C. Prescription drugs and products not covered by the plan (see the “Prescription drugs and products UMP does not cover” section). D. Costs for medical services and prescription drugs covered under the medical benefit. See the “Medical out-of-pocket limit” section for how the medical out-of-pocket limit works. What you will pay for after reaching your prescription drug out-of-pocket limit You will still be responsible for paying letters B through D above after you meet your individual prescription drug out-of-pocket limit. 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 prescription drug out- of-pocket limit. 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) as described the “What you pay for prescription drugs” section. Note: You will pay the entire cost for any prescription drug not covered by the plan, which does not apply to your prescription drug 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 Plus–PSHVN (PEBB) Certificate of Coverage