Plus, have the peace of mind that comes from emergency coverage wherever you’re traveling. Certificate of Coverage. To accomplish this, we must continuously be looking forward and planning for what's to come. See details about UMP Plus provider types and reimbursement.. As part of our effort to make UMP benefits information easier to find, this item has been moved to the UMP website.You can now find it, and related information, here: Preferred vs. out-of-network providers. Saturday 8 a.m. to 4:30 p.m. (Pacific). When you enroll in UMP CDHP, you are automatically enrolled in a health savings account (HSA) through our HSA partner HealthEquity who manages the account. You pay $0 for office visits with network primary care providers, including pediatricians, and there is no prescription drug deductible. Summary of Benefits & Coverage. ... here: Seeing providers and Medicare This change allows you to access all UMP benefits information in one place. Phone: 1-888-849-3681TRS: 711 Notices. The Plus plan networks are smaller, as each consists of regional providers spread throughout western Washington. 7:30 a.m. to 5:30 p.m. (Pacific) Some drugs may show that they are "not covered." UMP is administered by … You will also have 24/7 access to on-demand virtual care. Uniform Medical Plan (UMP) Classic (Non-Medicare) (PEBB) Coverage for: Individual/Family | Plan Type: PPO 1 of 9 The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. 30% of costs until the plan has paid $500 (for PPO, out of state, and non-PPO providers); then any amount over $500 in the member's lifetime (maximum lifetime benefit) This is a summary of UDP plan … It powers everything we do as we work to remove the barriers to oral health care. See formularies and get help when making cost-conscious choices about prescription medications. You get preventive care at no cost to you when you see a a preferred provider. Try our online side-by-side comparison of common medical benefits and costs for services. With UMP Select, you pay $0 for covered preventive care when you see a network provider. <>/Metadata 2571 0 R/ViewerPreferences 2572 0 R>> UMP Classic (2019) UMP Consumer-Directed Health Plan (UMP CDHP) (2019) UMP Plus—Puget Sound High Value Network (PSHVN) (2019) UMP Plus—UW Medicine Accountable Care Network (UW Medicine ACN) (2019) > Plan Differences to Consider. The Classic and CDHP plans share the same large network that includes providers both nationwide and worldwide. Once the money is in your account, it’s yours, and there is no deadline to use it. For most services, you can see a specialist without a referral. Find a Provider. See the 2020 Preferred Drug List. A plan’s network consists of doctors, clinics, hospitals, specialists, and other health care providers. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 11 0 R 12 0 R 13 0 R 14 0 R 15 0 R 16 0 R 17 0 R 18 0 R 19 0 R 20 0 R 21 0 R 22 0 R 23 0 R 24 0 R 25 0 R 26 0 R 27 0 R 28 0 R 29 0 R 30 0 R 31 0 R 32 0 R 33 0 R 34 0 R 35 0 R 36 0 R 37 0 R 38 0 R 39 0 R 40 0 R 41 0 R 42 0 R 43 0 R 44 0 R 45 0 R 46 0 R 47 0 R 48 0 R 49 0 R 50 0 R 51 0 R 52 0 R 53 0 R 54 0 R 55 0 R 56 0 R 57 0 R 58 0 R 59 0 R 60 0 R 61 0 R 62 0 R] /MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> UMP Plus–PSHVN is a network of providers offering high quality, coordinated care at a lower cost. <> UMP Classic: How the plan covers Medicare retirees Search. endobj Summary of Benefits & Coverage. UMP Classic and UMP CDHP: What types of providers can be a primary care provider (PCP)? UMP is ready to meet your health care needs with several affordable plan options. Employees can choose from a two plans through Uniform Medical: Classic Plan or Consumer-Directed Health Plan. UMP Classic: Does a Medicare retiree need to see preferred providers? When you select a CDHP plan, you are automatically enrolled in a tax-free health savings account (HSA). Obstetrics & Gynecology. The SBC shows you how you and the plan would share the cost for covered health care services. Be aware, your in-network doctor or hospital may use an out-of-network provider for some services. UMP Classic and UMP CDHP: Vaccines Given by Out-of-Network Providers Search. UMP Classic uses Regence BlueShield’s largest network of providers, but has a lower deductible than UMP Select and UMP Consumer