plan drugs may be covered for up to a 30-day supply in special circumstances—for instance, illness while traveling outside of the plan’s service area where there is no network pharmacy. You may have to pay more than your normal cost-sharing amount if you get your drugs at an out-of-network pharmacy. In addition, you will likely have to pay the pharmacy’s full charge for the drug and submit documentation to receive the reimbursement from UPHP. Depending on your income and institutional status, you will be reimbursed by UPHP up to the full cost of the drug, minus the copayment. In these situations, please check first with Customer Service to see if there is a network pharmacy nearby.

To find a pharmacy that participates with UPHP, use the search tool above. This search provides a list of UPHP network pharmacies. To get a complete description of your prescription coverage, including how to fill your prescriptions, please review the UPHP Evidence of Coverage and Formulary. Our pharmacy search tool allows you to search for pharmacies in your area by pharmacy type and county.

To use the search tool to locate a pharmacy in your area, you can search any of the following ways:

  1. Identify the “Pharmacy Type” you are looking for (retail, home infusion, long-term care, mail order, I/T/U); or
  1. Search and locate the “Pharmacy Type” section within this directory; or
  1. Search and locate the “County” you are looking for (counties are listed in alphabetical order); or
  1. Search and locate the “City” you are looking for (cities are listed in alphabetical order); or
  1. Search and locate a pharmacy by “Pharmacy Name” (pharmacies are listed in alphabetical order).

We call the pharmacies on this list our “network pharmacies” because we have made arrangements with them to provide prescription drugs to plan members. In most cases, your prescriptions are covered under UPHP only if they are filled at a network pharmacy or through our mail order pharmacy service. Once you go to one pharmacy, you are not required to continue going to the same pharmacy to fill your prescription but can switch to any other of our network pharmacies. We will fill prescriptions at non-network pharmacies under certain circumstances as described in your UPHP Evidence of Coverage.

Mail Order Pharmacies

You can get prescription drugs shipped to your home through our network mail order delivery program.  For refills of your mail order prescriptions, please contact us 14 days before you think the drugs you have on hand will run out to make sure your next order is shipped to you in time. Typically, you should expect to receive your prescription drugs 14 day from the time that the mail order pharmacy receives the order. If you do not receive your prescription drug(s) within this time, please contact Customer Service at 1-877-349-9324 (TTY: 711) Monday through Friday from 8 a.m. to 9 p.m. Eastern Time, with weekend ours Oct. 1 through March 31. The call is free.

Home Infusion Pharmacies

Search the list of UPHP network pharmacies to find a home infusion pharmacy provider in your area.

Long-term Care Pharmacies

Residents of a long-term care facility may access their prescription drugs covered under UPHP through the facility’s long-term care pharmacy or another network long-term care pharmacy.

Indian Health Service / Tribal / Urban Indian Health Program (I/T/U) Pharmacies

Only Native Americans and Alaska Natives have access to Indian Health Service/Tribal/Urban Indian Health Program (I/T/U) Pharmacies through UPHP’s pharmacy network. Those other than Native Americans and Alaskan Natives may be able to access these pharmacies under limited circumstances (i.e. emergencies).

If you would like a hard copy of the UPHP Provider and Pharmacy Directory mailed to you, please contact us.

H2161_2019_WP0001, Approved
Page Last Updated: 10/1/2018