TIP: You do not have to enroll in the tobacco cessation program to get coverage of nicotine replacement therapy or prescription drugs for tobacco cessation. See below for limits and rules on accessing these services. Nicotine replacement therapy The plan covers only certain nicotine replacement therapy products (such as gum, patches, sprays, inhalers, tablets, or lozenges) at the preventive rate. Those that are preventive are listed as “Preventive” in the Tier column on the UMP Preferred Drug List. The plan does not normally cover over-the-counter drugs, but the plan covers nicotine replacement products when they are purchased at a network pharmacy using your UMP member ID card. You may get nicotine replacement therapy directly from the tobacco cessation program (see the “Tobacco cessation program” section below), or by following these steps: 1. Get a prescription from your provider. 2. Take the prescription to a network pharmacy. 3. Make your purchase at the pharmacy counter of a network pharmacy. Give your prescription and your UMP member ID card to the pharmacist. The purchase must be submitted through the prescription drug system to be covered. If you do not provide a valid prescription at the pharmacy counter, the plan will not cover it. If you get a nicotine replacement therapy product not designated as preventive, the plan will not cover it, and you will pay the full cost. To request full coverage of non-preventive nicotine replacement therapy for a medical reason, see “How to request an exception” below. The plan does not cover e-cigarettes or vaporizers (“vapes”). Counseling The plan covers in-person counseling related to tobacco cessation at the preventive rate when you see a network provider. Phone or online counseling is covered only through the Tobacco cessation program described below. UMP members ages 17 and under may use the Smokefree Teen program as explained below. How to request an exception To request coverage of a prescription drug or nicotine replacement therapy not usually covered under this benefit, see “Requesting an exception for noncovered prescription drugs” on page 87 for how to request an exception. If your exception is approved, you will receive the approved product or prescription drug at no cost. Tobacco cessation program UMP members age 18 or older may participate in the tobacco cessation program. The program offers a variety of resources, including phone counseling, medications, personalized coaching, web tools, educational materials, nicotine replacement therapy, and other resources to help you stop tobacco use. It also offers a free personalized quit plan and has been proven to help individuals quit more successfully than trying to quit without support. To learn more, visit the UMP Care programs webpage at ump.regence.com/pebb/benefits/programs. If you get nicotine replacement therapy or prescription drugs for tobacco cessation that are not listed as “Preventive” in the Tier column on the UMP Preferred Drug List, you will pay as described in the “Nicotine replacement therapy” section on page 74. 74 2024 UMP Plus–PSHVN (PEBB) Certificate of Coverage