UMP Plus—UW Medicine ACN is a network of providers offering high quality, coordinated care at a lower cost. Regence. endobj A plan’s network consists of doctors, clinics, hospitals, specialists, and other health care providers. The Uniform Medical Plan (UMP) Pre-authorization List includes services and supplies that require pre-authorization or notification for UMP members. 2020 Changes to Uniform Medical Plan (UMP) Prescription Drug Formulary. By using providers within your network, your health care costs will be significantly lower than if you use providers outside your network. %PDF-1.7 1 0 obj The UMP Plus–PSHVN network is a limited network compared to UMP Achieve 1, UMP Achieve 2, and UMP High Deductible. To enroll in this plan, you must live in Chelan, Douglas, King, Kitsap, Pierce, Snohomish, Thurston, or Yakima county. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 20 0 R 28 0 R] /MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> The State of Washington contributes annually to the account on an individual or family basis. For most services, you can see a specialist without a referral. You also get covered preventive care at no cost to you when you see a preferred or participating provider. ASC First MI DME Supplier NPI Phone Number Confidential Voice MailFax Number YesNo Plus, have the peace of mind that comes from emergency coverage wherever you’re traveling. Visit Pharmacy to learn more about prescription drug coverage and cost, find a network pharmacy, learn about prescription drug policies, and log in to your pharmacy account.. UMP Plus has a lower deductible and monthly premium than UMP Achieve 2 while offering most of the same benefits. Welcome to the health plan that has been supporting school employees for nearly 60 years. UMP Achieve 1 uses Regence BlueShield’s largest network of providers. who takes my insurance? Additionally, you get covered preventive care at no cost to you when you see a network provider. UMP Plus has a lower deductible and monthly premium than UMP Achieve 2 while offering most of the same benefits. December 1, 2019 Uniform Medical Plan coverage limits Updates effective 1 2 /1/2019 The benefit coverage limitslisted below apply to these UMP plans: UniformMedical Plan (UMP) endobj There are slight variations in the language and benefits pertaining specifically to Massage Therapy depending on your client’s specific plan. UMP is administered by Regence BlueShield and Washington State Rx Services. Trusteed. The plan offers a lower monthly premium than UMP Achieve 2 and UMP Plus, but has a higher coinsurance (the amount you pay your provider) than other UMP plans. UMP Achieve 1 also covers the full cost of certain programs to quit using tobacco or manage diabetes. The Classic and CDHP plans share the same large network that includes providers both nationwide and worldwide. UMP High deductible uses Regence BlueShield’s largest network of providers. UMP Plus–PSHVN is a network of providers offering high quality, coordinated care at a lower cost. Uniform Medical Plan (UMP) administered by Regence BlueShield and WSRxS ... SEBB Continuation Coverage spousal plan questionnaire 2020. For Uniform Medical Plan (UMP) Members: Fax to: 1 (877) 663-7526 or Mail to: PO Box 2998, Tacoma, WA 98401-2998 If this is an expedited request and meets the definition indicated below, please check the expedited request box AND fax this form to 1 (855) 240-6498. You will also have 24/7 access to on-demand virtual care. 30% of costs until the plan has paid $500 (for PPO, out of state, and non-PPO providers); then any amount over $500 in the member's lifetime (maximum lifetime benefit) This is a summary of UDP plan benefits. <> 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. Certificate of Coverage. Visit HealthEquity or watch their recorded webinar to discover the many uses for your HSA. The UMP Plus network is a limited network, compared to UMP Achieve 1 and UMP Achieve 2. Copyright © 2020 Washington Health Care Authority, Long-term services and supports (LTSS) and hospice, Autism & Applied Behavioral Analysis (ABA) therapy, Medically Intensive Children's Program (MICP), American Indians and Alaska Natives (AI/AN), Apple Health coverage without managed care, Update my income or address (report a change), Pregnant mother finds comfort during uncertain times, Apple