• Experimental or investigational prescription drugs. • Homeopathic drugs, including FDA-approved prescription products. • Over-the-counter drugs, products containing an over-the-counter drug, or prescription drugs that have a nonprescription alternative, except for the drugs specified under “Exceptions covered” on page 91, or otherwise listed on the UMP Preferred Drug List. Note: Prescription drugs with a nonprescription alternative — including an over-the-counter alternative having similar safety, efficacy, and ingredients — are excluded. • Over-the-counter products not approved by and registered with the FDA. • Prescription drug costs covered by other insurance (see page 126 for coordination with other plans). • Prescription drugs not approved by the FDA. • Prescription drugs prescribed for excluded conditions. • Prescription drugs provided to a member, in whole or in part, while the member is admitted to an inpatient facility. Drugs provided in an inpatient setting are covered under the medical benefit. • Prescription drugs that are not medically necessary. • Prescription drugs that are repackaged. • Prescription drugs that the FDA’s DESI classifications have found to be less than effective. • Prescription drugs under a REMS program required by the FDA when prescribed outside REMS guidelines (see page 102 for details). • Most products considered as a medical device by the FDA. Medical devices may be covered under your medical benefit. The plan also excludes prescription drugs to treat conditions that are not covered under the medical benefit. These include, but are not limited to, prescription drugs for: • Cosmetic purposes. • Fertility or infertility. • Obesity (or weight loss). • Promoting hair growth. • Sexual dysfunction. Limits on plan coverage If you receive a service that is not medically necessary, is experimental or investigational, is listed as an exclusion in the “What the plan does not cover” section, or is listed as a noncovered or excluded prescription drug, you are responsible for paying all associated charges. Preauthorizing medical services ALERT! This section does not apply to prescription drugs. See page 103 for how to request preauthorization of drugs covered under the prescription drug benefit. 108 2024 UMP Classic (PEBB) Certificate of Coverage