Nurse line .................................................................................................................................................................................... 63 Nutrition counseling and therapy ................................................................................................................................... 64 Obstetric and newborn care ............................................................................................................................................... 64 Office visits ................................................................................................................................................................................. 66 Orthognathic and Telegnathic surgery ......................................................................................................................... 66 Pain and joint management, interventional ............................................................................................................... 66 Prescription drugs................................................................................................................................................................... 66 Preventive care ......................................................................................................................................................................... 66 Radiology .................................................................................................................................................................................... 69 Second opinions ...................................................................................................................................................................... 69 Skilled nursing facility ........................................................................................................................................................... 69 Sleep therapy ............................................................................................................................................................................ 70 Spinal and extremity manipulations............................................................................................................................... 71 Spinal injections ....................................................................................................................................................................... 71 Substance use disorder ........................................................................................................................................................ 71 Surgery ......................................................................................................................................................................................... 71 Temporomandibular joint (TMJ) disorder treatment ............................................................................................. 72 Therapy: Habilitative and Rehabilitative ...................................................................................................................... 72 Tobacco cessation services ................................................................................................................................................. 73 Transplants ................................................................................................................................................................................. 75 Urgent care ................................................................................................................................................................................ 75 Virtual care ................................................................................................................................................................................. 75 Vision care (diseases and disorders of the eye) ........................................................................................................ 77 Your routine vision benefits ........................................................................................................................................................ 77 Finding a routine vision provider ......................................................................................................................................... 77 Adults (age 19 or older) ............................................................................................................................................................ 78 Children (under age 19) ............................................................................................................................................................. 81 Vision claims administration .................................................................................................................................................. 83 Vision complaints and appeals .............................................................................................................................................. 84 Your prescription drug benefit .................................................................................................................................................. 85 The UMP Preferred Drug List ................................................................................................................................................. 85 How UMP decides which prescription drugs are preferred ..................................................................................... 87 Guidelines for prescription drugs UMP covers .............................................................................................................. 88 What you pay for prescription drugs ................................................................................................................................. 90 How the prescription drug cost-limit works ................................................................................................................... 92 Your prescription drug out-of-pocket limit..................................................................................................................... 93 Where to buy your prescription drugs .............................................................................................................................. 94 10 2024 UMP Plus–PSHVN (PEBB) Certificate of Coverage