Health client inspired to help others access health coverage, Apple Health supported client while searching for job, Telehealth helps a mother connect with her child during pandemic, Foster parent helps kids get overdue medical care through Apple Health, After accident, hiker gets the care she needs through Apple Health, Apple Health worker helps ease financial worries of new mother, Facing high diabetes treatment costs, Apple Health (Medicaid) saves the day, Access to housing, employment, and health care gives Yakima resident a second chance, Cancer patient lives a quality life thanks to Apple Health, New mother and baby have healthy start thanks to Apple Health, Apple Health covers medically necessary surgery when other insurance wouldn’t, Apple Health leads the way to a better life for autism spectrum disorder (ASD) client, Apple Health for Kids provides relief for new parents, Access to health care allows student to pursue education stress-free, Children’s Health Insurance Program (CHIP) keeps health care affordable for families, Helping Apple Health (Medicaid) clients when they need it most, Apple Health gives life to those with chronic disease, Mother and daughter have a better life because of Apple Health, Apple Health provides otherwise unaffordable, life-saving medication for HIV patient, Apple Health outreach staff help spread the word about free and low-cost health insurance, Apple Health and community partners help improve the health of the Latino population in Washington, Apple Health brings stability to lives of young couple, I can’t begin to explain how much Apple Health has helped me, I wouldn’t be able to afford health insurance otherwise, Apple Health gives me a sense of security, Helping people navigate their way to Washington Apple Health, Apple Health has given her such peace of mind, Contact Washington Apple Health (Medicaid), Child and youth behavioral health services, Wraparound with Intensive Services (WISe), Substance use disorder prevention and mental health promotion, Painful life lessons become strengths for crisis counselor, Integrated approach delivers all care “right here, right now”, General eligibility requirements that apply to all Apple Health programs, Modified Adjusted Gross Income (MAGI) based programs manual, Long-term services and supports (LTSS) manual, Uniform Medical Plan (UMP) administered by Regence BlueShield and WSRxS, Health plans with health savings accounts (HSAs), Medical Flexible Spending Arrangement (FSA), Not participating in a Washington State-sponsored retirement plan, Health plans with health savings accounts (HSAs) (non-Medicare), Long-term disability insurance (unpaid leave only), PEBB Continuation Coverage premiums (non-Medicare), PEBB Continuation Coverage premiums (Medicare), Life insurance premiums (unpaid leave only), Long-term disability insurance premiums (unpaid leave only), SEBB Continuation Coverage spousal plan questionnaire 2020, Public Employees Benefits Board (PEBB) Program, Archived agendas, minutes, & presentations, School Employees Benefits Board (SEBB) Program. UMP High Deductible covers the same services as UMP Achieve 2, but has a lower monthly premium and a higher deductible. If you choose DeltaCare, you must choose a primary care dentist from within the DeltaCare network when you enroll for coverage. UMP High Deductible uses Regence BlueShield’s largest network of providers and covers all the same services as UMP Achieve 1 and UMP Achieve 2, but has a lower monthly premium and a higher deductible. For most services, you can see the specialist you choose without a referral. Find a doctor will also help ensure you refer patients to in-network providers to minimize their out-of-pocket expenses.. Members can use Find a doctor to get results that are personalized to their networks and benefits. Uniform Medical Plan Pre-authorization List The Uniform Medical Plan (UMP) Pre-authorization List includes services and supplies that For prescription drugs, the deductible is $250 per member, $750 per family. To enroll in this plan, you must live in King, Kitsap, Pierce, Skagit, Snohomish, Spokane, or Thurston county. (HTCC) decision or a Regence BlueShield medical policy. You pay $0 for office visits with network primary care providers, including pediatricians, and there is no prescription drug deductible. ump.regence.com/sebb or call 1-800-628-3481 (TRS: 711) for a list of network providers (preferred providers). Each plan has a different state wide network. Note: To make sure you pay the right amount for your prescription, always show your UMP ID. 