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

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).

All services must meet UMP criteria for medical necessity; in particular, see #4 under the definition of "Medically Necessary Services, Supplies, or Interventions." If you receive services that do not meet all medical necessity criteria, you may have to pay the provider for part or all of the charges.

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.