Specialty drugs are high-cost injectable, infused, oral, or inhaled prescription drugs or products that require special handling and storage and are subject to additional rules. You may find out if a drug is a specialty drug by checking the UMP Preferred Drug List on the UMP Prescription drug coverage webpage, or by contacting WSRxS Customer Service (see Directory for link and contact information). Specialty drugs are covered under the cost-share tier listed on the UMP Preferred Drug List. Specialty drugs are covered only when purchased through the plan’s network specialty drug pharmacy. If that pharmacy does not have access to a specialty drug, you will be notified to fill your prescription at another specialty drug pharmacy. If the network specialty drug pharmacy gains access to the specialty drug, you will receive notification to transfer your prescription to that pharmacy. You may receive up to a 30-day supply for most specialty prescription drugs per prescription or refill. However, some may be limited to a 15-day supply due to high discontinuation rate, short duration of use, or to make sure that the prescription drug is not causing harmful side effects. Specialty drugs require preauthorization. See “Preauthorizing prescription drugs” on page 100 for how to request preauthorization. A patient care coordinator will work with you to schedule a delivery time for the prescription drug. The specialty drug pharmacy will deliver your prescription drugs anywhere in the U.S. that you choose, such as to your workplace or to a neighbor if you cannot be home for the delivery. Specialty prescription drugs often require special handling and storage. The plan is not responsible for replacement of lost, stolen, expired, or damaged prescription drugs or products (see the “What the plan does not cover” section). If your provider will be administering the prescription drug, you may have it shipped to the provider’s office. However, once the provider’s office receives the prescription drug, the provider takes responsibility for it. The plan’s network specialty drug pharmacy cannot ship outside the U.S. See “Travel overrides for prescription drugs” on page 104 if you will be traveling. Prescription cost-limit for specialty drugs ALERT! The prescription cost-limit is the most you will pay for an individual prescription. However, you may pay less based on normal coinsurance (see the "What you pay for prescription drugs" section). See the “How the prescription drug cost-limit works” section for details about the prescription cost-limit. This limit applies to individual prescriptions only. See the “Your prescription drug out-of-pocket limit” section for the annual limit to your prescription drug costs. Specialty drugs are usually limited to no more than a 30-day supply. The prescription cost-limit for a 30- day (or under) supply corresponds to the “You pay” column in the table found in the "How the prescription drug cost-limit works" section. However, some specialty prescription drugs are available only in packages with more than a 30-day supply. In such cases, the prescription cost-limit shown in the table found in the "How the prescription drug cost-limit works" section is calculated by multiplying the standard 30-day prescription cost-limit amount as follows: • A 31- to 60-day supply, multiply the standard prescription cost-limit by two. • A 61-day and greater supply, multiply the standard prescription cost-limit by three. 102 2024 UMP Select (PEBB) Certificate of Coverage