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. Until your prescription drug deductible is met: • The member pays the normal coinsurance for Value Tier and Tier 1 covered prescription drugs, subject to the prescription cost-limit (see the "How the prescription drug cost-limit works" section). • The member pays the full cost (allowed amount at a network pharmacy) for covered Tier 2 prescription drugs. For covered insulins, the member pays the normal coinsurance for Value Tier, Tier 1 and Tier 2 up to the prescription cost-limit (see the "How the prescription drug cost-limit works" section). Covered insulins are not subject to your prescription drug deductible. After you meet your prescription drug deductible, you pay $0 for all covered prescription drugs purchased through a network pharmacy for members in hospice care. This applies only to the member in hospice care. All quantity limits, preauthorization requirements, and coverage limits apply. ALERT! The member pays the full cost for noncovered prescription drugs. If the member purchases covered prescription drugs from a non-network pharmacy, the plan pays under the normal prescription drug benefit as described in the following sections: “What you pay for prescription drugs,” “How the prescription drug cost-limit works,” and “Your prescription drug out-of-pocket limit.” Prescriptions purchased from an excluded pharmacy will not be covered. See the definition of “Excluded pharmacy.” Respite care Respite care is continuous care of more than four hours a day to give caretakers temporary relief from caring for a member who is homebound or in hospice. The plan covers these services at 100 percent of the allowed amount after you meet your medical deductible, up to 14 visits per the member’s lifetime. Death with Dignity The Washington Death with Dignity Act allows terminally ill adults seeking to end their life to request lethal doses of prescription drugs. These terminally ill patients must be Washington residents who have less than six months to live. For more information about this Act, see chapter 70.245 RCW. Care described under this Act includes services covered by UMP, subject to standard plan requirements. If you have questions about medical services UMP covers, contact UMP Customer Service. If needed, UMP may assign a case manager to support you. If you have questions about prescription drugs UMP covers, contact WSRxS Customer Service. If your current provider is unable to meet your needs, or if you need assistance in finding a provider for these services, visit End of Life Washington’s website at endoflifewa.org. End of Life Washington is a community resource available to support the public in finding available providers. For more information about the Death with Dignity Act, visit: • The Department of Health’s website at doh.wa.gov/YouandYourFamily/IllnessandDisease/DeathwithDignityAct. 2024 UMP Classic (PEBB) Certificate of Coverage 55