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. Uniform Medical Plan Pre-authorization List The Uniform Medical Plan (UMP) Pre-authorization List includes services and supplies that Designed with K-12 employees in mind, our School Employees Benefits Board (SEBB) health plans offer robust benefits and include the same great service you have come to expect from Premera. 5 a.m. to 8 p.m. (Pacific) Medical Plans: Kaiser Foundation Health Plan of the Washington Kaiser Permanente NW 1,2,3 MY.KO.ORG/SEBB 1-800-813-2000 Kaiser Foundation Health Plan of Washington Tricare. ��)��S�>��훯=�������o������x��V\�p��e>k��C��� ߮I��(v7�p#�g2l��|��1���(�u��Jd��? Due to COVID-19, HCA’s lobby is closed. Supported by Regence, UMP Plus — PSHVN connects eligible School Employee Benefits Board (SEBB) Program members to high-quality primary and specialty care, close to home. 4 0 obj Available outside these hours with limited services.Extended hours: November 4, 11, and 18 until 8 p.m. to help answer open enrollment questions. You will also have 24/7 access to on-demand virtual care. The table below does not include every limit or exclusion under this benefit. All times are listed in Pacific Time. Choose a plan that opens doors to top doctors and coordinated, cost-saving networks close to home. Rehn & Associates . You will also have 24/7 access to on-demand virtual care. Uniform Medical Plan Contact us with any questions . (HTCC) decision or a Regence BlueShield medical policy. Direct clinical information reviews (MCG Health) For select CPT codes, Availity's electronic authorization tool automatically routes you to MCG Health's website where you can document specific clinical criteria for your patient. The UMP Plus – UW Medicine ACN includes many of the finest healthcare organizations in the region, and provides high-quality, excellent service and affordable healthcare. • Page 43: In the “Medical Benefits Comparison” chart: • Under “Hearing hardware” for the Kaiser Foundation Plan of the Northwest, Kaiser Foundation Plan of Washington, and Kaiser Foundation Plan of Washington Options, Inc. plans it should read, “$400 max per ear With UMP Achieve 2, you pay $0 for covered preventive care when you see a network provider. UMP Plus has no prescription drug deductible and has a lower medical deductible than UMP Achieve 1 and UMP Achieve 2 while offering most of the same benefits. 7:30 a.m. to 5:30 p.m. (Pacific) Once the money is in your account, it’s yours, and there is no deadline to use it. 24 hours a day, 7 days a week . Find out more about this opportunity to access great healthcare while saving money. Member. 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. Certificate of Coverage. Certificate of Coverage. UMP Achieve 1 also covers the full cost of certain programs to quit smoking or manage diabetes. Uniform Medical Plans can be found online. Last week, the Health Care Authority (HCA) announced it was awarding the TPA contract for its public employees (PEBB) self funded plan to Regence Blue Shield. Saturday 8 a.m. to 4:30 p.m. (Pacific). Members. For more details, refer to your plan’s . Postal Prescription Services (network mail-order pharmacy) 1-800-552-6694 ppsrx.com Most primary care office visits with primary care providers, including naturopaths from the support network, are covered at no cost to you. UMP Plus—PSHVN is only available in certain counties: King, Kitsap, Pierce, Snohomish, Thurston, and Yakima. <> Uniform Medical Plan (UMP) administered by Regence BlueShield and WSRxS. stream Wednesday, October 28, 4 to 5 p.m. UMP Plus-UW Medicine Accountable Care Network is now an option for SEBB-eligible members living in King, Snohomish, Kitsap, Pierce, Skagit, Thurston and Spokane counties. For most services, you can see the specialist you choose without a referral. Most health plans cover many … (HTCC) decision or a Regence BlueShield medical policy. SEBB Continuation Coverage:​Submit your form, Phone: 1-800-628-3481TRS: 711 Members. The Uniform Medical Plan (UMP) was built to provide top-quality, affordable healthcare to eligible Washington state public employees (active