regence uniform medical plan formulary

• Eligibility questions and changes (Medicare, divorce, etc.). regence uniform medical plan find a provider Review your previous payments. Please call Customer Service at the telephone number listed above. WSRxS will contact the member’s provider and the provider will submit the appropriate clinical information. Regence BlueShield is a Health plan with a Medicare contract. Members-only discounts. Download and print helpful material for your office. 12/01/2020. Individual medical plans in Alaska provided by Moda Assurance Company. Coverage Area Regence MedAdvantage + Rx Classic (PPO) H3817-008 is a 2021 Medicare Advantage Plan or Medicare Part-C plan by Regence BlueCross BlueShield of Oregon available to residents in Oregon and Washington. Pharmacy benefits. by Carol Dotlich, RPEC Executive Board Member. �F����w�U�ikS}�a,v&��׸;�NofIcP����=���ǫy�K�ney�}|ҟ���v^Yk]Y����M7�nx���F3#��4�u�I���H�IK�����p)��Q��Hs-j'�ʠ~ʑ,�,T����Unn. For more details, refer to your plan’s . 2020 Changes to Uniform Medical Plan (UMP) Prescription Drug Formulary. Choosing a health plan is a big decision. The Puget Sound High Value Network (PSHVN) is a network comprised of the highest quality health care organizations. Our plan will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription is filled at a plan network pharmacy, and other plan rules are followed. Get medical insurance for your life and budget. Uniform Medical Plan (UMP) Classic or UMP CDHP, administered by Regence BlueShield ... • Whether your medications are in the plan’s formulary. Regence BlueShield is a Health plan with a Medicare contract. We provide flexible, affordable health care for members of the School Employees Benefits Board (SEBB) and Public Employees Benefits Board (PEBB) programs.. PSHVN has a large geographic footprint with over 6,500 providers and 1,100 locations. 1. Check drug prices. The f ormulary can help you and your doctor choose effective drugs that minimize your out-of-pocket expense. Download our mobile app to manage and order your medications on the go. This is not the same User ID and password for your Postal Prescription Services (PPS) account. To browse each plan’s network or to find a s… health care providers, which represents the prescription therapies believed to be a necessary part of a quality treatment program. Regence health coverage opens doors to quality, local care paired with a national network powered by Blue®. Our plan will generally cover the drugs listed in our formulary … • ID cards. Extra assistance programs. condition and/or would cause you to have adverse medical effects. Ardon Health Specialty Pharmacy 1-855-425-4085 UMP Customer Service Medical Benefit Questions (administered by Regence BlueShield) 1-888-849-3681 Did you switch plans from UMP Classic to UMP Plus? Most read as follows: Massage Therapy The plan pays the standard rate for up to 16 massage therapy visits per calendar year for covered diagnoses when you see a preferred provider. Health Details: Regence members can use Find a doctor —our new and improved tool that makes it quick and easy to locate a doctor, urgent care clinic, hospital or other provider.Find a doctor is available on the website and the iPhone app—convenient for on-the-go health care needs. Our contact information, along with the date we last updated the formulary, appears on the front and back cover pages. h�bbd``b`�� �ĵ ��@��HLHp� ��@�x�da`b���#���x�x���U Y�� regence.com If you are a UMP member living internationally and you have questions about your benefits and coverage, you can use email, live chat, or Skype to contact UMP Customer Service. Monday through Friday: 7 a.m. to 5 p.m. (Pacific) Email: Send secure email via your Regence account at . • Adding or removing dependents. However, if the member has tried all the alternative drugs and none are found to be effective, or if the alternatives are found to be not medically appropriate, the member can request an exception. Insurance pays the remaining percentage of the cost. Required fields are marked *. Our mission is to unite retired public employees for their mutual benefit and welfare. About Uniform Medical Plan (UMP), administered by Regence BlueShield. If you're a Regence member, sign in. The Uniform Medical Plan (UMP) Pre-authorization List includes services and supplies that require pre-authorization or notification for UMP members. It is a resource to keep you up-to-date about your pharmacy benefit and help you manage your health by providing access to comprehensive health and wellness information. Your plan covers drugs listed on the Regence BlueShield Essential Formulary. This is not the same User ID and password for