ALERT: Continuous glucose monitors are not covered under the DME benefit. They are covered under the prescription drug benefit. See the “Diabetes care supplies” benefit for more information. Finding a network DME supplier You may purchase DME through a medical supplier. To find a network DME supplier, visit the UMP provider search (see Directory for link). You do not have to sign in to the Regence member site to search for a provider, but you will get more personalized results if you do. Click on the “All categories” link (found beneath “Doctors by name” and “Doctors by specialty”). Type “durable medical” into the search box; a drop-down list will appear. Select “Durable Medical Equipment & Supplies.” You should now have a list of network DME suppliers. Different DME suppliers carry different types of supplies. You may need to call to confirm that a supplier has what you need. Commercial DME You may purchase DME on Amazon by signing in to your Regence account and going to the Regence medical supplies webpage at regence.com/member/medical-supplies/. Select “Get started” in the Shop smart and save section. This will take you to the Amazon page where you will select and shop from one of the four categories for DME supplies: • Post-mastectomy • Illness and injury • New parents • Manage a condition You pay 100 percent of the billed charge and submit a claim for reimbursement. To submit a claim, select “Start your claim” in the “How to get repaid” section on the Regence medical supplies webpage at regence.com/member/medical-supplies/. The plan will reimburse you 85 percent of the allowed amount for covered DME supplies purchased through Amazon. To learn more contact UMP Customer Service. Emergency room TIP: If you need immediate care but your situation is not a medical emergency, see the “Urgent care” benefit for how to get treatment at a lower cost than in an emergency room. You pay a $75 copay and coinsurance for each emergency room visit, in addition to any amount owed toward your medical deductible. The plan covers facility charges for emergency room treatment when the treatment is for covered diagnoses and treatment of an injury. Charges for professional services may be billed separately from facility (hospital or emergency room) charges. When you receive emergency services, you cannot be balance billed. If your emergency room visit is determined to be a medical emergency, it will be paid at the network rate for both network and out-of-network facilities. Separate professional services charges will also be paid at the network rate if your emergency room visit is determined to be a medical emergency. If you are admitted to the hospital directly from the emergency room, the $75 emergency room copay will be waived. However, you must pay the inpatient copay. 54 2024 UMP Plus–PSHVN (PEBB) Certificate of Coverage