and retired), Leave Without Pay members, non-Medicare retirees or COBRA members. The Public Employees Benefit Board (PEBB) passed the following resolution at their April 24th meeting: #z�s2�Vg&%ul�1lwycKv�(��xOpxO�X�&��&�Iϒ]4�t�n�Q�"�_�bd�;�g�]Q�2�U�Y��au#mp9N�I�DWd��˵�8D�8�. Find and compare treatment options, facilities and providers. If you have questions or need more information, contact Washington State Rx Services at 1-888-361-1611 (TRS: 711). UMP Achieve 2 uses Regence BlueShield’s largest network of providers, but has a lower deductible and lower coinsurance than UMP Achieve 1. Cancel Proceed. When you enroll in UMP High Deductible, you are automatically enrolled in a health savings account (HSA) through our HSA partner HealthEquity who manages the account. Try Alex, our interactive, virtual guide. You pay $0 for office visits with network primary care providers, including pediatricians, and there is no prescription drug deductible. Your deductibles are fixed dollar amounts you must pay each calendar year for health care and/or prescription drug expenses before the plan starts paying for covered services. Premera cards with prefix PBQ (Reading/Writing/Speech services) ** Providence Hospital/Medical Network outsourced their mental health benefits to Providence Behavioral Health, aka … The UMP Select medical deductible is $750 per member and $2,250 per family. For most services, you can see a specialist without a referral, and you pay $0 for covered preventive care services when you see a network provider. UMP High Deductible automatically enrolls the subscriber in a health savings account (HSA), which allows you to set aside pre-tax money to pay for qualified medical expenses. Uniform Medical Plan Pre-authorization List The Uniform Medical Plan (UMP) Pre-authorization List includes services and supplies that To browse each plan’s network or to find a s… Uniform Medical Plan (SEBB) Web TPA. This plan has a combined deductible for medical and prescription drug expenses, which means you pay all of these expenses before the plan starts paying for covered medical services and covered prescription drugs. The UMP Plus – PSHVN participating organizations include: CHI Franciscan and independent providers as part of … The 113,000 public employees (over 250,000 when including their enrolled dependents) that receive benefits under the Uniform Medical Plan (UMP) represent one of the largest contracts available in the […] With UMP Achieve 1, you get covered preventive care at no cost to you when you see a preferred or participating provider. The table below does not include every limit or exclusion under this benefit. Washington State Rx Services (WSRxS) (prescription drug benefits) 1-888-361-1611 (TRS: 711) regence.com/ ump/sebb/ benefits/ prescriptions . For most services, you can see a specialist without a referral, and you pay $0 for covered preventive care services when you see a network provider. UMP is administered by Regence BlueShield and Washington State Rx Services. UMP Achieve 2 uses Regence BlueShield’s largest network of providers, but has a lower deductible than UMP Achieve 1 and UMP High Deductible. endobj With UMP Achieve 2, you get covered preventive care at no cost to you when you see a preferred or participating provider. UMP Achieve 2 also covers the full cost of certain programs to quit smoking or manage diabetes. This allows you to set aside pretax money to pay for qualified medical expenses, including prescription drugs and more. For most services, you can see a specialist without a referral. This plan uses a provider network. With UMP High Deductible, you pay $0 for covered preventive care services when you see a network provider. Uniform Medical Plan (UMP) is a collection of high-quality, self-insured preferred provider organization (PPO) health plans and accountable care plans offered through Washington State’s School Employees Benefits Board (SEBB) Program. x��=�n�H�����H �f�΅a�v��,6���{�d(��8-���ǃ����=��HIE٢K�6@$K,�\���T��(�q2,����uY&�I:_/����.�����>�'e��/��%~�K�����Jܼ��x�ƶl�KG�"��0vD��}���b������7��0�w�o$���A`Ł�o�����?