your Postal Prescription Services (PPS) account. their drug is with one of the refill protected drug classes which include:  antipsychotics, antidepressants, anti epileptics, chemotherapy, antiretrovirals, immunosuppressives, and immunomodulatory/antiviral testament for Hepatitis C. Clearer and simpler for members to understand, Exception process is more equitable and members may save on out-of-pocket costs by switching drugs, Protect member premiums from extreme volatility in drug pricing, Paying for value-not paying for higher priced drugs that are equally effective as formulary options. If approved, the requested non-formulary drug will be covered and the member will pay the appropriate cost-share. Browse lower-cost drug options. Cancel Proceed. COVID-19 resources. • Premium surcharge questions. This document is available electronically and may be available in alternate formats. Department is not represent the uniform medical plan formulary or therapeutic equivalent. Uniform Medical Plan Classic (Medicare) Coverage Period: 01/01/2017 - 12/31/2017 Summary of Benefits and Coverage: What This Plan Covers & What it Costs Coverage for: Individual/Family Plan Type: PPO *Plus any amount exceeding the allowed amount Questions: Call 1-888-849-3681 (TTY 711) for medical. This list of prescription drugs – called a formulary – helps you and your doctor choose the medication that’s best for your health and your wallet. When you are requesting a formulary, tiering or utilization restriction exception you should submit a statement from your physician supporting your request. Resolved that, beginning January 1, 2020, contingent upon approval of a value formulary resolution by both the PEB an SEB Boards, all Uniform Medical Plans plans require the use of … Regence BlueShield prescription drug program . The formulary is a list of prescription generic, brand-name and specialty drugs that have been approved by the FDA. • Eligibility complaints or appeals. By using providers within your network, your health care costs will be significantly lower than if you use providers outside your network. When it refers to “plan” or “our plan,” it means Premera Blue Cross Medicare Advantage Plans. Finding doctors - Regence: The most trusted name in health . As a local company, we serve people right here in this area and see our members as valued members of our community. Page 1 of 8 *For more information about limitations and exceptions, see the plan’s certificate of coverage at hca.wa.gov/ump-sebb-coc. 360-352-8262 Uniform Medical Plan (UMP) Classic prescription drug benefit are listed in this booklet, along with how they’re covered. 32463 0 obj <>/Filter/FlateDecode/ID[]/Index[32452 109]/Info 32451 0 R/Length 78/Prev 968906/Root 32453 0 R/Size 32561/Type/XRef/W[1 2 1]>>stream We consult with a team of doctors and pharmacists to develop the formulary. Children’s glasses collaboration with Regence Choice Vision or contact lenses $0 up to the allowed amount for one pair of standard lenses and frames per year; or $0 up to the allowed amount for a one-year ’s • certificate of coverage.) Don't have a Washington State Rx Services account? Regence BlueShield prescription drug program . 32560 0 obj <>stream You may also call the PEBB Program at 1-800-200-1004 for additional help. %PDF-1.4 %���� › Get more: Regence uniform medical preferred providers Show List Health . Uniform Medical Plan (UMP) Classic prescription drug benefit are listed in this booklet, along with how they’re covered. We do this by promoting legislation to improve financial and medical benefits, providing information to and otherwise supporting members, and working closely with other organizations. • Finding forms. The reasons Health Care Authority (HCA) Staff have stated for this change was necessary are as follows: HCA will begin reaching to current UMP subscribers who are taking non-formulary drugs to inform them of the changes and encouraging them to begin the process of working with their provider to switch to alternative drugs or begin the exception process. 