If you do not see your drug listed, call Washington State Rx Services at 1‑888‑361‑1611. UMP Select uses Regence BlueShield’s largest network of providers. Uniform CDHP covers all the same services as Uniform Medical Classic. You should confirm with your insurance provider that the doctor you select participates with your insurance plan. All plans pay for covered preventive services like annual checkups, and certain screenings and vaccines at no cost to you when you see a network provider. UMP Classic uses Regence BlueShield’s largest network of providers, but has a lower deductible than UMP Select and UMP Consumer Directed Health Plan (CDHP). We're sorry, but you arrived at this page by accident. %PDF-1.7 UMP Classic: How the plan covers Medicare retirees Search. With UMP Select, you pay $0 for covered preventive care when you see a network provider. Uniform Medical Plan Classic Find a Provider. Commercial and Uniform Medical Plan Pre-authorization Lists Added clarification effective May 1, 2020: Surgical Treatments for Hyperhidrosis (Surgery #165) CPT 32664 only requires pre-authorization for hyperhidrosis diagnoses L74.510 L74.511, L74.512, L74.513, L74.519, L74.52, R61 7:30 a.m. to 5:30 p.m. (Pacific) UMP Classic (2019) UMP Consumer-Directed Health Plan (UMP CDHP) (2019) UMP Plus—Puget Sound High Value Network (PSHVN) (2019) UMP Plus—UW Medicine Accountable Care Network (UW Medicine ACN) (2019) > Plan Differences to Consider. UMP Select also covers the full cost of certain programs to quit smoking or manage diabetes. ... here: Seeing providers and Medicare This change allows you to access all UMP benefits information in one place. UMP CDHP uses Regence BlueShield’s largest network of providers. Get medical insurance for your life and budget. Monday through Friday NOTE: Information about the cost of this plan (called the premium) will be provided separately. To accomplish this, we must continuously be looking forward and planning for what's to come. See formularies and get help when making cost-conscious choices about prescription medications. UMP Plus–UW Medicine ACN is a network of providers offering high quality, coordinated care at a lower cost. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 11 0 R 12 0 R 13 0 R 14 0 R 15 0 R 16 0 R 17 0 R 18 0 R 19 0 R 20 0 R 21 0 R 22 0 R 23 0 R 24 0 R 25 0 R 26 0 R 27 0 R 28 0 R 29 0 R 30 0 R 31 0 R 32 0 R 33 0 R 34 0 R 35 0 R 36 0 R 37 0 R 38 0 R 39 0 R 40 0 R 41 0 R 42 0 R 43 0 R 44 0 R 45 0 R 46 0 R 47 0 R 48 0 R 49 0 R 50 0 R 51 0 R 52 0 R 53 0 R 54 0 R 55 0 R 56 0 R 57 0 R 58 0 R 59 0 R 60 0 R 61 0 R 62 0 R] /MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Uniform Medical Plan (UMP) Classic (Non-Medicare) (PEBB) Coverage for: Individual/Family | Plan Type: PPO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. A plan’s network consists of doctors, specialists, clinics, hospitals, pharmacies, and other health care providers. The SBC shows you how you and the plan would share the cost for covered health care services. 2 0 obj Search. Summary of Benefits & Coverage. Phone: 1-888-849-3681TRS: 711 Pediatrics. See the 2020 Preferred Drug List. <>/Metadata 2571 0 R/ViewerPreferences 2572 0 R>> stream <> UMP is administered by Regence BlueShield and Washington State Rx Services. You pay $0 for office visits with network primary care providers, including pediatricians, and there is no prescription drug deductible. Tools Rating: 8.14 out of 10 (7 Ratings) As part of our effort to make UMP benefits information easier to find, this item has been moved to the UMP website. This page contains benefit information for 2020. Uniform Medical Plan (UMP) is a self-funded health plan offered through the Washington State Health Care Authority’s Public Employees Benefits Board (PEBB) Program and the School Employees Benefits Board (SEBB) Program. View our Mission, Vision, and Values . For most services, you can see a specialist without a referral. You can now find it, and related information, here: How UMP and Medicare work together This change allows you to access all UMP benefits information in one place. All medical plans require you to pay an annual deductible before the plan pays for covered services. Willamette Dental Group of