} Most read as follows: Massage Therapy The plan pays the standard rate for up to 16 massage therapy visits per Phone: 1-888-361-1611TRS: 711 When you choose a UMP plan, you get an active partner in your health care and a dedicated service team available to answer your questions quickly and help you make the most of your benefits. Willamette Dental Group of Washington, Inc. Life and accidental death and dismemberment (AD&D) insurance, For PEBB Continuation Coverage - Unpaid Leave, For PEBB Continuation Coverage - COBRA (enrolled in Medicare), For PEBB Continuation Coverage - COBRA (not enrolled in Medicare), Life and accidental death & dismemberment (AD&D) insurance, Washington Apple Health (Medicaid) providers, Enroll as a health care professional practicing under a group or facility, Existing Apple Health (Medicaid) providers, Request a Zoom license to connect with patients (during the COVID-19 pandemic), Claims and billing (guides/fee schedules), Provider billing guides and fee schedules, Program benefit packages and scope of services, Autism and Applied Behavior Analysis (ABA) therapy, Access to Care Standards (ACS) and ICD information, Service Encounter Reporting Instructions (SERI), Intensive Residential Treatment (IRT) Teams, Preadmission Screening and Resident Review (PASRR), Program of Assertive Community Treatment (PACT), Medications for opioid use disorder (MOUD), Screening, brief intervention, and referral to treatment (SBIRT), Ground emergency medical transportation (GEMT), King County Superior Court Juvenile Probation Services, Washington State Federally Recognized Tribes, Apple Health (Medicaid) drug coverage criteria, Substance use disorder (SUD) consent management guidance, Sign language interpreter contract transition, Children's Mental Health Lawsuit and Agreement, Ricky’s Law: Involuntary Treatment Act (ITA), State Youth Treatment - Implementation (SYT-I) Project, Washington Screening, Brief Interventions, and Referrals to Treatment (WASBIRT-PCI) Project, Children’s Behavioral Health Data and Quality Team, Children's Behavioral Health Executive Leadership Team (CBH ELT), Children and Youth Behavioral Health Work Group (CYBHWG), Family Youth System Partner Round Table (FYSPRT), Evidence-based and research-based practices, Analytics, Research, and Measurement (ARM), Initiative 1: transformation through ACHs, Initiative 2: long-term services & supports, Initiative 3: supportive housing & supported employment, Initiative 4: substance use disorder (SUD) IMD, Medicaid Transformation Learning Symposium, School Employees Benefits Board (SEBB) Program FAQs, Apple Health (Medicaid) quality strategy and compliance oversight, Apple Health (Medicaid) MCO and BH-ASO state contracts, Revised Indian Nation agreements and program agreements, Governor's Indian Health Advisory Council, Washington Prescription Drug Program (WPDP), Multi-payer Primary Care Transformation Model, HCA connects employee ambitions with career goals, Office of Medicaid Eligibility and Policy leads the effort in making access to Apple Health simple, Celebrating HCA’s nurses during National Nurses Week, May 6-12, Community based specialists help people with free or low-cost health care coverage, Military experiences shape personal and professional values, Artist turned graphic designer helps HCA create and maintain hundreds of print and web products, Infants at the Workplace Program provides support and flexibility for new parents, HCA goes ‘above and beyond’ for employees with disabilities, Black History Month celebration was a first at HCA, Apple Health (Medicaid) and managed care reports, Public Employees Benefits Board (PEBB) Program enrollment, School Employees Benefits Board (SEBB) Program enrollment, Washington State All Payer Claims Database (WA-APCD), Behavioral health and recovery rulemaking, Public Employees Benefits Board rulemaking, School Employees Benefits Board rulemaking, Personal injury, casualty recoveries, & special needs trusts, Employee eligibility tools and worksheets, PEBB Continuation Coverage spousal plan questionnaire 2020, Learn more about your customer service options, UMP Prescription drug benefit information, Knee or hip replacement and spine care information, UMP Plus—UW Medicine Accountable Care Network, Make the switch to UMP Plus—UW Medicine ACN, Knee or hip replacement or spine care information, Website feedback: Tell us how we’re doing, Watch the UMP Achieve 1, Achieve 2, and High Deductible, Watch the UMP Plus—Puget Sound High Value Network, Watch the UMP Plus—UW Medicine Accountable Care Network. It is a limited network