Commercial DME You may purchase DME on Amazon by signing in to your Regence account and going to the Regence medical supplies webpage at regence.com/member/medical-supplies/. Select “Get started” in the Shop smart and save section. This will take you to the Amazon page where you will select and shop from one of the four categories for DME supplies: • Post-mastectomy • Illness and injury • New parents • Manage a condition You pay 100 percent of the billed charge and submit a claim for reimbursement. To submit a claim, select “Start your claim” in the “How to get repaid” section on the Regence medical supplies webpage at regence.com/member/medical-supplies/. The plan will reimburse you 80 percent of the allowed amount for covered DME supplies purchased through Amazon. To learn more contact UMP Customer Service. Emergency room TIP: If you need immediate care but your situation is not a medical emergency, see the “Urgent care” benefit for how to get treatment at a lower cost than in an emergency room. You pay a $75 copay and coinsurance for each emergency room visit, in addition to any amount owed toward your medical deductible. The plan covers facility charges for emergency room treatment when the treatment is for covered diagnoses and treatment of an injury. Charges for professional services may be billed separately from facility (hospital or emergency room) charges. When you receive emergency services, you cannot be balance billed. If your emergency room visit is determined to be a medical emergency, it will be paid at the network rate for preferred, participating, and out-of-network facilities. Separate professional services charges will also be paid at the network rate if your emergency room visit is determined to be a medical emergency. If you are admitted to the hospital directly from the emergency room, the $75 emergency room copay will be waived. However, you must pay the inpatient copay. End-of-life counseling End-of-life counseling involves discussing and planning for your end-of-life care, including treatment options and advanced directives. The plan covers end-of-life counseling for all members up to 30 visits per year. There is no requirement to be terminally ill, on hospice, or in the final stages of life to receive end-of-life counseling services. End-of-life counseling associated with hospice services is paid at 100 percent after you meet your medical deductible. Outside of hospice, these services are paid as a medical benefit, subject to your medical deductible and coinsurance. For more information on hospice care, see page 53. Family planning services If you receive care from a network provider, the plan will pay for the following covered services at the preventive rate: • Contraceptive drugs and devices including condoms and spermicides • Voluntary and involuntary termination of pregnancy (abortion or miscarriage) 2024 UMP Select (PEBB) Certificate of Coverage 49
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