Washington, Inc. Life and accidental death and dismemberment (AD&D) insurance, For PEBB Continuation Coverage - Unpaid Leave, For PEBB Continuation Coverage - COBRA (enrolled in Medicare), For PEBB Continuation Coverage - COBRA (not enrolled in Medicare), Life and accidental death & dismemberment (AD&D) insurance, Washington Apple Health (Medicaid) providers, Enroll as a health care professional practicing under a group or facility, Existing Apple Health (Medicaid) providers, Request a Zoom license to connect with patients (during the COVID-19 pandemic), Claims and billing (guides/fee schedules), Provider billing guides and fee schedules, Program benefit packages and scope of services, Autism and Applied Behavior Analysis (ABA) therapy, Access to Care Standards (ACS) and ICD information, Service Encounter Reporting Instructions (SERI), Intensive Residential Treatment (IRT) Teams, Preadmission Screening and Resident Review (PASRR), Program of Assertive Community Treatment (PACT), Medications for opioid use disorder (MOUD), Screening, brief intervention, and referral to treatment (SBIRT), Ground emergency medical transportation (GEMT), King County Superior Court Juvenile Probation Services, Washington State Federally Recognized Tribes, Apple Health (Medicaid) drug coverage criteria, Substance use disorder (SUD) consent management guidance, Sign language interpreter contract transition, Children's Mental Health Lawsuit and Agreement, Ricky’s Law: Involuntary Treatment Act (ITA), State Youth Treatment - Implementation (SYT-I) Project, Washington Screening, Brief Interventions, and Referrals to Treatment (WASBIRT-PCI) Project, Children’s Behavioral Health Data and Quality Team, Children's Behavioral Health Executive Leadership Team (CBH ELT), Children and Youth Behavioral Health Work Group (CYBHWG), Family Youth System Partner Round Table (FYSPRT), Evidence-based and research-based practices, Analytics, Research, and Measurement (ARM), Initiative 1: transformation through ACHs, Initiative 2: long-term services & supports, Initiative 3: supportive housing & supported employment, Initiative 4: substance use disorder (SUD) IMD, Medicaid Transformation Learning Symposium, School Employees Benefits Board (SEBB) Program FAQs, Apple Health (Medicaid) quality strategy and compliance oversight, Apple Health (Medicaid) MCO and BH-ASO state contracts, Revised Indian Nation agreements and program agreements, Governor's Indian Health Advisory Council, Washington Prescription Drug Program (WPDP), Multi-payer Primary Care Transformation Model, HCA connects employee ambitions with career goals, Office of Medicaid Eligibility and Policy leads the effort in making access to Apple Health simple, Celebrating HCA’s nurses during National Nurses Week, May 6-12, Community based specialists help people with free or low-cost health care coverage, Military experiences shape personal and professional values, Artist turned graphic designer helps HCA create and maintain hundreds of print and web products, Infants at the Workplace Program provides support and flexibility for new parents, HCA goes ‘above and beyond’ for employees with disabilities, Black History Month celebration was a first at HCA, Apple Health (Medicaid) and managed care reports, Public Employees Benefits Board (PEBB) Program enrollment, School Employees Benefits Board (SEBB) Program enrollment, Washington State All Payer Claims Database (WA-APCD), Behavioral health and recovery rulemaking, Public Employees Benefits Board rulemaking, School Employees Benefits Board rulemaking, Personal injury, casualty recoveries, & special needs trusts, Employee eligibility tools and worksheets, PEBB Continuation Coverage spousal plan questionnaire 2020, Learn more about your customer service options, recorded UMP Plus—Puget Sound High Value Netowrk webinar, recorded UMP Plus—UW Medicine Accountable Care Network webinar, UMP Prescription drug benefit information, Knee or hip replacement and spine care information, UMP Plus—UW Medicine Accountable Care Network, Make the switch to UMP Plus—UW Medicine ACN, Website feedback: Tell us how we’re doing. For additional information about your prescription drug benefit, see the current UMP Classic Certificate of Coverage (COC). Kaiser Permanente WA Classic/Value & SoundChoice These plans require you to seek services by a Kaiser Permanente WA health provider. 