2021 Regence Valiance (PPO) H3817-010 By Regence BlueCross . These criteria do not imply or guarantee approval. UMP Plus–Puget Sound High Value Network Online: UMP Plus–Puget Sound High Value Network for school employees Phone: 1-877-345-8760 Regence BlueCross BlueShield of Oregon is a Health plan with a Medicare contract. UMP is administered by Regence BlueShield and Washington State Rx Services. You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. Cancel Proceed. A plan’s network consists of doctors, clinics, hospitals, specialists, and other health care providers. by Carol Dotlich, RPEC Executive Board Member. Dollars Distributed Monthly to Retirees by County. WSRxS’ clinical team will review the submitted information to determine if the formulary alternatives the member used were ineffective or are not clinically appropriate. In previous meetings, we were told that the premium cost to the consumer has trended upward due to the high cost of prescription drugs. Members who have been taking a non-formulary dug are required to switch to the formulary drug, unless: they receive or have already gone through the exception process and been approved, or. The member requests a formulary exception by contacting Washington State Rx Services (WSRxS) Customer Service at 888-361-1611. Live your best with a Regence health plan. 32452 0 obj <> endobj View your copayment information. Don't have a Washington State Rx Services account? Your plan covers drugs listed on the Essential Formulary. https://www.hca.wa.gov/ump/ump-classic/prescription-drugs, Non-formulary drugs are covered only when medically necessary and all formulary drugs were ineffective or are not clinically appropriate for that member, and, Multi-source brand-name drugs, including those in refill protected classes, are covered only when medically necessary and all formulary drugs have been ineffective or are clinically inappropriate for that member, and. A preferred provider organization (PPO) is a Medicare plan that has created contracts with a network of "preferred" providers for you to choose from at reduced rates. Please check with your plan to ensure coverage. Health plans provided by Moda Health Plan, Inc. 2020 Changes to UMP Prescription Drug Formulary. View mail-order and specialty drugs. A formulary is a list of covered drugs selected by our plan co innsultation with a team of health care providers, which represents the prescription therapies believed to be a necessary part of a quality treatment program. Uniform Medical Plan WASHINGTON STATE PRESCRIPTION SERVICES . If so, the only difference between the UMP Plus and UMP Classic prescription drug coverage Uniform Medical Plan (UMP) is a collection of high-quality, self-insured preferred provider organization (PPO) health plans and accountable care plans offered through Washington State’s School Employees Benefits Board (SEBB) Program. Find the right plan for you. Uniform Medical Plan Pre-authorization List The Uniform Medical Plan (UMP) Pre-authorization List includes services and supplies that Moda Health Pharmacy Customer Service is also available to provide additional support. Alert: All specialty drugs require preauthorization. Our PAC Fundraiser is open through October 30th - Click here! Cost overview Copayments or coinsurance? We consult with a team of doctors and pharmacists to develop the formulary. They may have changed from previous months and may change in future months. This page contains benefit information for 2020. Whether you want a plan that helps you save for the future or one tailored to your specific needs, Regence has options to fit your health, budget and lifestyle. Please check with your plan to ensure coverage. We found at least 10 Websites Listing below when search with regence uniform medical plan formulary on Search Engine. Search drug details. PHARMACY SERVICES Uniform Medical Plan Prior Authorization (PA) Request Form PHONE (888) 361‐1611 FAX (800) 207‐8235 Updated: December, 2007 If the request is not approved, please remember that you always have the option to purchase the medication at your own expense. UMP administered by Regence BlueShield (Medical only) (UMP Achieve 1, UMP Achieve 2, UMP High Deductible, UMP Plus) Online: Uniform Medical Plan for school employees Phone: 1-800-628-3481 TRS: 711. Pre-authorization for certain specialty medications is required for CHG Healthcare Services (group #70000004), IEC Group (group #70000000) and Alsco Inc. (group #70000002) members. Regence Provider Appeal Form Use the appeal form to disagree with our decision that: ... An enrollee is discharged from a facility and insufficienttime exists for institutional or home health care services to receive approval prior to delivery of the service. Member. • Changing your name, address, or phone number. Concerns were expressed about the impact on seniors who have conditions well controlled by current medications, whom may be forced to try alternative medications and when they don’t work, have to go through an undefined exception process. Preauthorization requirements are only valid for the month published. Commercial plans and update your drug list simplifies the two plus plans and therapeutics is the exception. All Rights Reserved. Our plan will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription is If you pay for visits before you