Preventive care for specified chronic conditions UMP covers services and supplies when prescribed to prevent the worsening of a diagnosed chronic condition or the development of a secondary condition. You pay coinsurance, but these services or supplies are not subject to any applicable deductible when received from a preferred or participating provider. Prescription drug benefit • Certain medications covered through the prescription drug benefit as outlined on the UMP Preferred Drug List; • Continuous glucose monitors (purchase at a network pharmacy to avoid balance billing); or • Glucometers (purchase at a network pharmacy to avoid balance billing). Medical benefit • Blood pressure monitor if you have a diagnosis of high blood pressure; • Hemoglobin A1c testing, and retinopathy screening if you have a diagnosis of diabetes; • International Normalized Ratio (INR) testing if you have a diagnosis of liver disease and/or bleeding disorders; • Low-Density Lipoprotein (LDL) testing if you have a diagnosis of heart disease; or • Peak flow meter if you have a diagnosis of asthma. Covered immunizations You pay the standard rate for covered immunizations that are not considered preventive. The plan covers immunizations listed on the Centers for Disease Control and Prevention (CDC) applicable immunization schedule (children, adolescents, adults) for U.S. residents. For a list of immunizations covered as preventive, visit the CDC website at cdc.gov/vaccines/schedules/index.html or contact UMP Customer Service. Some covered immunizations are classified as “may be recommended” by the CDC depending on medical condition or lifestyle. For those immunizations to be covered as preventive, you must meet the criteria specified on the CDC schedule. Immunizations covered under the preventive rate are not subject to your deductible. Covered immunizations given by the providers listed under the “Where to get immunizations” section below are paid under the preventive care benefit. If you see an out-of-network provider for covered preventive immunizations, you pay 40 percent of the allowed amount and the provider may balance bill you. Flu shots and COVID-19 vaccines are paid at 100 percent regardless of the provider’s network status. TIP: The plan covers flu shots and COVID-19 vaccines listed on the applicable CDC immunization schedule. For a list of immunizations covered as preventive, find a link to the CDC immunization schedules at the CDC website at cdc.gov/vaccines/schedules/index.html or contact UMP Customer Service. Where to get immunizations You pay $0 for immunizations covered under the preventive care benefit when received from a: • Preferred or participating provider. 2024 UMP CDHP (PEBB) Certificate of Coverage 67