UMP Plus members: Your prescription drug coverage is the same as UMP Classic's, except you do not pay a prescription drug deductible. UMP Plus benefits are effective on January 1, 2016.
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 (UMP Classic only) or prescription drug out-of-pocket limit.
UMP Classic only: 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 independent and regional pharmacies in Washington State as well as national chains. Search for a network pharmacy by using 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).
Many network pharmacies have vaccinating pharmacists able to administer preventive immunizations at no cost to you. Find a list of network vaccinating pharmacies by using the online pharmacy locator or call 1-888-361-1611.
TIP: If you take an ongoing prescription drug and purchase between an 84- and 90-day supply, you may be able to save money by using a Choice90 network pharmacy or PPS mail-order pharmacy. Search for a network pharmacy by using the online pharmacy locator or call 1-888-361-1611
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.)
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.
Steps to get started:
1. Set up an account with PPS by going to www.ppsrx.com or calling PPS at the phone number listed above.
2. Mail your prescription to PPS. Your provider can also electronically send or fax your prescription to PPS at 1-800-723-9023. Prescriptions faxed to PPS must:
- Be faxed from the provider’s office fax machine.
- Be on the provider’s letterhead.
- Include the patient’s name, address, phone number, plan ID number, and date of birth.
NOTE: Only a provider can fax in a prescription. Not following these instructions may cause a delay in filling your prescription.
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).
UMP Classic only: 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 plans pay 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.
*This is an external site that requires registering for a personal online account.