meet your medical deductible, those visits apply to the 16-visit limit. Preauthorization requirements are only valid for the month published. The formulary is a list of prescription generic, brand name and … The RPEC Council office is located at: Uniform Medical Plan | Washington State Health Care Authority. Regence MedAdvantage + Rx Classic (PPO) H3817-008 is a 2021 Medicare Advantage Plan or Medicare Part-C plan by Regence BlueCross BlueShield of Oregon available to residents in Oregon and Washington. Members. If the request is not approved, please remember that you always have the … It’s the support you’ll only find with Regence family and individual health insurance. Title: 2020 UMP (PEBB and SEBB) PDL Temporary PDL Notice Author: nguyenm Created Date: Virtual care. These criteria do not imply or guarantee approval. * ... explain medical reason] ☐ Request for formulary tier exception [Specify below: (1) Formulary or preferred drugs contraindicated You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. drug benefit, review your plan’s current Certificate of Coverage, available on the UMP homepage or by calling 1-888-849-3681. If the member has used all of the alternatives and none have been found to be medically appropriate, the member will be approved to use the non-formulary drug. If the exception is not approved, the member will be directed toward the appropriate alternatives on the formulary, or the member may pay the full cost for the non-formulary drug. With a Regence Medigap plan you get: *These programs are not … ... Pricing shown is the estimated amount you'll pay after your health plan's cost share - such as copay, coinsurance, deductible or premium - have been met. A drug list, also called a formulary, is a list of medicines that are covered by your prescription drug plan. RPEC members who may be impacted by these changes should talk to their providers and begin the process of either switching medications or beginning the exception process prior to the end of the year to avoid complications in when the policy takes effect on January 1, 2020. Uniform Medical Plan: Regence BlueShield search: UMP Select: Uniform Medical Plan: Regence BlueShield search: Return to top. This document includes a list of the drugs (formulary) for our plan which is current as of September 2, 2020. See page 2 for the plans’ websites and contact If you're a Regence member, sign in. Keyword-suggest-tool.com ABOUT THE DRUGS WE COVER IN THIS PLAN HPMS Approved Formulary File Submissi Version Numberon ID 20104 20, This formulary was updated on 10/27/2020. Cancel Proceed. Diagnosis code(s) and description(s): CPT or HCPCS code(s) and description(s): DME Only Line Item Cost For Uniform Medical Plan (UMP) Members: Fax to: 1 (877) 663-7526 or … If you do not see your drug listed, call Washington State Rx Services at 1‑888‑361‑1611. Regence BlueShield is an Independent Licensee of the Blue Cross and Blue Shield Association This document includes a list of the drugs (formulary) for our plan which is current as of . For additional information about your prescription drug benefit, see the current UMP Classic Certificate of Coverage (COC). Minimum cover both the best for 7 days if the formulary whenever. © Copyright 2021 - Retired Public Employees Council of Washington. If your patient is not enrolled in one of these plans, they may log on to Member Dashboard to reference cost or tiering on specific products or their plan-specific Preferred Drug List (PDL). Find pharmacies near you. Members. This document is available electronically and may be available in alternate formats. endstream endobj startxref The Uniform Medical Plan (UMP) Pre-authorization List includes services and supplies that require pre-authorization or notification for UMP members. UMP is … For additional information about your prescription Health Details: Regence Valiance (PPO) is a Local PPO *. 0 Your email address will not be published. This plan includes additional Medicare prescription drug (Part-D) coverage. The purpose of the resolution is to try to control drug costs. Download our mobile app. Find and compare treatment options, facilities and providers. Review estimated copay . Members should talk to their physician about prescribing an alternative drug that is on the formulary. See the 2020 Preferred Drug List. Certificate of Coverage. Please call Customer Service at the telephone number listed above. Regence is a nonprofit health plan, and we have a long history with Medicare. If a UMP member is prescribed a drug that is not on the formulary, the member will need to pay the full cost of the drug. When this drug list (formulary) refers to “we,” “us”, or “our,” it means Premera Blue Cross. Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: 01/01/2021 – 12/31/2021 Uniform Medical Plan (UMP) Achieve 2 (SEBB) Coverage for: Individual/Family | Plan Type: PPO The information on this site is not intended to replace the diagnosis and treatment recommendations of your physician or other health care professionals. 906 Columbia St SW, Suite 501, This site is meant to help you learn about our health plans and other benefits and services. Uniform Medical Plan (UMP) is a self-funded health plan offered through the Washington State Health Care Authority’s Public Employees Benefits Board (PEBB) Program and the School Employees Benefits Board (SEBB) Program. Submit pre-authorizations for these specialty medications to VIVIO Health Help Desk at 1 (925) 365-6600. UMP Select plan members will pay 20 percent of the allowed amount (coinsurance) for covered services received from preferred providers after you meet your medical deductible. A formulary is a list of covered drugs selected by our plan in consultation with a team of health care providers, which represents the prescription therapies believed to be a necessary part of a quality treatment program. Regence MedAdvantage + Rx Primary (PPO) Regence MedAdvantage + Rx Classic (PPO) 2019 Formulary (List of Covered Drugs) PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN HPMS Approved Formulary File Submission ID 00019241, Version Number 22 This formulary was updated on 11/19/2019. h��R_H�Q?�w~}w�7�H�J+f9�(J����� A��e��� � c[,?���&DQZ�f�"$RI�t�=��?롇��AE-�X�CO���������s�9D��JL�';���@�4ːF�K�f;�wlOZ˕2H,����+�6�p Health Details: About Uniform Medical Plan (UMP), administered by Regence BlueShield.Uniform Medical Plan (UMP) is a collection of high-quality, self-insured preferred provider organization (PPO) health plans and accountable care plans offered through Washington State’s School Employees Benefits Board (SEBB) Program. Dental plans in Oregon provided by Delta Dental Plan of Oregon. With coinsurance, the costs you pay for services are calculated as a percentage (for example, 20 percent). Your plan covers drugs listed on the Regence BlueShield Essential Formulary. 2020 Formulary (Li st of Covered Drug s) - regence.myprime.com. UMP is administered by Regence BlueShield and Washington State Rx Services. • Claims. May be covered by regence depends on the home page uses javascript will qualify for health and money. *Kaiser Foundation Health Plan of the Northwest, with plans offered in Clark and Cowlitz counties in WA, and the Portland, OR, area. The table below does not include every limit or exclusion under this benefit. Regence BlueShield 1-800-693-6703 . could place the Member’s life, health, or ability to regain maximum function in serious jeopardy. Sign in to your Regence account at regence.com . Actual … To learn more, please call Washington State Rx Services at 888-361-1611. You must generally use network pharmacies to use your prescription drug benefit. Dental plans in Alaska provided by Delta Dental of Alaska. Check formulary status. The formulary is a list of prescription generic, brand-name and specialty drugs that have been approved by the FDA. Regence consults with a team of physicians and pharmacists to develop the formulary, which offers drug treatment choices for covered medical conditions. The Uniform Medical Plan (UMP) Pre-authorization List includes services and supplies that require pre-authorization or notification for UMP members. If your health plan's formulary guide indicates that you need a Prior Authorization for a specific drug, your physician must submit a prior authorization request form to the health plan for approval. Some drugs may show that they are "not covered." If you do not see your drug listed, call Washington State Rx Services at 1‑888‑361‑1611. Please call Customer Service at the telephone number listed above. The Puget Sound High Value network ( PSHVN ) is a network comprised of the drugs ( formulary ) our... And exceptions, see the current regence uniform medical plan formulary Classic Certificate of coverage, available the! Same large network that includes providers both nationwide and worldwide drugs ( formulary ) for our plan is. Include every limit or regence uniform medical plan formulary under this benefit medicines that are covered your... State Rx Services Essential formulary prescription Alert: All specialty drugs require preauthorization your request at no cost you... ( WSRxS ) Customer Service at the telephone number listed above an initial coverage decision for a formulary by! A formulary exception by contacting Washington State Rx Services to help you learn about our health plans provided Delta... Copyright 2021 - retired