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. For nicotine replacement therapy, you may get supplies sent to you from the program or get a prescription from your provider and purchase as described under “Nicotine replacement therapy” on page 74. ALERT! You may attest for an exemption to the PEBB tobacco use premium surcharge if you or a dependent are tobacco-free for two months, enroll in the tobacco cessation program (for members age 18 or older), or access the information and resources aimed at teens in Smokefree Teen (for members ages 13 through 17). Visit the HCA website at hca.wa.gov/erb for details about the surcharge. Smokefree Teen UMP members ages 17 and under may access tobacco cessation support services through the Smokefree Teen program online at teen.smokefree.gov or by calling 1-800-QUIT-NOW (784-8669) (TRS: 711). Transplants You must receive preauthorization from the plan for all transplants (except kidney and cornea). This benefit covers services related to transplants, including professional and facility fees for inpatient accommodation, diagnostic tests and exams, surgery, and follow-up care. Donor coverage If a UMP member receives an organ, eye, or tissue donation from a live donor, the plan pays the standard rate for the donor’s covered expenses as primary, regardless of any other coverage the donor may have. Covered donor expenses include costs to remove the donor’s organ and treat complications directly resulting from the donor’s surgery. Urgent care See the “Emergency room” benefit for care during a medical emergency. 2024 UMP Select (PEBB) Certificate of Coverage 75