Using mail-order pharmacies when UMP is secondary If your primary plan uses UMP’s network mail-order pharmacies, these pharmacies may process payments for both plans and charge you only what is left. Make sure that UMP’s network mail-order pharmacies have your information for both plans and know which plan is primary. However, if your primary plan uses a different mail-order pharmacy, you will have to use your primary plan’s mail-order pharmacy, then submit a paper claim for payment by UMP. See the “Submitting a claim for prescription drugs” section for how to do this. Where to buy your prescription drugs ALERT! If you use a non-network retail pharmacy, you will pay the entire cost of the prescription drug at the time of purchase and must submit a claim for reimbursement. However, only the allowed amount for covered drugs will apply to your deductible or out-of- pocket limit, if applicable. Prescriptions purchased from an excluded pharmacy are not covered. Pharmacies are contracted through a different network than medical providers. Retail pharmacies WSRxS has a large national network of retail pharmacies, which includes many independent and regional pharmacies in Washington State, as well as national chains. Search for a network pharmacy on the UMP Prescription drug coverage webpage or contact WSRxS Customer Service (see Directory for link and contact information). When you get your prescriptions at a network pharmacy, the pharmacy sends the claim to the plan for you, and you pay only your cost-share (coinsurance and deductible) as described in the “What you pay for prescription drugs” section. Covered insulin prescriptions filled at network pharmacies are not subject to your deductible. Note: You will pay the entire cost for any prescription drug not covered by the plan, which does not apply to your deductible or your out-of-pocket limit. TIP: If you take a prescription drug regularly, you may be able to save money by filling up to a 90-day supply at a network retail pharmacy or through UMP’s network mail-order pharmacies. Search for a network pharmacy and compare prices on the UMP Prescription drug coverage webpage. Network vaccination pharmacies Many network retail pharmacies have vaccination pharmacists who may give covered preventive immunizations at no cost to you. Contact a network pharmacy ahead of time to make sure the pharmacy has the vaccine you need. Present your UMP member ID card at the pharmacy counter before receiving a vaccine. 94 2024 UMP CDHP (PEBB) Certificate of Coverage
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