therapy visits per calendar year for covered diagnoses when you see a network provider. The copay will not apply toward your medical deductible, but the copay will apply to the out-of-pocket limit. All visits will apply to the 24-visit limit. You must have a prescription for massage therapy treatment from a covered provider type, such as a physician. The plan does not cover massage therapy when you see an out-of-network provider. ALERT! The plan only covers network massage therapists. To find a network massage therapist, use the UMP Provider search or contact UMP Customer Service (see Directory for link and contact information). Mastectomy and breast reconstruction ALERT! See page 56 for coverage of breast reconstruction or mastectomy services related to gender affirming care. You pay the standard rate for a mastectomy as treatment for disease, illness, or injury, as well as: • Physical complications of all stages of a mastectomy. • Prostheses. • Reconstruction of the breast on which the mastectomy was performed. • Surgery and reconstruction of the other breast to produce a symmetrical appearance. Mental health See the “Behavioral health” benefit. Naturopathic physician services While naturopaths are a covered provider type, naturopaths may recommend services that the plan does not cover. You will pay all costs for excluded and non-medically necessary services, even if your naturopathic physician recommends or prescribes them (see the “Medically necessary or medical necessity” definition for more information). The plan does not cover herbal, homeopathic, or other dietary supplements (including vitamins and minerals, except as described on page 89), even if a covered provider type prescribes them. Nurse line You can speak with a registered nurse 24 hours a day, 7 days a week by calling 1-888-402-4237 (TRS: 711). You will get immediate, professional advice on health questions. Our nurses can help you decide whether you need to see a doctor, go to an urgent care clinic or emergency room or care for yourself at home. The nurse line is provided at no cost to you. 2024 UMP Plus–UW Medicine ACN (PEBB) Certificate of Coverage 63