ALERT! The plan does not cover other mail-order pharmacies outside of UMP’s network mail- order pharmacies if UMP is your primary insurance. If UMP is your secondary insurance, you may use another mail-order pharmacy. Refills may be ordered through UMP’s network mail-order pharmacies. When using UMP’s network mail- order pharmacies, the same prescription drug deductible, coinsurance, preauthorization requirements, and limits on coverage apply as for prescription drugs purchased at retail network pharmacies. ALERT! Drugs can be expensive. If you are not able to be home to receive the drug in the mail, it may be a good idea to request that it be sent with a requirement for a signature or find an alternate point of delivery to ensure the package is not stolen. 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). Prescriptions mailed, or orders placed in December but not filled until January 1 or after, are subject to your prescription drug deductible applicable on the date the prescription is processed. Because of increased volume at the end of the year, prescriptions submitted to the network mail-order pharmacies in December may not be processed during the current plan year. If there is a shortage of a specific prescription drug that UMP’s network mail-order pharmacies cannot control, and it does not have the quantity you ordered, the network mail-order pharmacies will contact you to discuss your options for obtaining your prescription(s). ALERT! Some Durable Medical Equipment (DME) items are not available through UMP’s network mail-order pharmacies. You will need to get them through a network retail pharmacy or preferred DME provider. How to get the plan discount Be sure to fill your prescriptions at a network pharmacy and show your ID card at the pharmacy counter. If you do, you pay for covered prescription drugs based on the allowed amount (WSRxS’ standard reimbursement). If you do not show your UMP member ID card at a network pharmacy or you use a non- network pharmacy, then you may be charged a higher amount. If the amount charged is more than the UMP allowed amount, you will pay the difference in addition to your coinsurance. Prescriptions purchased from an excluded pharmacy are not covered. If you have more than one insurance plan and UMP is your secondary insurance, show both plan member ID cards at the pharmacy and make sure they know which plan pays first so the pharmacy may bill the plans in the correct order. Non-network pharmacies: Retail You will save money when you buy your prescriptions at network retail pharmacies and network mail- order pharmacies. You may buy your prescriptions (except specialty drugs) at a non-network retail pharmacy, but you will pay more if you do. If you get your prescriptions filled at a non-network retail pharmacy, the following applies: 100 2024 UMP Classic (PEBB) Certificate of Coverage