You must receive preauthorization from UMP for the following services. If you don't, UMP may not cover the service. To ensure you receive the maximum benefit, call 1-800-762-6004 (or 425-670-3000 in the Seattle area) for preauthorization before receiving these services. Your provider may fax preauthorization requests to 425-670-3197.

• Artificial intervertebral disc surgery.
• Biofeedback for mental health treatment.
• Breast MRIs for screening purposes.
• Cardiac and pulmonary rehabilitation.
• Certain injectable drugs that are not normally approved for self-administration, when obtained through a retail pharmacy or Wellpartner, the network mail-order pharmacy (these drugs are indicated on the Washington State Rx Services Preferred Drug List).
• Cochlear implants.
• Continuous glucose monitors.
• Chemical dependency treatment:
  • Inpatient services (all overnight stays in hospitals or other facilities).
  • Intensive outpatient services.
  • Partial hospitalization.
  • Residential treatment facilities.
• Discography.
• Durable medical equipment, supplies, and prostheses rentals beyond three months, or for rentals or purchases over $1,000.
• Genetic services, except for screening during pregnancy. Authorization may be granted only for services performed by a certified genetic counselor.
• Home health care requires preauthorization if:
  • Visits are daily.
  • Treatment is expected to last more than three weeks.

  You must receive reauthorization every two weeks unless UMP tells you otherwise.

• Hospice care, including respite care: UMP covers hospice care from UMP network providers in full for up to six months when preauthorized. Respite care has a $5,000 lifetime maximum limit.
• Hyperbaric Oxygen treatment.
• Inpatient admissions for rehabilitation (physical, occupational, speech, and neurodevelopmental therapy).
• Intrathecal pumps.
• Mental health services:
  • Inpatient services (overnight stays in hospitals or other facilities).
  • Intensive outpatient services.
  • Partial hospitalization.
  • Residential treatment facilities.
• Negative Pressure Wound Therapy and related services.
• Obstructive Sleep Apnea Surgery.
• Positron Emission Tomography (PET) scans, except for cancer staging.
• Skilled nursing facility admissions.
• Spinal (cervical, lumbar) fusion.
• Stents, drug coated or drug-eluting (DES).
• Temporomandibular joint (TMJ) surgery.
• Transplants. The treating facility's transplant program must also accept you, and you must follow the program's protocol.
• Varicose veins treatment.