• Computed tomography (CT) • Computed tomography angiography (CTA) • Magnetic resonance angiography (MRA) • Magnetic resonance imaging (MRI) • Myocardial perfusion imaging (MPI) • Nuclear cardiology: ▪ Blood pool imaging ▪ First pass ventriculography ▪ Infarct imaging ▪ Multiple-gated acquisition (MUGA) scan • Positron emission tomography (PET and PET-CT) Second opinions This benefit covers: • Second opinions you choose to get. The plan covers these under the medical benefit, once you meet your medical deductible and pay the coinsurance. • Second opinions required by the plan. The plan covers these at 100 percent (you do not have to meet your medical deductible or pay the coinsurance). If you do not get a second opinion when required by the plan, coverage for services may be denied. • Expert Second Opinion program. This program, provided by 2nd.MD, offers members the opportunity to consult virtually with specialists. It also provides for expert lead consultation and post- consultation follow-up support. To learn more visit the 2nd.MD website at 2nd.md/ump or call 1-866- 982-1434 (TRS: 711). Skilled nursing facility Skilled nursing facility services are paid at the inpatient rate. The plan must preauthorize services before you are admitted to a skilled nursing facility (see the “Limits on plan coverage” section). In addition, the facility must notify the plan within 24 hours of your admission (see page 110). This benefit covers skilled nursing facility charges for services, supplies, and room and board, including charges for services such as general nursing care made in connection with room occupancy. The plan covers up to 150 days per calendar year. Room and board is limited to the skilled nursing facility’s average semiprivate room rate, except where a private room is determined to be medically necessary. The plan does not cover stays at a skilled nursing facility that are primarily convalescent or custodial in nature. Private duty nursing furnished by a licensed home health agency may be substituted as an alternative to placement at a skilled nursing facility only if: • Skilled nursing facility care is medically necessary, not primarily convalescent or custodial in nature, and would be covered by the plan; • Private duty nursing is the most cost-effective setting (private duty nursing must be an equal or lesser cost compared to a nursing facility); and • The member's provider agrees that private duty nursing is medically appropriate and will adequately meet the member's needs. 68 2024 UMP Classic (PEBB) Certificate of Coverage