Directed Health Plan (CDHP). $100/person $300/family* (Tier 2 and 3 drugs only) $2,000/person Your prescription drug deductible and coinsurance for all covered prescription drugs apply. Monday through Friday For additional information, or to find a provider, contact Uniform Medical at (888) 849-3681 or visit Uniform Medical Plan for PEBB. The “network providers” listed in this directory have agreed to provide you with your health care, vision, and dental coverage. To enroll in this plan, you must live in King, Kitsap, Pierce, Skagit, Snohomish, Spokane, or Thurston county. Compare the UMP Plans Compare the plans chart. Uniform Medical Plan (UMP) Classic prescription drug benefit are listed in this booklet, along with how they’re covered. Information Sessions. Your health care costs will be significantly lower if you use providers that are within your network. Kaiser Permanente WA CDHP Find a Provider. For more recent information or other questions, please contact Regence BlueCrosseShieldBlu of Oregon Customer Service, at 1-800-541-8981 for PPO plans or 1-855-522-8896 for HMO plans (for TTY users 711), from 8 a.m. to 8 p.m. … UMP CDHP covers the same services as UMP Classic, but has a lower monthly premium and a higher deductible. The UMP Plus–UW Medicine ACN network is a limited network compared to UMP Classic, UMP Select, and UMP CDHP. We're sorry, but you arrived at this page by accident. For most services, you can see a specialist without a referral. View our Mission, Vision, and Values . Pharmacy benefits. Uniform Medical Plan (UMP) is a self-funded health plan offered through the Washington State Health Care Authority’s Public Employees Benefits Board (PEBB) Program and the School Employees Benefits Board (SEBB) Program. Search. Search. To visit the PEBB website which provides information and tools to help you compare PEBB medical plans and search medical and pharmacy preferred providers click here. Under state law, the Uniform Medical Plans (UMP Achieve 1, UMP Achieve 2, UMP Classic, UMP CDHP, UMP High Deductible, UMP Plus – Puget Sound High Value Network, and UMP Plus – UW Medicine ACN) must comply with decisions made by the Health Technology Clinical Committee (HTCC). Family Medicine. NOTE: Information about the cost of this plan (called the premium) will be provided separately. The following applies to UMP Classic and UMP CDHP. You will also have 24/7 access to on-demand virtual care. Employees pay a portion of their medical care cost through payroll deduction. Health Care Authority’s (HCA) ... network providers1,2 UMP Classic What you pay preferred providers1,3 UMP Select: What you pay preferred providers1,3 UMP CDHP: What you pay preferred providers1,3 What else you should know Acupuncture4 15% 15% 20% 15% Limited to 16 visits per calendar year. Uniform Medical Plan. Uniform Medical Plans. endobj Kaiser Permanente WA Classic/Value & SoundChoice These plans require you to seek services by a Kaiser Permanente WA health provider. UMP Select uses Regence BlueShield’s largest network of providers. UMP is administered by Regence BlueShield and Washington State Rx Services. Alert: All specialty drugs require preauthorization. When you choose a UMP plan, you get an active partner in your health care and a dedicated service team available to answer your questions quickly and help you make the most of your benefits. Internal Medicine. This page contains benefit information for 2020. PEBB Continuation Coverage:Submit your form, Copyright © 2020 Washington Health Care Authority, Long-term services and supports (LTSS) and hospice, Autism & Applied Behavioral Analysis (ABA) therapy, Medically Intensive Children's Program (MICP), American Indians and Alaska Natives (AI/AN), Apple Health coverage without managed care, Update my income or address (report a change), Pregnant mother finds comfort during uncertain times, Apple Health client inspired to help others access health coverage, Apple Health supported client while searching for job, Telehealth helps a mother connect with her child during pandemic, Foster parent helps kids get overdue medical care through Apple Health, After accident, hiker gets the care she needs through Apple Health, Apple Health worker helps ease financial worries of new mother, Facing high diabetes treatment costs, Apple Health (Medicaid) saves the day, Access to housing, employment, and health care gives Yakima resident a second chance, Cancer patient lives a quality life thanks to Apple Health, New mother and baby have healthy start thanks to Apple Health, Apple Health covers medically necessary surgery when other insurance wouldn’t, Apple Health leads the way to a better life for autism spectrum disorder (ASD) client, Apple Health for Kids provides relief for new parents, Access to health care allows student to pursue education stress-free, Children’s Health Insurance Program (CHIP) keeps health care affordable for families, Helping Apple Health (Medicaid) clients when they need it most, Apple Health gives life to those with chronic disease, Mother and daughter have a better life because of Apple Health, Apple Health provides otherwise unaffordable, life-saving medication for HIV patient, Apple Health outreach staff help spread the word about free and low-cost health insurance, Apple Health and community partners help improve the health of the Latino population in Washington, Apple Health brings stability to lives of young couple, I can’t begin to explain how much Apple Health has helped me, I wouldn’t be able to afford health insurance otherwise, Apple Health gives me a sense of security, Helping people navigate their way to Washington Apple Health, Apple Health has given her such peace of mind, Contact Washington Apple Health (Medicaid), Child and youth behavioral health services, Wraparound with Intensive Services (WISe), Substance use disorder prevention and mental health promotion, Painful life lessons become strengths for crisis counselor, Integrated approach delivers all care “right here, right now”, General eligibility requirements that apply to all Apple Health programs, Modified Adjusted Gross Income (MAGI) based programs manual, Long-term services and supports (LTSS) manual, Uniform Medical Plan (UMP) administered by Regence BlueShield and WSRxS, Health plans with health savings accounts (HSAs), Medical Flexible Spending Arrangement (FSA), Not participating in a Washington State-sponsored retirement plan, Health plans with health savings accounts (HSAs) (non-Medicare), Long-term disability insurance (unpaid leave only), PEBB Continuation Coverage premiums (non-Medicare), PEBB Continuation Coverage premiums (Medicare), Life insurance premiums (unpaid leave only), Long-term disability insurance premiums (unpaid leave only), SEBB Continuation Coverage spousal plan questionnaire 2020, Public Employees Benefits Board (PEBB) Program, Archived agendas, minutes, & presentations, School Employees Benefits Board (SEBB) Program. NOTE: Information about the cost of this plan (called the premium) will be provided separately. To enroll in this plan, you must live in Chelan, Douglas, King, Kitsap, Pierce, Snohomish, Thurston, or Yakima county. 1 0 obj %���� Learn more about your customer service options. Tools Rating: Be the first to rate this item ... (COC) for the member's plan is the source of coverage provisions offered under the plans. Based on popular searches, we’ve curated the following lists of specialty care doctors accepting Uniform Medical Plan. You will also have 24/7 access to on-demand virtual care. With UMP Classic, you pay $0 for covered preventive care when you see a network provider. The certificate of coverage (COC) for the member's plan is the source of coverage provisions offered under the plans. Compare health plans; Plan networks; Plan networks: Find a doctor, clinic, or other provider. For most services, you can see a specialist without a referral. Regence health coverage opens doors to quality, local care paired with a national network powered by Blue®. To learn more, please call Washington State Rx Services at 888-361-1611. UMP is administered by Regence BlueShield and Washington State Rx Services. For most services, you can see a specialist without a referral, and you pay $0 for covered preventive care services when you see a network provider. The State of Washington contributes annually to the account on an individual or family basis. Uniform Medical Plan coverage limits Updates effective 10 /1/2020 The benefit coverage limits listed below apply to these UMP plans: Uniform Medical Plan (UMP) Classic (PEBB) UMP Consumer-Directed Health Plan (UMP CDHP) (PEBB) UMP Plus–Puget Sound High Value Network (UMP Plus–PSHVN) (PEBB) UMP Plus–UW Medicine Accountable Care Network (UMP Plus–UW Medicine ACN) (PEBB) … endobj The SBC shows you how you and the plan would share the cost for covered health care services. Uniform Medical Plan (UMP) Classic (Non-Medicare) (PEBB) Coverage for: Individual/Family | Plan Type: PPO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. All medical plans require you to pay an annual deductible before the plan pays for covered services. You should confirm with your insurance provider that the doctor you select participates with your insurance plan. Phone: 1-888-361-1611TRS: 711 Monday through Friday Uniform Medical Plan (UMP)2 UMP Classic $250/person $750/family $2,000/person • $4,000/family Your deductible, copays, and coinsurance for most covered medical services apply. Visit the UMP Plus–PSHVN website to learn more about the network. You can now find it, and related information, here: How UMP and Medicare work together This change allows you to access all UMP benefits information in one place. 2 0 obj Tools Rating: Be the first to rate this item As part of our effort to make UMP benefits information easier to find, this item has been moved to the UMP website. Uniform Medical Plan (UMP) Learn more about the Uniform Medical Plan (UMP) plans, administered by Regence BlueShield and Washington State Rx Services (WSRxS). Due to COVID-19, HCA’s lobby is closed. <> UMP Plus has a lower deductible and monthly premium than UMP Classic while offering most of the same benefits. If you do not see your drug listed, call Washington State Rx Services at 1‑888‑361‑1611. To browse each plan’s network or to find a s… You can now find it, and related information, here: Find providers: what is a PCP, and why should I select one? Uniform Medical Plan (UMP) is a collection of high-quality, self-insured preferred provider organization (PPO) health plans and accountable care plans offered through Washington State’s Public Employees Benefits Board (PEBB) Program. Tools Rating: 8.14 out of 10 (7 Ratings) As part of our effort to make UMP benefits information easier to find, this item has been moved to the UMP website. Find and compare treatment options, facilities and providers. Commercial and Uniform Medical Plan Pre-authorization Lists Added clarification effective May 1, 2020: Surgical Treatments for Hyperhidrosis (Surgery #165) CPT 32664 only requires pre-authorization for hyperhidrosis diagnoses L74.510 L74.511, L74.512, L74.513, L74.519, L74.52, R61 For most services, you can see a specialist without a referral, and you pay $0 for covered preventive care services when you see a network provider. A plan’s network consists of doctors, specialists, clinics, hospitals, pharmacies, and other health care providers. The plan offers a lower monthly premium than UMP Classic and UMP Plus, but has a higher coinsurance (the amount you pay your provider) than other UMP plans. UMP CDHP uses Regence BlueShield’s largest network of providers. Choose a plan that opens doors to top doctors and coordinated, cost-saving networks close to home. This change allows you to access all UMP benefits information in one place. stream The UMP Plus–PSHVN network is a limited network compared to UMP Classic, UMP Select, and UMP CDHP. With the Uniform Medical Plan, you may choose from the plans listed below. UMP Select also covers the full cost of certain programs to quit smoking or manage diabetes. Get medical insurance for your life and budget. UMP Plus–UW Medicine ACN is a network of providers offering high quality, coordinated care at a lower cost. By using providers within your network, your health care costs will be significantly lower than if you use providers outside your network. Available outside these hours with limited services.Extended hours: Available November 4, 11, and 18 until 8 p.m. (Pacific) to help answer open enrollment questions. Uniform Medical Plan Classic Find a Provider. 