Help with your appeal: If you decide to appeal and want help with your appeal, you may have your doctor, a friend, lawyer, or someone else help you. There are several groups that can help you. If you are covered by Medicare, you may contact the Medicare Rights Center toll free at 1-888-466-9050 (TRS: 711). You may also contact the National Institute on Aging at 1-800-222-2225 (TRS: 711) to request the phone number of your local Area Agency on Aging or Health Insurance Counseling and Assistance Program (HICAP). Your prescription drug benefit See the Directory for prescription drug contact information. Your plan’s prescription drug benefit is managed by a partnership of companies known as Washington State Rx Services (WSRxS): • Preauthorization, appeals, and customer service: Moda Health • Network mail-order pharmacies: ▪ Costco Mail-Order Pharmacy ▪ Postal Prescription Services (PPS) ▪ Note: The plan does not cover prescription drugs purchased through mail-order pharmacies located outside the U.S. • Network specialty drug pharmacy: Ardon Health Visit the UMP Prescription drug coverage webpage to: • Find a link to the UMP Preferred Drug List and the Drug Price Check tool. • Find a link to your online pharmacy account. • Find information on mail-order and specialty drugs. • Learn about submitting prescription drug claims. • Locate network pharmacies or network vaccination pharmacies. Review prescription drug policies and programs. Contact the mail-order or specialty drug pharmacy directly for help placing or tracking prescription orders. If additional help is needed, contact WSRxS Customer Service. Note: Regence BlueShield does not provide prescription drug benefits for UMP. Always contact WSRxS with questions about your prescription drug coverage. TIP: The UMP Preferred Drug List is available on the UMP Prescription drug coverage webpage (see Directory for link). On this webpage, you will also find a link to the Drug Price Check tool. The UMP Preferred Drug List The UMP Preferred Drug List (sometimes called a “formulary”) lists all of the preferred drugs that UMP covers. Drugs not listed on the Preferred Drug List are not covered unless an exception is requested and approved by UMP. Excluded prescription drugs and products are not eligible for an exception. For the exception process, refer to “Requesting an exception for noncovered prescription drugs” on page 87. The UMP Preferred Drug List includes: 2024 UMP Plus–PSHVN (PEBB) Certificate of Coverage 85