To find out how much your drug will cost, you can use the Prescription Price Check Tool, or call 1-888-361-1611.
ALERT! If you use a non-network pharmacy of any type, you will pay the entire cost of the drug upfront and must submit a claim. However, only the allowed amount for covered drugs will count toward your prescription drug deductible or prescription drug out-of-pocket limit.
If you are retired and enrolled in Medicare, please read more information on pharmacies.
Washington State Rx Services has a large network of retail pharmacies, which includes many pharmacies in Washington State as well as national chains. To see if your pharmacy is in the network, check the online pharmacy locator or call 1-888-361-1611.
You can use any pharmacy, but you will save money if you use a network pharmacy. When you get your prescriptions at a network pharmacy, the pharmacy sends the claim to the plan for you, and you pay only your cost-share (coinsurance and prescription drug deductible).
ALERT! PPS cannot ship outside of the United States. See "Travel Overrides for Prescription Drugs" if you will be traveling.
Postal Prescription Services (PPS): 1-800-552-6694 (Monday-Friday 6 a.m. to 6 p.m. Pacific Time, Saturday 10 a.m. to 2 p.m.)
Washington State Rx Services 1-888-361-1611 (Monday-Friday 7:30 a.m. to 5:30 p.m.)
NOTE: If you use a specialty drug (says “SP” under Specialty drug column of the UMP Preferred Drug List), the plan covers it only when you use the network specialty pharmacy, Ardon Health.
Postal Prescription Services (PPS) is the plan's network mail-order pharmacy. You may call PPS or Washington State Rx Services for more information about mail order. See instructions on how to fax prescriptions to the network mail-order pharmacy.
Refills can be ordered through your online pharmacy account, or by calling PPS directly.
When using PPS, the same prescription drug deductible, preauthorization requirements, and limits on coverage apply as for prescription drugs purchased at a retail network pharmacies.
ALERT! If there is a shortage of a specific drug that PPS cannot control and it doesn't have the quantity you ordered, PPS will contact you to discuss your options for obtaining your prescription(s).
Prescriptions mailed or orders placed in December but not filled until January 1 or after will be subject to the prescription drug deductible applicable on the date the prescription is processed. Because of increased volume at the end of the year, prescriptions submitted to PPS in December may not be processed during the current benefit year.
ALERT! Some durable medical equipment items are not available through PPS; you will need to get them through a network retail pharmacy or preferred durable medical equipment provider.
Use Network Pharmacies and Show Your ID Card to Get the Plan Discount
The plan pays for prescription drugs based on the allowed amount (Washington State Rx Services' standard reimbursement). If you use a non-network pharmacy or do not show your ID card at a network pharmacy, and the amount charged is more than the allowed amount, you will pay the difference in addition to your coinsurance.