• Tier 2 are preferred brand-name prescription drugs and some high-cost generic drugs The UMP Preferred Drug List is based on the Washington Preferred Drug List and recommendations by one of the P&T Committees that partner with WSRxS (see the “How UMP decides which prescription drugs are preferred” section for more information). Preferred provider(s) A preferred provider is a provider: • In the Regence service area and contracted as part of Regence BlueShield’s PPO network; or • Outside the Regence service area and contracted with another Blue Cross or Blue Shield organization in the BlueCard® Program (designated as a Provider in the “Preferred Provider Organization (“PPO”) Network”) to provide services and supplies to plan members. Preferred Provider Organization (PPO) A Preferred Provider Organization (PPO) is a health plan that has a network of providers who have agreed to provide services at discounted rates. Members may self-refer to most specialists. UMP Classic is a PPO. Prenatal Prenatal means during pregnancy. Prescription cost-limit The prescription cost-limit is the most you pay for a Value Tier drug, Tier 1 drug, and Tier 2 drug at a network pharmacy. See the “How the prescription drug cost-limit works” section for more information. See the “Your prescription drug out-of-pocket limit” section for annual limits to covered prescription drug costs. Prescription drug Prescription drug means a drug approved by the FDA that can be dispensed only with an order given by a properly authorized person. The designation of a medication as a prescription drug is made by the FDA. Prescription drug benefit Prescription drug benefit refers to services subject to your prescription drug deductible and coinsurance. See the “What you pay for prescription drugs” section for a description of how this works. Prescription drug out-of-pocket limit See the “Out-of-pocket limit, prescription drug” definition. Preventive care Preventive care means those services described by the Public Health Services Act, Section 2713: • Covered immunizations recommended by the CDC. • Evidence-informed preventive care and screenings for women as described in HRSA Guidelines in accordance with 45 CFR §147.130 (a)(iv). • Evidence-informed preventive care screenings for infants, children, and adolescents supported by the Health Resources and Services Administration (HRSA). 2024 UMP Classic (PEBB) Certificate of Coverage 199