Drugs that have over-the-counter alternatives available are not covered. That is, if you can get the drug or an equivalent drug over-the-counter (without a prescription), the plan does not pay for the drug, even if you have a prescription and buy it from a pharmacy. Therefore, if you use a PPI, you pay the entire cost of the drug, and what you pay for PPIs does not count toward your deductible (prescription deductible for UMP Classic) or out-of-pocket limit (UMP CDHP).
For advice on alternative medications, talk to your prescribing provider.
ALERT! PPIs prescribed for persons under age 18 are covered, because the available over-the-counter alternatives are not approved for persons under age 18. Contact Washington State Rx Services at 1-888-361-1611 for more information.
*Drugs commonly used to treat chronic heartburn or GERD: For example, Prilosec/omeprazole, Prevacid/lansoprazole, Nexium/esomeprazole