3 0 obj Alert: All specialty drugs require preauthorization. Family Medicine. Uniform Medical Plan (UMP)2 UMP Classic $250/person $750/family $2,000/person • $4,000/family Your deductible, copays, and coinsurance for most covered medical services apply. Search. To enroll in this plan, you must live in King, Kitsap, Pierce, Skagit, Snohomish, Spokane, or Thurston county. The plan offers a lower monthly premium than UMP Classic and UMP Plus, but has a higher coinsurance (the amount you pay your provider) than other UMP plans. The SBC shows you how you and the plan would share the cost for covered health care services. Phone: 1-888-361-1611TRS: 711 If information given here is inconsistent with the applicable COC, the rules in the applicable COC will apply. For most services, you can see a specialist without a referral, and you pay $0 for covered preventive care services when you see a network provider. To browse each plan’s network or to find a s… Visit HealthEquity or watch their recorded webinar to discover the many uses for your HSA. %���� You will also have 24/7 access to on-demand virtual care. Compare the UMP Plans Compare the plans chart. UMP Classic also … To enroll in this plan, you must live in Chelan, Douglas, King, Kitsap, Pierce, Snohomish, Thurston, or Yakima county. Monday through Friday 30% of costs until the plan has paid $500 (for PPO, out of state, and non-PPO providers); then any amount over $500 in the member's lifetime (maximum lifetime benefit) This is a summary of UDP plan … UMP is ready to meet your health care needs with several affordable plan options. Information Sessions. Welcome Public Employees Benefits Board (PEBB) Program Members. The State of Washington contributes annually to the account on an individual or family basis. The “network providers” listed in this directory have agreed to provide you with your health care, vision, and dental coverage. Some drugs may show that they are "not covered." To learn more, please call Washington State Rx Services at 888-361-1611. Search. Employees can choose from a two plans through Uniform Medical: Classic Plan or Consumer-Directed Health Plan. Find and compare treatment options, facilities and providers. The Plus plan networks are smaller, as each consists of regional providers spread throughout western Washington. Your health care costs will be significantly lower if you use providers that are within your network. Based on popular searches, we’ve curated the following lists of specialty care doctors accepting Uniform Medical Plan. Pharmacy benefits. Uniform Medical Plan (UMP) Classic (Non-Medicare) (PEBB) Coverage for: Individual/Family | Plan Type: PPO 1 of 9 The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Available outside these hours with limited services.Extended hours: Available November 4, 11, and 18 until 8 p.m. (Pacific) to help answer open enrollment questions. You pay $0 for office visits with network primary care providers, including pediatricians, and there is no prescription drug deductible. Compare health plans; Plan networks; Plan networks: Find a doctor, clinic, or other provider. Be aware, your in-network doctor or hospital may use an out-of-network provider for some services. 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Your coverage depends on what your provider recommends for your condition. Tools Rating: Be the first to rate this item ... (COC) for the member's plan is the source of coverage provisions offered under the plans. The UMP Plus–PSHVN network is a limited network compared to UMP Classic, UMP Select, and UMP CDHP. endobj 5 a.m. to 8 p.m. The following applies to UMP Classic and UMP CDHP. Kaiser Permanente WA CDHP Find a Provider. You will also have 24/7 access to on-demand virtual care. For additional information, or to find a provider, contact Uniform Medical at (888) 849-3681 or visit Uniform Medical Plan for PEBB. When you select a CDHP plan, you are automatically enrolled in a tax-free health savings account (HSA). This change allows you to access all UMP benefits information in one place. MedAdvantage + Rx Classic, and Regence MedAdvantage + Rx Enhanced’s network providers. With UMP Classic, you pay $0 for covered preventive care when you see a network provider. It could include: Inpatient: A hospital, state psychiatric hospital, or in Washington state, a designated Treatment and Evaluation facility.Some admissions require pre-approval. Please see our Health Savings Account webpage for employees enrolled in a CDHP. UMP Plus - Puget Sound High Value … By using providers within your network, your health care costs will be significantly lower than if you use providers outside your network. endobj 4 0 obj Home > Welcome Public Employees Benefits Board (PEBB) Program Members. Saturday 8 a.m. to 4:30 p.m. (Pacific). Deductibles. $100/person $300/family* (Tier 2 and 3 drugs only) $2,000/person Your prescription drug deductible and coinsurance for all covered prescription drugs apply. ABOUT THE DRUGS WE COVER IN THIS PLAN HPMS Approved Formulary File Submissi Version Numberon ID 20104 21, This formulary was updated on 11/24/2020. Notices. See details about UMP Plus provider types and reimbursement.. As part of our effort to make UMP benefits information easier to find, this item has been moved to the UMP website.You can now find it, and related information, here: Preferred vs. out-of-network providers. Under state law, the Uniform Medical Plans (UMP Achieve 1, UMP Achieve 2, UMP Classic, UMP CDHP, UMP High Deductible, UMP Plus – Puget Sound High Value Network, and UMP Plus – UW Medicine ACN) must comply with decisions made by the Health Technology Clinical Committee (HTCC). Find a Provider. Uniform Medical Plan (UMP) is a collection of high-quality, self-insured preferred provider organization (PPO) health plans and accountable care plans offered through Washington State’s Public Employees Benefits Board (PEBB) Program. Plus, have the peace of mind that comes from emergency coverage wherever you’re traveling. For most services, you can see a specialist without a referral. UMP Classic: Does a Medicare retiree need to see preferred providers? To get detailed information about your health care coverage, please see your Evidence of Coverage. Save with a local care team and access the country’s largest provider network. For most services, you can see a specialist without a referral, and you pay $0 for covered preventive care services when you see a network provider. Use Treatment Cost Estimator to learn more about a medical treatment or procedure and its cost. Visit the UMP Plus–UW Medicine ACN website to learn more about the network. With UMP CDHP, you pay $0 for covered preventive care services when you see a network provider. Uniform Medical Plan coverage limits Updates effective 10 /1/2020 The benefit coverage limits listed below apply to these UMP plans: Uniform Medical Plan (UMP) Classic (PEBB) UMP Consumer-Directed Health Plan (UMP CDHP) (PEBB) UMP Plus–Puget Sound High Value Network (UMP Plus–PSHVN) (PEBB) UMP Plus–UW Medicine Accountable Care Network (UMP Plus–UW Medicine ACN) (PEBB) … 1 0 obj Tools Rating: Be the first to rate this item As part of our effort to make UMP benefits information easier to find, this item has been moved to the UMP website. Uniform Medical Plan (UMP) Learn more about the Uniform Medical Plan (UMP) plans, administered by Regence BlueShield and Washington State Rx Services (WSRxS). UMP Plus–PSHVN is a network of providers offering high quality, coordinated care at a lower cost. To visit the PEBB website which provides information and tools to help you compare PEBB medical plans and search medical and pharmacy preferred providers click here. Internal Medicine. You will also have 24/7 access to on-demand virtual care. Certificate of Coverage. UMP Classic also covers the full cost of certain programs to quit smoking or manage diabetes. We apologize for any inconvenience. This allows you to set aside pre-tax money to pay for qualified medical expenses, including prescription drugs and more. You can now find it, and related information, here: Find providers: what is a PCP, and why should I select one? Uniform Medical Plans. With the Uniform Medical Plan, you may choose from the plans listed below. CDHP plans offer lower monthly premiums, a higher deductible, and a higher out-of-pocket limit than most