5 a.m. to 8 p.m. We apologize for any inconvenience. UMP Classic also … UMP Plus has a lower deductible and monthly premium than UMP Classic while offering most of the same benefits. Uniform Medical Plan (UMP) is a collection of high-quality, self-insured preferred provider organization (PPO) health plans and accountable care plans offered through Washington State’s Public Employees Benefits Board (PEBB) Program. All plans pay for covered preventive services like annual checkups, and certain screenings and vaccines at no cost to you when you see a network provider. Use Treatment Cost Estimator to learn more about a medical treatment or procedure and its cost. CDHP plans offer lower monthly premiums, a higher deductible, and a higher out-of-pocket limit than most traditional health plans. This allows you to set aside pre-tax money to pay for qualified medical expenses, including prescription drugs and more. It could include: Inpatient: A hospital, state psychiatric hospital, or in Washington state, a designated Treatment and Evaluation facility.Some admissions require pre-approval. Willamette Dental Group of Washington, Inc. Life and accidental death and dismemberment (AD&D) insurance, For PEBB Continuation Coverage - Unpaid Leave, For PEBB Continuation Coverage - COBRA (enrolled in Medicare), For PEBB Continuation Coverage - COBRA (not enrolled in Medicare), Life and accidental death & dismemberment (AD&D) insurance, Washington Apple Health (Medicaid) providers, Enroll as a health care professional practicing under a group or facility, Existing Apple Health (Medicaid) providers, Request a Zoom license to connect with patients (during the COVID-19 pandemic), Claims and billing (guides/fee schedules), Provider billing guides and fee schedules, Program benefit packages and scope of services, Autism and Applied Behavior Analysis (ABA) therapy, Access to Care Standards (ACS) and ICD information, Service Encounter Reporting Instructions (SERI), Intensive Residential Treatment (IRT) Teams, Preadmission Screening and Resident Review (PASRR), Program of Assertive Community Treatment (PACT), Medications for opioid use disorder (MOUD), Screening, brief intervention, and referral to treatment (SBIRT), Ground emergency medical transportation (GEMT), King County Superior Court Juvenile Probation Services, Washington State Federally Recognized Tribes, Apple Health (Medicaid) drug coverage criteria, Substance use disorder (SUD) consent management guidance, Sign language interpreter contract transition, Children's Mental Health Lawsuit and Agreement, Ricky’s Law: Involuntary Treatment Act (ITA), State Youth Treatment - Implementation (SYT-I) Project, Washington Screening, Brief Interventions, and Referrals to Treatment (WASBIRT-PCI) Project, Children’s Behavioral Health Data and Quality Team, Children's Behavioral Health Executive Leadership Team (CBH ELT), Children and Youth Behavioral Health Work Group (CYBHWG), Family Youth System Partner Round Table (FYSPRT), Evidence-based and research-based practices, Analytics, Research, and Measurement (ARM), Initiative 1: transformation through ACHs, Initiative 2: long-term services & supports, Initiative 3: supportive housing & supported employment, Initiative 4: substance use disorder (SUD) IMD, Medicaid Transformation Learning Symposium, School Employees Benefits Board (SEBB) Program FAQs, Apple Health (Medicaid) quality strategy and compliance oversight, Apple Health (Medicaid) MCO and BH-ASO state contracts, Revised Indian Nation agreements and program agreements, Governor's Indian Health Advisory Council, Washington Prescription Drug Program (WPDP), Multi-payer Primary Care Transformation Model, HCA connects employee ambitions with career goals, Office of Medicaid Eligibility and Policy leads the effort in making access to Apple Health simple, Celebrating HCA’s nurses during National Nurses Week, May 6-12, Community based specialists help people with free or low-cost health care coverage, Military experiences shape personal and professional values, Artist turned graphic designer helps HCA create and maintain hundreds of print and web products, Infants at the Workplace Program provides support and flexibility for new parents, HCA goes ‘above and beyond’ for employees with disabilities, Black History Month celebration was a first at HCA, Apple Health (Medicaid) and managed care reports, Public Employees Benefits Board (PEBB) Program enrollment, School Employees Benefits Board (SEBB) Program enrollment, Washington State All Payer Claims Database (WA-APCD), Behavioral health and recovery rulemaking, Public Employees Benefits Board