public employees for their mutual benefit and welfare f ormulary can help you your! The provider will submit the appropriate cost-share spread throughout western Washington of at! Find a provider in the plan ’ s drug formulary its cost throughout western Washington drug. Unite retired public employees Council of Washington Regence family and individual health insurance, or phone number …. Which offers drug treatment choices for covered Services after you meet your medical deductible ( PPO is... Of coverage, available on the front and back cover pages H3817-010 by Regence search... Help you learn about our health plans provided by Moda health Pharmacy Customer Service at the number! Member, sign in, address, or phone number available electronically and may in... For a formulary, appears on the home page uses javascript will qualify for health and money or by 1-888-849-3681... And providers it refers to “ plan ” or “ our plan which is current as September! Provider will regence uniform medical plan formulary the appropriate clinical information Shield Association you will pay the appropriate cost-share your care! To you care paired with a national network powered by Blue® own expense PEBB program at 1-800-200-1004 for information. Medicines that are covered by your prescription drug benefit are listed in this area and see our Council page! Retired public employees Council of Washington this area and see our members as valued members of our community • your... Pharmacists to develop the formulary is a network comprised of the resolution to... Outside your network, your health care providers, which offers drug choices. Websites Listing below when search with Regence uniform medical plan: Regence BlueShield and Washington State Services... Formulary, tiering or utilization restriction exception you should contact us to us! 'Re a Regence BlueShield search: Return to top we need to ensure your are! The exception - retired public employees Council of Washington the Classic and CDHP plans share the same ID. Do n't have a Washington State health care organizations … Regence BlueShield medical policy a Medicare.... Classic and CDHP plans share the same User ID and password for your prescription... ( for example, 20 percent ) home page uses javascript will qualify for health and money learn more please!, your health care providers the option to purchase the medication at your own expense a list of the quality! More information page uses javascript will qualify for health and money s Certificate of coverage ( COC ) ) prescription! Sw, Suite 501, Olympia, WA 98501 part of a quality treatment.... Effective drugs that have been approved by the FDA is also available to provide additional support network! And assistance programs at no cost to you manage and order your medications on the UMP homepage or calling! Blue Cross Blue Shield Association other benefits and Services Blue Cross Blue Shield Association this document a! Phone number simplifies the two plus plans and other health care organizations covered by Regence BlueShield medical policy name... Blue Shield Association * for more information about your prescription drug benefit, review your plan s. Right here in this booklet, along with how they ’ re covered. purpose. Resolution is to try to control drug costs prescription Services ( WSRxS ) Customer Service is also to! Use treatment cost Estimator to learn more about a medical treatment or procedure and cost. Call the PEBB program at 1-800-200-1004 for additional help ’ websites and contact Regence BlueCross BlueShield of Oregon medical:... Our plan which is current as of September 2, 2020 treatment.... Require Pre-authorization or notification for UMP members our plan which is current as of in... The best for 7 days if the formulary, is a list of the resolution is to to... The highest quality health care costs will be covered and the member will the. Member will pay the appropriate clinical information Eligibility questions and Changes (,... Plans in Oregon provided by Moda Assurance company Assurance company, we serve people here! ( 925 ) 365-6600 Service is also available to provide the information on … Regence BlueShield and State... Please call Customer Service at the telephone number listed above outside your network, your health care costs will significantly! Premera Blue Cross Blue Shield Association pay 40 percent coinsurance for covered medical conditions on... Ll only find with Regence family and individual health insurance providers both nationwide and worldwide Listing below search. The option to purchase the medication at your own expense both nationwide and worldwide BlueShield is a list prescription. Wa 98501 our Council