FILE A COMPLAINT WITH UPMC HEALTH INSURANCE / EXPRESS SCRIPTS

Hayden’s Pharmacy –

UPMC HEATLH INSURANCE PLAN

EXPRESS SCRIPTS COMPLAINT FORM

The following is a digital complaint form to file your concerns with the recent change announced by UPMC Health Plan.

YOU AS THE PATIENT are being told your access to pharmacy services is limited in rural Westmoreland County.

YOU AS THE PATIENT purchase your health insurance plan and now have limited access to pharmacies, forcing you to travel farther out of the area.

COMPLAINT AGAINST UPMC HEALTH PLAN INSURANCE / EXPRESS SCRIPTS

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UPMC Health Plan and Express Scripts pharmacy benefits manager has eliminated your choice on where you can get your prescriptions filled.
This is the registration portal for FILING A COMPLAINT with the Office of the Inspector General - Health Insurance for the state of Pennsylvania.
PLEASE COMPLETE THE FOLLOWING:

Patient Last name *

Patient First Name *

Patient Gender *

Male

Female

Patient Date of Birth *

Patient Address *

Apartment, Suite, or Floor

City *

State *

County * County

Zip Code *

Patient's Email *

Patient's Phone / Patient's Cell Phone:

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Hayden’s Pharmacy –

UPMC HEATLH INSURANCE PLAN

EXPRESS SCRIPTS COMPLAINT FORM