traditional health plans. The employee premium is based on the employee’s choice of plan and coverage for lawful spouses, state-registered domestic partners, and dependent children. When you enroll in UMP CDHP, you are automatically enrolled in a health savings account (HSA) through our HSA partner HealthEquity who manages the account. If you use an in-network doctor or other health care provider, this plan will pay some or all of the costs of covered services. <> Once the money is in your account, it’s yours, and there is no deadline to use it. Certificate of Coverage . x��=ksܸ��]���[wRʦIW*W�}�^�e�\*��jDi�2efdGW�㯻ArH� 8$,�kז��t��h�W��|qd���շ�c�X��׫���q���Շ����:�_m��j��z�xsď~����`o������0��i(XȒL0��/_��wl����/_\��|�����B�Yʀ��Y�>l`�O�v���q��@�a�����qjy��O/_�zq�_F���;��/_� P������0�D�~�l�px�A�N��#=� �������$5��*[x0�&��\�0���� �[��a?�����k�����{��Αbq*�S���?n6������Ŷ�[/_��˷���'�t�����L��EH�i � ��.�#C$��Ձ]�t�\��O��@���Ѩ���u���v{�.�ŭ/. UMP Plus has a lower deductible and monthly premium than UMP Classic while offering most of the same benefits. When you choose a UMP plan, you get an active partner in your health care and a dedicated service team available to answer your questions quickly and help you make the most of your benefits. You get preventive care at no cost to you when you see a a preferred provider. UMP is administered by … It powers everything we do as we work to remove the barriers to oral health care. For most services, you can see a specialist without a referral. Watch a PEBB Information Session which explains all the PEBB plans, enrollment and eligibility by clicking here. UMP Plus has a lower deductible and monthly premium than UMP Classic while offering most of the same benefits. Sign In. For more recent information or other questions, please contact Regence BlueCrosseShieldBlu of Oregon Customer Service, at 1-800-541-8981 for PPO plans or 1-855-522-8896 for HMO plans (for TTY users 711), from 8 a.m. to 8 p.m. … Learn more about your customer service options. Health Care Authority’s (HCA) ... network providers1,2 UMP Classic What you pay preferred providers1,3 UMP Select: What you pay preferred providers1,3 UMP CDHP: What you pay preferred providers1,3 What else you should know Acupuncture4 15% 15% 20% 15% Limited to 16 visits per calendar year. UMP CDHP covers the same services as UMP Classic, but has a lower monthly premium and a higher deductible. NOTE: Information about the cost of this plan (called the premium) will be provided separately. Try our online side-by-side comparison of common medical benefits and costs for services. UMP is administered by Regence BlueShield and Washington State Rx Services. UMP Classic and UMP CDHP: What types of providers can be a primary care provider (PCP)? Uniform Medical Plan (UMP) Classic prescription drug benefit are listed in this booklet, along with how they’re covered. Obstetrics & Gynecology. A plan’s network consists of doctors, clinics, hospitals, specialists, and other health care providers. The UMP Plus–UW Medicine ACN network is a limited network compared to UMP Classic, UMP Select, and UMP CDHP. Due to COVID-19, HCA’s lobby is closed. endobj What are my plan options? Summary of Benefits & Coverage. The certificate of coverage (COC) for the member's plan is the source of coverage provisions offered under the plans. The Classic and CDHP plans share the same large network that includes providers both nationwide and worldwide. Choose a plan that opens doors to top doctors and coordinated, cost-saving networks close to home. UMP Classic and UMP CDHP: Vaccines Given by Out-of-Network Providers Search. Uniform Medical Plan (UMP) is a collection of high-quality, self-insured preferred provider organization (PPO) health plans and accountable care plans offered through Washington State’s Public Employees Benefits Board (PEBB) Program. Visit the UMP Plus–PSHVN website to learn more about the network. Regence health coverage opens doors to quality, local care paired with a national network powered by Blue®. Employees pay a portion of their medical care cost through payroll deduction. , see the current UMP Classic also … Save with a local care team and access the country ’ largest. 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