• Home health aides and clinical social services, provided in conjunction with the skilled services of a registered nurse (RN), licensed practical nurse (LPN) or physical, occupational, or speech therapist • Disposable medical supplies as well as prescription drugs provided by the home health agency • Home infusion therapy • Home care of wounds resulting from injury or surgery • End-of-life counseling (see page 55) For services that may be covered under another benefit, such as nutritional counseling or follow-up care for bariatric surgery, see that benefit in this COC for coverage rules and limitations. These limitations apply even if the services are provided in the home or by a home health provider. For information on substitution of private duty nursing as an alternative benefit in lieu of hospitalization or in lieu of admission to a skilled nursing facility, see page 61 (hospital services) or page 69 (skilled nursing facility). Contact UMP Customer Service if you have questions. Hospice care Support network provider type: You must use a UMP Plus–UW Medicine ACN provider or a covered provider within the support network to receive network level benefits (see description in the “Support network providers” section). Hospice (inpatient, outpatient, and respite care) is services provided by a state-licensed hospice program in the home or in a hospice facility to terminally ill patients. Services include pain relief care and support services that address the needs of terminally ill members and their families without intent to cure. Medical Hospice services received from network providers are covered at 100 percent of the allowed amount after you meet your medical deductible. The plan covers hospice care for terminally ill members for no more than six months. See page 55 for coverage of end-of-life counseling. If you need hospice care, your provider will refer you to the program. For additional assistance, you may contact UMP Customer Service. Prescription drugs For covered prescription drugs, UMP members in hospice care receive special coverage when using network pharmacies, including the network specialty drug pharmacy and the network mail-order pharmacies. The plan pays for all covered prescription drugs purchased through a network pharmacy at 100 percent of the allowed amount for members in hospice care. This applies only to the member in hospice care. All quantity limits, preauthorization requirements, and coverage limits apply. 2024 UMP Plus–UW Medicine ACN (PEBB) Certificate of Coverage 59