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TIP: UMP covers durable medical equipment (DME) at the network benefit rate only if you get the equipment or supply from a UMP network DME supplier or other network medical provider. Check UMP's online directory for network DME suppliers, or call Customer Service at 1-800-762-6004. Many network pharmacies are not contracted as network DME suppliers.
You must receive preauthorization from UMP for durable medical equipment rentals of more than three months, and rentals or purchases over $1,000.
UMP does not cover equipment that costs more than less-costly equipment that serves the same medical purpose. To ensure coverage of any equipment or supplies, you may request preauthorization for durable medical equipment items.
The durable medical equipment benefit covers services and supplies that are prescribed by an approved provider type, medically necessary, and used to treat a covered condition, including:
- Artificial limbs or eyes (including implant lenses prescribed by a physician and required as a result of cataract surgery or to replace a missing portion of the eye).
- Breast prostheses and bras as required by mastectomy. (See "Mastectomy and Breast Reconstruction").
- Breast pumps, but only for medical conditions of the mother or baby.
- Casts, splints, crutches, trusses, and braces.
- Continuous Positive Airway Pressure (CPAP) devices.
- Insulin pumps and related pump supplies.
- Ostomy supplies.
- Oxygen and rental equipment for its administration.
- Penile prosthesis when other accepted treatment has been unsuccessful and the impotence is:
- Caused by a covered medical condition.
- A complication directly resulting from a covered surgery.
- A result of an injury to the genitalia or spinal cord.
- Rental or purchase (at UMP's option) of durable medical equipment such as wheelchairs, hospital beds, and respiratory equipment. (The combined rental fees cannot exceed full purchase price.)
- Wig or hairpiece to replace hair lost due to radiation therapy or chemotherapy for a covered condition, up to a lifetime maximum of $100. Other wigs and hairpieces are not covered.
The plan limits coverage of durable medical equipment to one item of that equipment and the accessories needed to operate the item. You are responsible for the entire cost of any additional pieces of the same or similar equipment you purchase or rent for personal convenience or mobility. UMP does not cover replacement of lost, stolen, or damaged durable medical equipment.
ALERT! The plan does not cover replacement of lost or stolen durable medical equipment.
Insulin Pumps and Related Supplies
Insulin pumps and related pump supplies are covered as durable medical equipment (DME). For the highest benefit level, use a network durable medical equipment supplier. Go to the UMP online directory and search for a "Durable Medical Equipment and Prosthetic Supplier" or call Customer Service at 1-800-762-6004. Note: These supplies are not available through Wellpartner, the mail-order pharmacy.
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