The table below explains your costs for prescription drugs covered by UMP Classic.

If you have questions about your prescription drug coverage, call 1-888-361-1611.

Prescription Drug Deductible: $100 Individual, $300 Family

Tier All Network Pharmacies The Most You'll Pay
Per 30-Day Supply*

(Prescription Cost-Limit)
Value Tier 5% coinsurance
No deductible
$10*
Tier 1
Select Generic Drugs
10% coinsurance
No deductible
$25*
Tier 2
Preferred Drugs
30% coinsurance
Deductible applies
$75*
Tier 3
Nonpreferred Drugs
50% coinsurance
Deductible applies
Specialty drugs only: $150
No limit for non-specialty drugs

*This is the most you'll pay per 30-day supply. For a 31- to 60-day supply, multiply by 2; for a 61- to 90-day supply, multiply by 3.