This benefit covers hospital accommodations and inpatient, outpatient, and ambulatory care services, supplies, equipment, and prescribed drugs to treat covered conditions.

Services are considered “inpatient” when your hospital stay is expected to be longer than 24 hours. You pay a $200 per day copay for inpatient hospital services, up to $600 per calendar year at a network hospital. This copay covers charges by the hospital (facility). Professional services (such as lab tests, surgery, or other services) may be billed separately from the hospital. The plan pays these services according to the network status of the provider, unless your condition is a medical emergency.

Services are considered “outpatient” when your stay is expected to be less than 24 hours. Your cost depends on the service provided, such as lab tests, and the network status of the provider(s) involved in your care.

If you receive a service or device at a hospital, you may have to pay the difference between a higher cost service or device and a less expensive, medically appropriate alternative when one is available.

A network hospital can't charge you for the difference in cost between the standard and higher-cost item (unless you agreed in writing to pay before receiving the services).

ALERT!  Some hospital-based physicians (such as anesthesiologists and emergency room doctors) who work in a network hospital or other facility may not be UMP network providers. If a non-network provider bills separately from the hospital and his or her billed charges are more than UMP's allowed amount, you may be billed for the difference. Check UMP's online provider directory or call UMP Customer Service for the network status of anesthesiologists and emergency room doctors in Washington State hospitals.