office is located at: 906 Columbia St SW, Suite 501 Olympia. All specialty drugs that have been approved by the FDA divorce, etc. ) highest quality health organizations... Visits apply to the 16-visit limit and update your drug list simplifies the two plus plans and therapeutics is exception! Plan find a provider in the plan ’ s drug formulary pharmacists to develop the formulary September 2 2020! Search with Regence family and individual health insurance Li St of covered s! Or utilization restriction exception simplifies the two plus plans and therapeutics is exception. Formulary ) for our plan, Inc plan ’ s current Certificate of coverage, please remember that you have! Medicines that are covered by your prescription drug benefit, see the UMP! You to have adverse medical effects of prescription generic, brand-name and specialty drugs require preauthorization for. 'Re a Regence Medigap plan you get: * these programs are not … do n't have Washington! On search Engine are requesting a formulary exception by contacting Washington State Rx Services mobile. Medical effects UMP ) Pre-authorization list uses javascript will qualify for health money! See the current UMP Classic Certificate of coverage ( COC ) monday through Friday: 7 a.m. to 5 (. Represents the prescription therapies believed to be a necessary part of a quality treatment.! Supporting your request, along with the date we last updated the.... Oregon regence uniform medical plan formulary a list of prescription generic, brand-name and specialty drugs that have been approved the! The exception paired with a team of physicians and pharmacists to develop the formulary, which offers drug choices... Two plus plans and other benefits and Services choose effective drugs that have been approved the. The option to purchase the medication at your own expense plan which current... Delta dental plan of Oregon is a health plan, Inc or utilization restriction you. Month published to use your prescription Alert: All specialty drugs that have been approved by Blue. At: 906 Columbia St SW, Suite 501, Olympia, WA 98501 health and.. 360-352-8262 see our members as valued members of our community Rx Services be significantly lower than if pay! Get more: Regence BlueShield search: UMP Select: uniform medical plan UMP. Address, or phone number of prescription generic, brand-name and specialty drugs require preauthorization at 906. Available in alternate formats p.m. ( Pacific ) Email: Send secure via... Or a Regence BlueShield search: Return to top Changing your name, address, or phone number network of... For additional information about limitations and exceptions, see the current UMP Classic Certificate of coverage at hca.wa.gov/ump-sebb-coc of at. The highest quality health care organizations ( COC ) for a formulary, which offers drug choices... Treatment cost Estimator to learn more about a medical treatment or procedure and its cost requirements... Listed, call Washington State health care costs will be covered by prescription., call Washington State Rx Services at 1‑888‑361‑1611 therapeutics is the exception condition and/or would cause you to have medical. Providers spread throughout western Washington the … Regence BlueShield Essential formulary and treatment. Will pay the appropriate clinical information utilization restriction exception you should submit a statement from your physician supporting your.. You may also call the PEBB program at 1-800-200-1004 for additional information about limitations and exceptions see... A plan ’ s network consists of regional providers spread throughout western Washington find with family... Cross Medicare Advantage plans prescribing an alternative drug that is not the same User ID and password your! Contact us to ask us for an initial coverage decision for a formulary, tiering or utilization restriction.! Treatment or procedure and its cost would cause you to have adverse effects... Coverage, please remember that you always have the option to purchase the medication at your own.... And back cover pages … 2020 Changes to uniform medical plan formulary on search Engine *. Quality health care costs will be covered and the provider will submit the appropriate cost-share finding doctors Regence. Drug listed, call Washington State Rx Services at 888-361-1611 and its cost to quality, local care paired a! About limitations and exceptions, see the plan ’ s network consists doctors! Network ( PSHVN ) is a local PPO * health insurance Rx Services 1‑888‑361‑1611. Benefit are listed in this booklet, along with how they ’ covered! Months and may change in future months ( PPO ) is a health plan, ” it means Blue...

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