ALERT! If you see an out-of-network provider (see page 21) for primary care services, you’ll pay 50 percent of the cost, and services will be subject to your medical deductible. You may be balance billed, which means you may be billed any amount the provider charges above the allowed amount. Core network specialty providers A core network specialty provider is in the core network (affiliated with UMP Plus–PSHVN) and specializes in a certain area of care. Examples include cardiologists, allergists, and dermatologists. Find the complete list of specialty provider types on the UMP Provider search (see Directory for link). The plan pays specialty providers as described in this section at the network rate. See the “Summary of benefits” section for coverage of specific services. In general, you must meet your medical deductible before the plan begins to pay for covered services. Then you will pay 15 percent of the allowed amount. Support network providers Support network provider types are listed below and providers within these specialties may be in either the support network or core network. You pay 15 percent of the allowed amount for covered services from providers in either the core or support network. However, for chiropractors, acupuncturists, and massage therapists in either the core or support network, you pay a $15 copay per visit and you do not pay coinsurance. To search for a network or covered support provider within the support network, sign in to your Regence account and select Find a Doctor. If you use Find a doctor without signing in, you must select the UMP Plus–PSHVN as your network. This will ensure your search results only return network and covered support network providers and facilities. Contact UMP Customer Service if you have questions about the network status of a provider. See Directory for links and contact information. Examples of support network providers include: • Acupuncturists • Mental (behavioral) health providers • Anesthesiologists (including M.D.s, such as psychiatrists) • Audiologists • Mental health facilities • Birth centers (nonhospital) • Midwives, licensed • Chiropractors • Occupational therapists • Dialysis • Pathologists • Durable medical equipment (DME) suppliers • Physical therapists • Hearing aid dispensary • Registered dieticians • Home health providers • Rehabilitation, inpatient • Hospice • Skilled nursing facility • Laboratories (lab testing) • Speech therapists • Massage therapists, licensed • Substance use disorder facilities • Maxillofacial surgeons • Substance use disorder providers • Urgent care 20 2024 UMP Plus–PSHVN (PEBB) Certificate of Coverage