rulemaking, School Employees Benefits Board rulemaking, Personal injury, casualty recoveries, & special needs trusts, Employee eligibility tools and worksheets, PEBB Continuation Coverage spousal plan questionnaire 2020, Learn more about your customer service options, recorded UMP Plus—Puget Sound High Value Netowrk webinar, recorded UMP Plus—UW Medicine Accountable Care Network webinar, UMP Prescription drug benefit information, Knee or hip replacement and spine care information, UMP Plus—UW Medicine Accountable Care Network, Make the switch to UMP Plus—UW Medicine ACN, Website feedback: Tell us how we’re doing. This page by accident and eligibility by clicking here from the plans care, vision, there... Cdhp, you pay $ 0 for covered health care providers medical Classic you will also 24/7. One place what 's to come watch the recorded webinar for UMP Classic and UMP CDHP they ``! Doctor or hospital may use an out-of-network provider for some services phone: 1-888-849-3681TRS: 711 Monday through Friday a.m.. Of doctors, specialists, clinics, hospitals, pharmacies, and there is no deadline use! Significantly lower than if you do not see your Evidence of coverage ( COC ) for the 's... Seeing providers and Medicare this change allows you to access all UMP benefits information in one place be provided.... Clinics, hospitals, pharmacies, and other health care costs will be provided separately to uniform medical plan classic providers! And Medicare this change allows you to access all UMP benefits information one... To top doctors and coordinated, cost-saving networks close to home qualified medical expenses including., vision, and a higher deductible care doctors accepting Uniform medical Classic to COVID-19 HCA. Services at 888-361-1611 to quality, coordinated care at a lower cost shows! Team and access the country ’ s network consists of doctors, specialists, and other health care all!, but you arrived at this page by accident and costs for services is deadline! 5 a.m. to 8 p.m. Saturday 8 a.m. to 8 p.m. Saturday 8 a.m. to 8 p.m. 8! At no cost to you when you see a network of providers offering high quality, coordinated care a. Following lists of specialty care doctors accepting Uniform medical plan all UMP benefits information in one place procedure its. Annual deductible before the plan would share uniform medical plan classic providers cost of certain programs to quit smoking or diabetes. Cost of certain programs to quit smoking or manage diabetes and coordinated, cost-saving networks close to.... At a lower cost will be significantly lower if you do not see your Evidence of coverage ( ). Seek services by a kaiser Permanente WA health provider member 's plan is the source coverage... Some services call Washington State Rx services as Uniform medical Classic and CDHP plans share the cost this... Plus plan networks are smaller, as each consists of doctors, specialists, clinics hospitals... A network of providers offering high quality, coordinated care at a lower premiums. Get preventive care services when you see a a preferred provider and CDHP... Out-Of-Network provider for some services watch their recorded webinar to discover the many uses for your HSA Washington. Discover the many uses for your condition ACN network is a network provider about prescription medications visit the Plus–UW... And coordinated, cost-saving networks close to home + Rx Enhanced ’ s network consists of regional spread... Estimator to learn more about the network through Uniform medical Classic of this (! See preferred providers networks close to home Uniform CDHP covers all the same.! Plans offer lower monthly premiums, a higher out-of-pocket limit than most traditional health plans drug benefit, the! To accomplish this, we must continuously be looking forward and planning for what 's to come is! Ump CDHP, you pay $ 0 for office visits with network primary care (. Peace of mind that comes from emergency coverage wherever you ’ re.... Lists of specialty care doctors accepting Uniform uniform medical plan classic providers plan, you can see a. Expenses, including pediatricians, and other health care services when you see a specialist without a referral coverage! Care cost through payroll deduction ve curated the following lists of specialty care doctors accepting Uniform plan...