compared to UMP Achieve 1, you get covered care... For UMP Plus UMP Plus—UW Medicine ACN website to learn more about a treatment. Kitsap, Pierce, Snohomish, Thurston, and there is no deadline to use.... Will be significantly lower than if you have a favorite dentist, it s!, are covered at no cost to you when you see a specialist without a regence uniform medical plan sebb. Compare treatment options, facilities and providers for prescription drugs, the deductible is 250. '' �_�bd� ; �g� ] Q�2�U�Y��au # mp9N�I�DWd��˵�8D�8� spousal plan questionnaire 2020 ) ��S� ��훯=�������o������x��V\�p��e... Ump Plus–PSHVN website to learn more about this opportunity to access great healthcare while saving.. Plus—Uw Medicine ACN is a limited network compared to UMP Achieve 1 uses Regence BlueShield ’ largest. Pshvn ) is regence uniform medical plan sebb limited network, are covered at no cost to you when you see network! Contact Washington State Rx services at 1-888-361-1611 ( TRS: 711 ) ump/sebb/! And CDHP plans share the same benefits & �� & �Iϒ ] ''... Care office visits with primary care providers close to home network ( PSHVN ) is administered by Regence Medical. Within your network, your health care needs with several affordable plan options no cost to you with... The language and benefits pertaining specifically to Massage Therapy depending on your ’..., it ’ s with network primary care dentist from within the DeltaCare network when you see a preferred participating! You must choose a plan that opens doors to top doctors and coordinated, cost-saving networks close to.. Peace of mind that comes from emergency coverage wherever you ’ re traveling, hospitals specialists. Visit HealthEquity or watch their recorded webinar to discover the many uses for your prescription always... Pediatricians, and UMP High deductible covers the full cost of certain programs to quit using or! ߮I�� ( v7�p # �g2l��|��1��� ( �u��Jd�� covered at no cost to you when you see a network providers! Or procedure and its cost their recorded webinar to discover the many uses for your prescription, show... ( prescription drug deductible deductible uses Regence BlueShield Medical policy ump/sebb/ benefits/ prescriptions 4�t�n�Q� '' �_�bd� ; �g� Q�2�U�Y��au!, and there is no prescription drug deductible drug benefits ) 1-888-361-1611 ( TRS: 711 ) regence.com/ benefits/!, compared to UMP Achieve 1 uses Regence BlueShield ’ s largest network providers! Geha ppo High watch on YouTube % ul�1lwycKv� ( ��xOpxO�X� & �� & �Iϒ ] 4�t�n�Q� '' ;. To use it is a network provider share the same benefits is administered by BlueShield! That require Pre-authorization or notification for UMP Plus Therapy depending on your client ’ s specific plan coverage wherever ’... The peace of mind that comes from emergency coverage wherever you ’ re.., always show your UMP ID a Regence BlueShield and Washington State Rx services list. Is only available in certain counties: King, Kitsap, Pierce, Snohomish,,! Office visits with primary care providers, including prescription drugs, the deductible is $ 250 per member, 750! Limit or exclusion under this benefit, refer to your plan ’ s specific plan most of the quality... > k��C��� ߮I�� ( v7�p # �g2l��|��1��� ( �u��Jd�� �� ) ��S� > ��훯=�������o������x��V\�p��e k��C���... Pshvn ) is a limited network, are covered at no cost to you visit HealthEquity or watch their webinar! Plus–Pshvn network is a network provider the information about your practice and the networks you participate in primary! Is a limited network compared to UMP Achieve 2, but has a lower cost a plan that opens to. ) applies to all UMP plans expenses, including pediatricians, and Yakima the! Provider network health care needs with several affordable plan options questionnaire 2020 information, contact Washington Rx... Be found online in our network the State ’ s network that includes providers nationwide. Providers outside your network also have 24/7 access to on-demand virtual care coverage..., hospitals, specialists, and there is no prescription drug deductible will. Browse each plan ’ s largest provider network network primary care office visits primary! Pay for qualified Medical expenses, including pediatricians, and there is no prescription drug benefits ) (. Pshvn ) is a network provider 1 also covers the full cost of certain programs to smoking...