The RPEC Council office is located at: 2020 Changes to Uniform Medical Plan (UMP) Prescription Drug Formulary. Live your best with a Regence health plan. Pharmacy benefits. 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. The formulary is a list of prescription generic, brand-name and specialty drugs that have been approved by the FDA. The member requests a formulary exception by contacting Washington State Rx Services (WSRxS) Customer Service at 888-361-1611. Health plans provided by Moda Health Plan, Inc. 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. 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. The information on … This document includes a list of the drugs (formulary) for our plan which is current as of . We consult with a team of doctors and pharmacists to develop the formulary. Alert: All specialty drugs require preauthorization. We found at least 10 Websites Listing below when search with regence uniform medical plan formulary on Search Engine. 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. 2020 Changes to UMP Prescription Drug Formulary. Download our mobile app to manage and order your medications on the go. 32463 0 obj
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Don't have a Washington State Rx Services account? �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. Regence BlueShield 1-800-693-6703 . Sign in to your Regence account at regence.com . The table below does not include every limit or exclusion under this benefit. • Eligibility complaints or appeals. 2021 Regence Valiance (PPO) H3817-010 By Regence BlueCross . We consult with a team of doctors and pharmacists to develop the formulary. ... Use Treatment Cost Estimator to learn more about a medical treatment or procedure and its cost. The f ormulary can help you and your doctor choose effective drugs that minimize your out-of-pocket expense. Your plan covers drugs listed on the Regence BlueShield Essential Formulary. 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. The lists of medications are included on our Commercial Pre-authorization List.. The Public Employees Benefit Board (PEBB) passed the following resolution at their April 24th meeting: 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 a value-based formulary and : Information provided to the board indicated that 20% of UMP users are retirees and 40% of the drug spend is retirees. When it refers to “plan” or “our plan,” it means Premera Blue Cross Medicare Advantage Plans. This website is operated by Horizon Blue Cross Blue Shield of New Jersey and is not New Jersey’s Health Insurance Marketplace. With a Regence Medigap plan you get: *These programs are not … If the request is not approved, please remember that you always have the option to purchase the medication at your own expense. In previous meetings, we were told that the premium cost to the consumer has trended upward due to the high cost of prescription drugs. * ... explain medical reason] ☐ Request for formulary tier exception [Specify below: (1) Formulary or preferred drugs contraindicated %PDF-1.4
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. could place the Member’s life, health, or ability to regain maximum function in serious jeopardy. *Kaiser Foundation Health Plan of the Northwest, with plans offered in Clark and Cowlitz counties in WA, and the Portland, OR, area. View your copayment information. By using providers within your network, your health care costs will be significantly lower than if you use providers outside your network. Regence BlueShield is a Health plan with a Medicare contract. UMP is administered by Regence BlueShield and Washington State Rx Services. Preauthorization requirements are only valid for the month published. Dental plans in Oregon provided by Delta Dental Plan of Oregon. The Uniform Medical Plan (UMP) Pre-authorization List includes services and supplies that require pre-authorization or notification for UMP members. Insurance pays the remaining percentage of the cost. © Copyright 2021 - Retired Public Employees Council of Washington. UMP is administered by Regence BlueShield and Washington State Rx Services. See our Council Office page for more information. Uniform Medical Plan (UMP) Classic or UMP CDHP, administered by Regence BlueShield ... • Whether your medications are in the plan’s formulary. Actual … 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. The Classic and CDHP plans share the same large network that includes providers both nationwide and worldwide. When you are requesting a formulary, tiering or utilization restriction exception you should submit a statement from your physician supporting your request. The Uniform Medical Plan (UMP) Pre-authorization List includes services and supplies that require pre-authorization or notification for UMP members. Find pharmacies near you. h�bbd``b`�� �ĵ ��@��HLHp� ��@�x�da`b���#���x�x���U Y��
About Uniform Medical Plan (UMP), administered by Regence BlueShield. This document includes a list of the drugs (formulary) for our plan which is current as of September 2, 2020. Search drug details. The information on this site is not intended to replace the diagnosis and treatment recommendations of your physician or other health care professionals. %%EOF
Regence health coverage opens doors to quality, local care paired with a national network powered by Blue®. If you pay for visits before you meet your medical deductible, those visits apply to the 16-visit limit. Plus, preventive care and assistance programs at no cost to you. ... 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. This document is available electronically and may be available in alternate formats. Our plan will generally cover the drugs listed in our formulary … 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. Regence BlueShield is an Independent Licensee of the Blue Cross and Blue Shield Association 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 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. Uniform Medical Plan: Regence BlueShield search: UMP Select: Uniform Medical Plan: Regence BlueShield search: Return to top. Dental plans in Alaska provided by Delta Dental of Alaska. For an updated formulary, please contact us. It’s the support you’ll only find with Regence family and individual health insurance. The formulary is a list of prescription generic, brand-name and specialty drugs that have been approved by the FDA. These criteria do not imply or guarantee approval. Title: 2020 UMP (PEBB and SEBB) PDL Temporary PDL Notice Author: nguyenm Created Date: You should contact us to ask us for an initial coverage decision for a formulary, tiering or utilization restriction exception. 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. health care providers, which represents the prescription therapies believed to be a necessary part of a quality treatment program. 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. The formulary is a list of prescription generic, brand name and … Department is not represent the uniform medical plan formulary or therapeutic equivalent. 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 this drug list (formulary) refers to “we,” “us”, or “our,” it means Premera Blue Cross. • Premium surcharge questions. Regence consults with a team of physicians and pharmacists to develop the formulary, which offers drug treatment choices for covered medical conditions. Check formulary status. Your plan covers drugs listed on the Essential Formulary. Please check with your plan to ensure coverage. See the 2020 Preferred Drug List. 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. 2020 Formulary (Li st of Covered Drug s) - regence.myprime.com. This is not the same User ID and password for your Postal Prescription Services (PPS) account. 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. Choosing a health plan is a big decision. 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. Moda Health Pharmacy Customer Service is also available to provide additional support. UMP Plus–Puget Sound High Value Network Online: UMP Plus–Puget Sound High Value Network for school employees Phone: 1-877-345-8760 Download our mobile app. A plan’s network consists of doctors, clinics, hospitals, specialists, and other health care providers. Head-to-toe coverage and low-cost virtual care.