You must receive preauthorization from UMP for the following services. If you don't, UMP may not cover it. To ensure you receive UMP benefits, call 1-800-762-6004 (or 425-670-3000 in the Seattle area) for preauthorization before receiving these services. Preauthorization requests must be sent in by a provider, and may be faxed to the Medical Review Department at 425-670-3197.

• 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 UMP Preferred Drug List).
• Cochlear implants.
• Discography.
• Durable medical equipment, supplies, and prostheses for rentals beyond three months, or for rentals or purchases over $1,000.

  It also may be to your benefit to request preauthorization on some frequently prescribed durable medical equipment (such as light boxes, hospital beds, and breast pumps). This helps us address potential coverage issues in advance.

• Genetic counseling and testing, except for testing during pregnancy. Authorization may be granted only for testing performed by a specialist center/provider designated by UMP, and must be provided by a certified genetic counselor.
• Home health care: You must receive preauthorization for cases in which:
  • Visits are daily.
  • Treatment is expected to last more than three weeks.

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

  When only infusion therapy services are provided, home health services do not require preauthorization.

• 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.
• Inpatient admissions for rehabilitation (physical, occupational, speech, and neurodevelopmental therapy).
• Lumbar fusion for chronic low back pain or lumbar degerative disc disease.
• Mental health inpatient services (overnight stays in hospitals or other facilities).
• Negative Pressure Wound Therapy Pumps and related services.
• Orthotics.
• Positron Emission Tomography (PET) scans, except for diagnosis or staging of cancer.
• Skilled nursing facility admissions.
• Temporomandibular joint (TMJ) surgery.
• TENS (Trancutaneous Electrical Nerve Stimulation) Units.
• Transplants (including bone marrow, umbilical cord, and stem cell transplants). The treating facility's transplant program must also accept you, and you must follow the program's protocol.
• Varicose veins, treatment of.